Deck 10: High-Risk Gaps and Cracks I: Social Determinants of Health, Health Disparities, and Mental Health

Question 1

Social determinants of health have the most impact on patient outcomes and patient healthcare experiences. Which manifestation is recognized as a social determinant?

A) Crowded living conditions
B) Injection drug use
C) Low income
D) Discrimination

Answer 1

D
Explanation: Low income, is a social environment determinant that affects the ability to pay for care, medications and food? Crowded living conditions is an example of a physical environment determinant. Injection drug use, along with alcohol, unprotected sex, and smoking, is considered an individual behavior determinant. Gender identity is considered to be a determinant related to biology and genetics although it can be a cause of discrimination and less ideal healthcare.

Question 2

Social and financial barriers create a lack of access to healthcare services, which results in the lack of connected care of any kind. Which source is recognized as the best to alleviate the effects of social determinants?

A) Social services agencies
B) Healthcare professionals
C) National policy changes
D) Healthcare insurance

Answer 2

A
Explanation: Social services agencies are the best sources to help patients with social determinants of health because of the ability to address the causes of the determinants. Many healthcare facilities and health professionals are more narrowly focused on procedures and processes that treat and cure patients. National policy changes have two major barriers: the lack of political will to solve these problems and a lack of funding. Healthcare insurance alone is not a resource to help patients with social determinants for healthcare.

Question 3

Which type of services aimed at alleviating social determinants is covered by Medicare Part A?

A) Social services
B) Patient advocates
C) Medical practices
D) Nurse care coordinators

Answer 3

A
Explanation: Since social work is a covered service under Medicare Part A, both skilled nursing facilities and home health agencies employ social workers who assist patients with transportation, insurance, benefits and entitlements, and psychosocial and family issues. In primary care and specialty medical practices, there have typically been few professionals whose work is dedicated to the social determinants of health. As medical practices hire patient advocates and embedded nurse care coordinators, this is starting to change.

Question 4

In which way does nursing lead in the process of translating the social determinants of health awareness into action?

A) Recommending internships for graduate nurses focused on social determinants
B) Collaborating with social and community agencies to address social determinants
C) Developing independent public nursing practices to address social determinants
D) Requiring advanced practice nurses to serve one year alleviating social determinants

Question 5

For patients and families who are coping with mental health problems, the disconnect between mental health and medical care in the United States is a yawning chasm. Which medical condition appears to be closing the medical-mental health gap?

A) The current epidemic of opioid drug abuse
B) Incidences of mental health and gun violence
C) The rapidly increasing availability of street drugs
D) Increases of mental health patients in emergency care

Question 6

Which statement best describes the connection between mental health issues and chronic health conditions?

A) Mental health issues often lead to chronic disease conditions related to lifestyle choices.
B) Chronic disease is frequently the cause of mental health conditions such as depression.
C) Patients with mental health issues die more quickly than those with chronic disease alone.
D) Unexpected incidences of accidents and death are higher in patients with chronic disease.
E)All of the above

Question 7

Mental health issues are frequently identified in either primary care or emergency room settings, yet there is no agreement about which type of medical professional should treat these patients. Which statement about the management of mental health patients is most accurate?

A) The current model, which consists of medical practitioners referring patients to mental health clinicians, works well.
B) Primary care clinicians are too overwhelmed with the complexity of medical patients to treat mental health patients.
C) Because of the severity of mental illness, mental health patients willingly accept care from mental health clinicians.
D) Shortages of mental health practitioners prevent many referred mental health patients from ever receiving care.

Question 8

Nurses can counteract negative attitudes and discrimination about behavioral health conditions by approaching mental health and substance use problems with different specialized and specific care standards than those applied to chronic diseases.

Question 9

In regards to the care of complex, high-need patients, ineffective and inefficient care has less to do with the patients than with the system that is delivering care to them.

Question 10

A commonsense best practice for supporting patients with mental health conditions who are being treated in medical settings is to deny that attitudes and stigma exist about mental health issues.