Chapter 5: Global Health Nursing School Test Banks

Chapter 5: Global Health
Test Bank

MULTIPLE CHOICE

1. A public health nurse is concerned about a recent influenza outbreak in Germany. Why would the nurse be interested in a health issue occurring outside of the United States?
a. Highly infectious diseases can circle the world quickly through worldwide travel.
b. Other nations rely on the United States for guidance to address health issues.
c. According to the World Health Organization (WHO) guidelines, nurses should assist in disease control efforts.
d. Nurses have a moral obligation to keep the public safe and healthy.
ANS: A
Although there are certainly ethical and moral commitments to help fellow humans, the practical reason is that it is almost impossible to isolate a contagious disease within the country of origin, since more than 2 million people cross national boundaries daily.

DIF: Cognitive Level: Application REF: p. 114

2. Which factor is primarily responsible for the differences in health care needs and health care outcomes among the various countries?
a. Economic development
b. Political system
c. Social-cultural system
d. Religious affiliation
ANS: A
Health is dramatically affected by poverty, which is an outcome of economic development.

DIF: Cognitive Level: Comprehension REF: p. 114

3. A public health nurse is discussing actions that countries must take in order to reduce poverty successfully. Which of the following actions is the nurse likely to suggest?
a. Adopt a democratic government for their people.
b. Create a national health care plan.
c. Give preference to women and infants.
d. Provide predictable and sustained funding.
ANS: D
The health of the population in developing countries is dramatically affected by poverty. After the United Nations Millennium Summit in 2000, the governments of the 22 wealthiest donor nations agreed to commit 0.7% of their gross domestic product by the year 2015 toward accomplishment of the Millennium Development Goals. This funding is necessary in order to decrease the rates of poverty worldwide.

DIF: Cognitive Level: Application REF: p. 115

4. What was the primary commitment agreed upon when the United Nations Millennium Declaration was adopted?
a. Adoption of specific environmental actions
b. Elimination of poverty
c. Enforcement of maternal and infant health standards
d. Provision of safe water and sanitation
ANS: B
The global representatives committed themselves to giving a very high priority to the commitment of funding toward reducing the rates of worldwide poverty by 2015.

DIF: Cognitive Level: Knowledge REF: p. 115

5. Which of the following efforts is being led by the World Health Organization (WHO)?
a. Establishing standards for medications and vaccines
b. Providing food for all the worlds residents
c. Eliminating polio as an infectious disease
d. Ensuring safe water for all the citizens of the world
ANS: A
WHO is leading the effort to establish international standards for medications and vaccines. It was founded to be the worlds health advocate and provides technical support and health care services to member nations, with an emphasis on poorer nations.

DIF: Cognitive Level: Comprehension REF: p. 115

6. A community/public health nurse has recently accepted a position with the United Nations International Childrens Fund (UNICEF). What will be the primary focus of the nurse working for this organization?
a. Building and staffing hospitals in undeveloped countries
b. Providing health education for mothers of children
c. Establishing clinics for surgical interventions for handicapped persons
d. Helping with economic development in undeveloped countries
ANS: B
The efforts of UNICEF are concentrated in the area of maternal and child health. More recent efforts have been geared toward ensuring availability of fresh water and safe food supplies, providing health education for mothers of children, education for girls, and immunization programs aimed at reducing or eliminating vaccine-susceptible communicable diseases.

DIF: Cognitive Level: Application REF: p. 116

7. A developing country has been in contact with the World Bank. What is this country accomplishing by connecting with this intergovernmental organization?
a. Ensuring that the economy is based on the U.S. dollar
b. Supporting specific projects, especially to establish new businesses
c. Requesting a loan to improve the infrastructure
d. Helping to establish a national banking system
ANS: C
The World Bank funds government projects to improve a countrys infrastructure through low-interest loans to developing countries for improvements in education, health, agriculture, and natural resource management.

