Health Belief Model or Orem’s self-care Deficit Theory

How does critical theory differ from other nursing theories such as the health belief model or Orem’s self-care deficit theory?

1. A health care provider has charged more than a managed care organization (MCO) typically pays for a procedure. Which of the following would most likely be the result?
2. Provider may be removed from the MCO’s list of approved providers.
3. The MCO will re-examine the payment for that procedure.
4. Provider would get the typical payment instead of what was charged.
5. The MCO would be forced to increase its typical payment for that procedure.

2. A nurse is explaining case management to a client. Which of the following statements would be the most appropriate for the nurse to make?
3. “We assess, plan, facilitate, and advocate to save money as much as possible.”
4. “We coordinate your care so you obtain needed services without incurring undue costs.”
5. “We seek the lowest cost provider to give you what care is necessary.”
6. “We collaborate with you to coordinate your care for the best outcome.”

3. A hospital is going to start a care management program. Which of the following groups of clients would most likely be selected to first receive such services? Health Belief Model or Orem’s self-care Deficit Theory.
4. Clients who represent the most common diagnosis group to be admitted
5. Clients who request such services from their local hospital
6. Clients with chronic illnesses
7. Clients with the least education

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4. Who first created the idea of a continuum of care, which later evolved into the term “case management”?
5. Florence Nightingale, when she engaged in activities such as writing letters for the wounded.
6. Lillian Wald, who created health education programs for the whole community.
7. Social workers, who function as discharge planners, use the term.
8. Those who coordinated services for discharged psychiatric patients after World War II (WWII) used the term.

5. Which of the following best describes the aftermath of the deinstitutionalization of mentally ill patients into the community during the 1970s?
6. Community health centers were created and gave care to such clients.
7. Families were eager to accept their family members back home.
8. Many mentally ill clients without social skills ended up in nursing homes.
9. Without follow-up care, many clients were readmitted to care.

6. Which of the following elderly persons are often the targets of case management?
7. Those who are homebound and have multiple complex problems
8. Those who live alone without close relatives
9. Those who show clear evidence of mental and physical decline
10. Those with chronic long-term health problems needing pharmaceutical intervention. Health Belief Model or Orem’s self-care Deficit Theory.

7. Which of the following nurses fought to have American nursing controlled by nurses rather than physicians?
8. Clara Barton
9. Florence Nightingale
10. Lavinia Dock
11. Lillian Wald

8. Which of the following nurses used political expertise to influence the federal government to develop a Children’s Bureau?
9. Clara Barton
10. Florence Nightingale
11. Lavinia Dock
12. Lillian Wald

9. Which of the following best describes the most important factor in legislation?
10. The amount of financing and lobbying behind each choice
11. The beliefs, attitudes, and values of the policy
12. The preferences of the majority of American voters
13. The president’s ongoing encouragement for one particular choice

10. Which of the following is accomplished through the use of public policy?
11. Solutions to problems of public concern are developed.
12. A rational, logical problem-solving decision-making process is implemented.
13. Public safety nets for vulnerable populations are created.
14. Economic and business management principles are applied.

11. Which of the following best describes why it is so difficult to change the paradigm of health care from disease orientation to promoting health orientation?
12. The belief exists that those without insurance could obtain insurance if they worked hard enough.
13. People find it difficult to agree on what the ideal paradigm should be.
14. People realize the media have exaggerated the problems that result from lack of insurance.
15. Serious reallocation of resources would have to occur.

12. Which of the following best describes the principal factor behind ongoing legislation on the federal level related to health care?
13. Change is needed to reflect differences in health needs today.
14. Efforts must be put in place to control constantly increasing costs.
15. There is a need to focus on the population as a whole.
16. Technological breakthroughs should be expanded.

13. Which of the following best describes the most common organization for receiving personal health care in the United States today? Health Belief Model or Orem’s self-care Deficit Theory.
14. A group of physicians all in a particular specialty group who share an office
15. Community health center that includes educational and social services
16. Fee for service by a physician in practice by himself or herself
17. Managed care organization with capitated payments to providers, both professionals and organizations

14. Which of the following best describes how voluntary health agencies fit into the overall health care system?
15. They fill in the gaps between services offered by private and public health systems.
16. They primarily serve as sources of financial aid for the underserved.
17. They supplement the effort of the public health care system.
18. They support research, education, and services for particular groups of patients.

