Deck 10: Diversity and Disparities in Health Care

Question 1

According to the Sullivan Commission report of 2004 what is a major contributor to the healthcare delivery disparity problem?

A) The disparity in the healthcare workforce.
B) Minority underrepresentation on governmental task forces to improve services.
C) Unwillingness of minority populations to take responsibility for their own health needs.
D) The increasing minority population will soon outnumber the traditional majority population numbers.

Answer 1

The disparity in the healthcare workforce.

Question 2

The nurse is in a position to provide input into the creation of a healing organization. This nurse should advocate for which position?

A) Clear, honest, and open apologies from administration regarding prior barriers to staff job satisfaction.
B) Patient care environments that allow staff to complete their tasks efficiently.
C) Systems of admission and care that provide easy access to services, attention, and staff.
D) Patient care and staff work areas that are free from microbes, including those that might be brought in by visitors.

Answer 2

Systems of admission and care that provide easy access to services, attention, and staff.

Question 3

The healthcare agency is using regular staff meetings to improve its organizational culture and healing environment. What should the nurse leading these meetings encourage?

A) Open discussion, with no feedback
B) An agenda strictly focused on patient care issues
C) Relevant questions, asked respectfully
D) Unanimous staff agreement with agency policies and practices

Answer 3

Relevant questions, asked respectfully

Question 4

A health agency with a consonant culture will demonstrate which signs or symbols of its culture? Select all that apply.

A) Each care unit has its own dress code, which is displayed prominently on its bulletin board.
B) Administrative offices are located in a separate building.
C) Employee articles about satisfying patient care experiences are included in the agency's newsletter.
D) Separate snack areas are established on each unit, replacing the central cafeteria.
E) There is agency wide staff participation in the annual summer picnic.

Question 5

Nurses in a hospital are asked to provide input on decisions regarding architectural changes for their units. Based on research on private versus shared rooms, the nurses should opt for which design?

A) Wards of four patients in order to facilitate speed of care delivery.
B) Double rooms, which the patient prefers due to decreased expense.
C) Double rooms, which make the patient feel more secure.
D) Private rooms, to decrease nosocomial infection rates.

Question 6

The nurse manager identifies that many of the unit staff belong to Generation Y. How can the manager most effectively motivate this group of employees?

A) Speak about goals in a general fashion, but use a serious tone in expression of the goals.
B) Emphasize long-term benefits of continued employment with this agency.
C) Demonstrate that all work systems are firmly in place and well-established.
D) Foster an atmosphere open to technology and intelligent creativity.

Question 7

Which situation must be avoided in order for the organization to be compliant with the American Disabilities Act?

A) Failure to meet any request of need of a disabled employee.
B) Asking questions about the severity of the disability during the hiring process.
C) A focus, during the hiring process, on whether the job candidate can perform essential job functions.
D) A specific definition of the functions of the position, including amount of time allowed for each function.

Question 8

The NAM or IOM recommends that education about diversities focus on which areas?

A) Language, ethnic group, and staff diversity
B) Attitudes, behavior, and family history
C) Attitudes, knowledge, and skills
D) Language, cultural rituals, and cultural dissonance

Question 9

What type of barrier is not considered to be a major barrier to quality healthcare associated with health literacy?

A) Access to care
B) Location in the U.S.
C) Illness management
D) General information processing

Question 10

The health facility serves a large minority population with its own particular language. How would this population best be included in the agency's culture?

A) Use family members as interpreters.
B) Computer programs with common phrases available to patients and staff.
C) A list of interpreters available for calling in when needed.
D) Staff representative of the minority and other staff with bilingual skills.

Question 11

What demographics are projected for the U.S. by 2043? Select all that apply.

A) No group will make up the majority.
B) African-Americans will be largest group.
C) Non-Hispanic white population will be the largest single group.
D) Decrease of the total minority population
E) Majority-majority population

Question 12

A new nursing leader assesses that there is a low level of trust in the organization. Which staff report would indicate that this is beginning to be corrected?

A) Staff members feel safe to approach the leader and be heard.
B) Systems are in place for staff to have input in decisions.
C) They are expected to communicate clearly with each other.
D) They can expect to receive written notices of praise for work well done.

Question 13

Which interventions help to meet the Institute of Medicine's recommendations to decrease disparities in healthcare? Select all that apply.

A) The nurse manager hires a nurse who speaks English and the language of the primary minority served by the facility.
B) The nursing department develops standard nursing care plans for ethnically diverse patients and files them according to ethnicity.
C) The nurse allows the patient's nontraditional care provider open visitation at the patient's request.
D) The nurse helps the patient select foods from the standard hospital menu.
E) The nurse contacts building maintenance to bring five additional chairs to the waiting room to accommodate the patient's large extended family.