DIF: Cognitive Level: Application REF: p. 116

8. Which of the following statements represents an example of the epidemiologic transition?
a. As economics improve, the life expectancy increases.
b. As education improves, the number of physicians and nurses increases.
c. As global funding increases, the incidence of communicable disease decreases.
d. As preventable diseases increase, the global infection rate decreases.
ANS: A
The poorer the country, the more likely its citizens are to suffer from preventable diseases and early death. The epidemiologic transition refers to a change in illness pattern. Currently, a shift is being seen again as chronic diseases are replacing deaths from infectious disease worldwide.

DIF: Cognitive Level: Application REF: p. 117

9. Which of the following is the leading contributor to illness and death in developing countries?
a. Inadequate sources of food
b. Unsafe water
c. Limited availability of immunizations and antibiotics
d. Lack of sanitary sewer systems
ANS: B
Nearly 1 billion people (14% of the world population) do not have safe water supplies. Many diseases could be prevented if water supplies, sanitation, and hygiene were improved.

DIF: Cognitive Level: Knowledge REF: p. 117

10. A public health nurse is investigating the health of children worldwide. Which of the following sources of data should be used to determine which country has the healthiest children?
a. Percentage of mothers who breast-feed their infants
b. Rate of immunization
c. Rate of malnutrition
d. Percentages of generalist versus specialist physicians
ANS: C
Undernutrition is a contributing cause to about one third of deaths in children worldwide. Stunting of growth results from long periods of malnutrition. Damage from malnutrition during fetal development and the first 2 years of life may be irreversible.

DIF: Cognitive Level: Application REF: p. 118

11. Which of the following actions demonstrate where most of the international efforts have focused in relation to the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic?
a. Caring for people who are stigmatized and not wanted by anyone
b. Providing education about the cause and spread of the virus
c. Funding voluntary counseling and testing programs
d. Saving children who will be orphans with no one to care for them
ANS: B
International efforts have concentrated on primary prevention. A few examples of these efforts are education about the cause and spread of the virus and advocacy of the use of condoms and other protective measures during sexual activity; improvement in the procurement, storage, and administration of blood; and advocacy efforts aimed at women and men who are at risk because they have multiple sexual partners. Voluntary counseling and testing programs would be an example of secondary prevention. Caring for people and saving children are examples of tertiary prevention.

DIF: Cognitive Level: Application REF: p. 119

12. Which of the following characterizations best describes the approach to paying for health care used in the United States?
a. Decentralized, free market approach that does not provide care to all citizens
b. Central government control of all aspects of health care, which is consistent with socialist philosophy
c. Health care that is planned and paid for and in which independent practitioners are employed
d. Federal government as the entity that negotiates and funds care for persons who cannot afford it
ANS: A
The U.S. health care system is based on the free market approach, capitalism, and an entrepreneurial model. All other industrialized countries have some form of national health care system that provides coverage to all, or nearly all, citizens.

DIF: Cognitive Level: Comprehension REF: p. 119

13. Which of the following descriptions is the best example of how the Bismarck model is implemented?
a. Multiple insurance providers develop options for health care delivery to the population.
b. A centralized government department controls all of health care that is provided in the country.
c. A government system plans and pays for health care delivered by private enterprise.
d. The government plans and funds care provided by its employees in government-owned health facilities.
ANS: C
In the Bismarck model, funding is by insurance or subsidized by the government, and the patient has a choice of private providers. Organizing and delivering care are shared by government and private enterprise.

DIF: Cognitive Level: Application REF: p. 120

14. Which of the following descriptions is the best example of how the Beveridge model is implemented?
a. A government system plans and pays for health care delivered by private enterprise.
b. Multiple insurance providers develop options for health care delivery to the population.
c. A government system plans and pays for health care delivered by private enterprise.
d. The government plans and funds care provided by its employees in government-owned health facilities.
ANS: D
In the Beveridge model, in contrast to the Bismarck model, national government controls health care with national planning, organizing, financing, and delivering care to all. Most health care providers are government employees, and services are provided in government-operated health centers.

