A)
Rationale: Social determinants of health are defined as the circumstances in which people are born, grow up, live, work, and age, and the systems put in place to deal with illness. These circumstances are shaped by economics, social policies, and politics. Social systems have an impact on a community, and consequently the health of that community. Culture contributes to the overall character of a community and, in turn, influences its health needs. A community is defined by boundaries that often determine what services are available to individuals.
D
Rationale: The leading causes of death in 5- to 9-year-olds are unintentional injuries, cancer, and congenital anomalies. For infants less than 1 year of age, the leading causes of death are congenital anomalies, disorders related to premature birth, and SIDS. In the 1- to 4-year-old group, the leading causes of death are unintentional injuries, congenital anomalies, and homicide. In the 10- to 14-year-old group, the leading causes of death are unintentional injuries, cancer, and homicide. In the 15- to 24-year-old group the leading causes of death are unintentional injuries, homicide, and suicide.
C
Rationale: Public health interventions are population-based if they consider all levels of practice, including the community, the systems, and the individuals or families in that system who are known to be at risk. Community-focused interventions change community norms, attitudes, awareness, practices, and behaviors. Systems-focused interventions change organizations, policies, laws, and power structures. Individual-focused interventions change knowledge, attitudes, beliefs, practices, and behaviors of individuals.
B
Rationale: In the hospital and community setting, assessment is a dynamic, ongoing method that uses observations and interactions to collect information, recognize changes, analyze needs, and plan care. In the community, the nurse uses assessment to provide a baseline to evaluate the physiologic, psychological, and functional capacity of the client and identify environmental factors that may affect the client's health status. In the hospital setting, assessment is used to provide ongoing monitoring of acute conditions and plan appropriate interventions, as well as to ensure continuity of discharge planning. Physicians primarily use assessment to determine pathology and appropriate therapeutic interventions.
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b. community-based care.
Community-oriented nurses emphasize health protection, maintenance, and promotion and disease prevention, as well as self-reliance among clients. Regardless of whether the client is a person, a family, or a group, the goal is to promote health through education about prevailing health problems, proper nutrition, beneficial forms of exercise, and environmental factors such as safe food, water, air, and buildings. Community-based care is nursing care that is provided in a setting. A smoking cessation clinic is an example of primary prevention, not secondary or tertiary.
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