Question 14

A nursing agency's managers are planning to make the organization more flexible and internally focused. What should be included in these managers' strategies?

A) A halt to any changes in policy and procedure
B) Increased involvement of management in all aspects of clinical decision-making
C) Involving all staff in knowledge of and full participation in financial and market values of the organization
D) Rewarding innovation and involvement of staff in change

Question 15

Which patients are at risk for difficulty associated with lack of healthcare literacy? Select all that apply.

A) A patient who speaks English as a second language.
B) A patient who is illiterate.
C) A patient who has complicated prescriptions regimens.
D) A patient who is under stress.
E) A patient who is seen by a number of specialists during hospitalization.

Question 16

The healthcare organization has a long history of a dissonant culture. How can nurse leaders in the facility promote change to a healing culture? Select all that apply.

A) Hire staff with strong clinical skills and then provide education on values consistent with those of a healing culture.
B) Hire staff with similar cultural backgrounds to reduce differences.
C) Foster retention of administrators and staff with diverse backgrounds but with similar, consistent thinking habits and ideas.
D) Assessing the mission statement of the organization for its stated values.
E) Appraise whether stated values are cherished and demonstrated.

Question 17

What goals of HHS Disparities Action Plan focus on? Select all that apply.

A) Strengthen the health and human services infrastructure and workforce
B) Increase efficiency, transparency, and accountability in HHS programs
C) Transfer HHS programs to the states
D) Advance scientific knowledge and innovation
E) Increase emergency preparedness

Question 18

The Governing Board of the hospital has completed an assessment of the organization's culture. Which findings would lead the Board to determine that the culture is healthy? Select all that apply.

A) There is wide variation in the expectations of individual employees and departments.
B) The decisions made about care are staff-centered.
C) There is evidence that the values of the organization and the health professionals working there are similar.
D) The organization is designed to serve its health professionals.
E) New people who come into the organization learn about the culture by connecting behaviors and consequences.

Question 19

Which findings would indicate to the nurse executive that a dissonant culture exists in the healthcare agency? Select all that apply.

A) Nurses frequently voice complaints to the administration about healthcare deficiencies when they emerge.
B) The facility has a high turnover rate among its registered nursing staff.
C) The organization focuses more on patient issues than on financial viability.
D) There is a means for providing care for those patients who lack health insurance coverage.
E) The education budget for the division of nursing has been cut by half.

Question 20

Which example would not apply to Schein's view of organizational culture?

A) Organization vision statement
B) Unwritten rules about communication
C) HCO logo
D) Salaries paid to all staff

Question 21

During the latest employee survey it was established that the staff find the hospital "dirty" and "non-conducive to health and healing." Which strategy can help with the staff's perception of the organization?

A) Recognize the findings and determine a method to change.
B) Acknowledge the findings and ask the staff members what role they play in the appearance of the hospital.
C) Contact the Director of Environment Services and expect a plan to address the findings.
D) Study the financial statements and determine which areas can be closed to divert revenue to newer parts of the hospital.

Question 22

The results of a patient discharge questionnaire reveal that the hospital is not easy to navigate and is not physically comfortable for visitors. What should be done to address these findings?

A) Appoint a committee to review the questionnaire.
B) Contact a local furniture company to change the chairs in the waiting room.
C) Create a multidisciplinary committee to analyze the navigation of the hospital, looking for comfort characteristics.
D) Nothing. Since these patients are no longer in the hospital, the information is not helpful.

Question 23

Why is it that most nursing positions are held by those classified as "baby boomers?"

A) The era when then people came of age was a time of great advancement in healthcare and many people wanted to become a part of that movement.
B) Most nurses are women and when baby boomers were coming of age, the two professions most accepting of women were nursing and teaching.
C) This group is hard working and loyal, which are attributes that are often found in nurses.
D) This generation is focused on material gain and nursing provides a good salary structure.

Question 24

Which actions support the organization's goal to increase transparency? Select all that apply.

A) The organization publicizes safety reports on the hospital website.
B) The hospital participated in a widely published study on the use of a new type of equipment.
C) Patient satisfaction reports are displayed on bulletin boards throughout the facility.
D) The hospital maintains all error reports as confidential.
E) Hospital policy and procedures are publically available.

Question 25

An anonymous note left in the hospital's suggestion box read, "There are many errors made with patient care, but the nurses are afraid to tell anyone." What can the hospital leadership do with this information?

A) Nothing, since it was anonymous.
B) Take the information seriously and begin a focus group to analyze reasons why the staff do not report errors.
C) Call the nurse managers together and tell them to find out which one of the staff nurses wrote the note.
D) Write an open letter to the staff reinforcing the disciplinary processes for anyone who violates patient care procedures.