DIF: Cognitive Level: Application REF: p. 121

15. A community/public health nurse is preparing a presentation for a local community group about the infant mortality rate in the United States. Which of the following information would be included in the presentation?
a. The number of women who are uninsured is higher in the United States than in other developed countries.
b. There is a lack of comprehensive planning for prenatal care in the United States.
c. The United States has one of the lowest infant mortality rates in the world.
d. Additional health care services are provided to pregnant women in the United States.
ANS: B
The United States does not have comprehensive planning for prenatal care; in contrast, other countries with national health care systems do have such planning. This is a significant contributor to the infant mortality results. In 2010, the United States was ranked forty-third in infant mortality rates.

DIF: Cognitive Level: Comprehension REF: pp. 124-125

16. According to the World Health Organization (WHO), which countries have the best health care in the world?
a. Australia, Great Britain, and New Zealand
b. France, Japan, and Great Britain
c. Spain, Italy, and Germany
d. United States and Canada
ANS: B
Using the WHOs five criteria, France has the best health care among developed countries, and the health care systems of Japan, Great Britain, and Germany are rated higher than that of the United States.

DIF: Cognitive Level: Knowledge REF: p. 125

17. Which of the following is the leading cause of premature death in industrialized countries?
a. Alcohol-related illnesses
b. Automobile accidents
c. Tobacco-related illnesses
d. Malnutrition
ANS: C
Tobacco-related illnesses are the leading cause of premature death in industrialized countries. Tobacco use accounts for 63% of deaths in the current, global, noncommunicable disease epidemic.

DIF: Cognitive Level: Knowledge REF: p. 125

18. A community/public health nurse actively implements the recommendations from the Global Treaty on Tobacco Control. On the basis of this treaty, which of the following actions is the nurse most likely to perform?
a. Encouraging states to implement smoking bans
b. Supporting a global ban on tobacco advertisements to youth
c. Lobbying to make the production of tobacco products illegal
d. Suggesting an increase in cigarette taxes across the world
ANS: B
The Global Treaty on Tobacco Control was passed at the 2003 meeting of the World Assembly. This treaty endorses a global ban on tobacco advertisement and promotion to children younger than 18 years and suggests limits to exposure to second-hand smoke. The Treaty also ends subsidies for tobacco production but does not include making its production illegal. In addition, the Treaty prohibits tax-free, duty-free sales of tobacco products but does not suggest an increase to cigarette taxes.

DIF: Cognitive Level: Analysis REF: p. 126

19. A community/public health nurse is investigating the current health threats that are occurring at the global level. Which of the following concerns is the nurse likely to discover?
a. Shortage of health care professionals
b. New infectious diseases
c. More potent drugs
d. Terrorism
ANS: D
Health problems associated with war, civil insurrection, and terrorism appear to be escalating, and no country is immune.

DIF: Cognitive Level: Application REF: p. 126

20. A community/public health nurse would like to join an international professional nursing organization that supports nursing leadership and research. Which of the following organizations would best meet this criterion?
a. International Council of Nurses (ICN)
b. Sigma Theta Tau
c. The International Nursing Federation (INF)
d. World Health Organizations Nursing Council (WHONC)
ANS: B
Both Sigma Theta Tau, the international nursing honor society, and the International Council of Nurses (ICN) are global organizations. However, Sigma Theta Tau is the international honor society of nursing. This organization is dedicated to supporting nursing leadership, research, and clinical excellence.

DIF: Cognitive Level: Application REF: p. 127

MULTIPLE RESPONSE

1. Which of the following were among the specific goals of the United Nations Millennium Declaration? (Select all that apply.)
a. Achieving universal primary education
b. Achieving agriculture efficiency and effectiveness
c. Ensuring democracy in all governments
d. Eradicating extreme poverty and hunger
e. Establishing a global partnership for development
f. Promoting gender equality and female empowerment
ANS: A, D, E, F
The primary goal is elimination of worldwide poverty. Among the eight steps were to eradicate extreme poverty and hunger, to achieve universal primary education, to promote gender equality and empower women, to reduce child mortality, to improve maternal health, and to establish a global partnership for development.

DIF: Cognitive Level: Knowledge REF: p. 128

2. What were some of the Top 10 Best Buys of health interventions? (Select all that apply.)
a. Encouraging condom use and treating sexually transmitted diseases (STDs)
b. Enforcing traffic regulations and installing speed bumps
c. Giving nutrients to children and pregnant women
d. Imposing taxes on tobacco products
e. Providing insecticide-treated bed nets in malaria-endemic areas
f. Distributing prescription drugs for free to low-income persons
ANS: A, B, C, D, E
If money, time, and effort are invested, the actions suggested included monitoring childrens health and vaccinating against major childhood killers, imposing taxes on tobacco products to increase their cost, mounting a coordinated attack on the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic by promoting 100% condom use in at-risk populations and providing antiretroviral treatment, providing children and pregnant women with essential nutrients, providing insecticide-treated bed nets in malaria-endemic areas, and enforcing traffic regulations and installing speed bumps at dangerous intersections to reduce traffic-related injuries.

DIF: Cognitive Level: Knowledge REF: pp. 129-130

3. Why is tuberculosis a serious health problem? (Select all that apply.)
a. The largest numbers of new cases are occurring in the South-East Asia Region of the World Health Organization.
b. Receiving treatment for tuberculosis is a social stigma.
c. People are often co-infected with tuberculosis and human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS).
d. Many cases of tuberculosis are occurring in industrialized countries.
e. The disease is endemic in Africa.
f. The standard treatment for the disease is a short course of directly observed therapy (DOTS).
ANS: A, C, F
Tuberculosis is the second leading infectious disease killer of adults worldwide, with the largest numbers of new cases occurring in the South-East Asia Region of the World Health Organization (WHO). People are often co-infected with tuberculosis and HIV/AIDS; tuberculosis case rates and deaths have increased since 1995 in African countries with the highest rates of HIV infection. Drug-resistant strains have complicated the treatment regimen for tuberculosis, and so the standard treatment has become DOTS. No social stigma is associated with this treatment plan. Many cases are occurring in developing countries, not industrialized countries (such as the United States).

DIF: Cognitive Level: Comprehension REF: p. 130

4. A community/public health nurse is working with a client who has just immigrated to the United States from Canada. The client states that the Canadian health care system has many problems. Which of the following statements would the client likely have made? (Select all that apply.)
a. Canada does not have enough physicians.
b. Canada uses socialized medicine to provide health care services.
c. Health care costs are increasing in Canada.
d. Physicians working in Canada earn less money than in the United States.
e. The quality of health care is poor in Canada.
f. There are long waits to see a primary care physician in Canada.
ANS: C, D
The Canadian health care system is based on social insurance, not socialized medicine. Physicians have private practices. There are an adequate number of physicians. There is no wait for a primary care physician, although there may be for specialists. Physicians in Canada are paid less than physicians in the United States. The quality of health care in Canada is better than that in the United States, with a lower infant death rate and a longer life span. The costs of health care are escalating throughout the world.

DIF: Cognitive Level: Application REF: p. 130

5. Which of the following is an example of an emerging disease? (Select all that apply.)
a. Human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS)
b. H1N1 influenza
c. Tuberculosis
d. Severe acute respiratory syndrome (SARS)
e. Avian influenza
f. Malaria
ANS: B, D, E
Emerging infectious diseases are either old diseases that are rapidly increasing in incidence or geographic range or new, previously unknown conditions. SARS, H1N1 influenza, and avian influenza are all examples of emerging infectious diseases that have important implications for global politics, health systems, and international migration and travel.

DIF: Cognitive Level: Application REF: p. 131

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