15. Which of the following levels of government primarily establishes regulations and provides funding for health care?
16. Federal government
17. Local health departments
18. Regional health districts
19. State health departments

16. Which of the following federal agencies is responsible for administering most of the federal health-related activities?
17. Centers for Disease Control and Prevention (CDC)
18. Department of Health and Human Services (DHHS)
19. Health Resources and Services Administration (HRSA)
20. National Institutes of Health (NIH)

17. Which of the following is the best definition of economics?
18. Assets that can be traded for different assets
19. Income and outgo of monies
20. Science of allocation of resources
21. Study of goods, services, talents, and transportation

18. A client living in the 1920s received health care services. Which of the following would have been the most likely form of payment?
19. Patients paid out of their pockets for whatever care the provider charged.
20. Public health employees gave care to those who needed it.
21. There was little health care to be had, regardless of a person’s wealth.
22. Workers who belonged to a union had their bills paid by insurance.

19. Which of the following statements best describes what happened to health care providers during the Great Depression?
20. The amount of charity care greatly increased.
21. Both hospitals and physicians went bankrupt.
22. Government funding was legislated to assist those in need.
23. Public health greatly expanded to care for those in need.

20. Why did employers decide to offer health insurance as an employee benefit?
21. Hospitals and physicians quit offering charity care to those who could not pay.
22. Society was focused on not having to pay for doctor visits and other needed health benefits.
23. Teachers were role models for unions to demand insurance as a benefit.
24. To obtain and retain the limited number of persons available to work when government rules prohibited raising wages, insurance was offered.

21. Which of the following statements best describes how the population of the United States is changing? Health Belief Model or Orem’s self-care Deficit Theory.
22. Growth will occur because of a decrease in the death rate.
23. Growth will occur because of ongoing immigration.
24. Growth will occur because of an increase in the birth rate.
25. Growth will occur because of lengthening of the normal life span.

22. Which of the following statements best defines Leininger’s term “culture universal”?
23. The preference to be cared for by someone from their own cultural group for maximum ease and comfort
24. The commonalities of values, norms, and life patterns that are held in all cultures
25. The particular values, beliefs, and patterning of behavior that is universal within a particular culture
26. The health care roles, norms, and behaviors that are involved when illness or injury occurs

23. A patient had wrapped a tummy band around her newborn’s abdomen. What should the nurse say to the new mother?
24. “Can you explain to me the purpose of wrapping a band around the baby’s tummy?”
25. “In the hospital, we prefer to expose the umbilical cord to air so it’s easier to put medication on it as it dries up.”
26. “Let me put some medication on the baby’s cord, and then I’ll put the tummy band back.”
27. “Please remove that band; it is not helpful as the umbilical cord needs to be kept clean and dry.”

24. A baby was dehydrated because of diarrhea. The mother explained that she had finally gone to a folk healer who told her to give the baby herbal tea, which did seem to be helping a bit, but the baby still seemed ill. Which of the following statements would be the most appropriate reply by the nurse?
25. “Folk healers cannot cure such problems; let me give you appropriate fluids for your baby.”
26. “Let’s go back to feeding the baby formula, and see how the baby does.”
27. “You continue to give the baby herbal tea, but let’s put some sugar and salt in the tea.”
28. “Your healer is correct; fluids are crucial for your baby. Let me give you some special fluids for you to give the baby.” Health Belief Model or Orem’s self-care Deficit Theory.

25. A nurse carefully explained that the medication had to be taken three times a day, with each meal. The patient came to the clinic with symptoms of medication overdose. How should the nurse respond?
26. “Can you explain what you believe happened to make you so ill now?”
27. “Can you tell me when in the day you and your family eat?”
28. “Please review with me when I taught you to take your medication.”
29. “Why did you take more medication than we suggested?”

26. Which of the following statements best describes the relationship between the environment and health?
27. Because of the large number of variables involved, the relationship between environment and health cannot be researched.
28. Because the environment has such long-term effects on health, research findings are not yet available.
29. Research shows that a healthy environment has limited impact on one’s health.
30. Research shows that a healthy environment increases quality of life and years of healthy living.

27. When using an environmental perspective, which of the following would be the most important question for a nurse to ask when assessing potential health problems?
28. “Can you tell me how you have been feeling?”
29. “Can you tell me what you do at work?”
30. “What brings you here today?”
31. “What problems have you been having?”

28. How does critical theory differ from other nursing theories such as the health belief model or Orem’s self-care deficit theory?
29. Critical theory can be used by professionals other than nurses.
30. Critical theory focuses on oppression and facilitates group action.
31. Critical theory is not directly related to health promotion.
32. Critical theory confronts changing an individual’s beliefs.

29. Which of the following statements best describe why environmental health is more challenging than other variables related to an individual’s health? Health Belief Model or Orem’s self-care Deficit Theory.
30. Environmental health affects susceptible individuals more than groups.
31. Environmental health demands that individuals be willing to change their beliefs.
32. Environmental health is dependent on social neighborhoods, as well as geography.
33. Environmental health requires social, economic, and political changes to improve.

30. Which of the following nursing actions would be the most helpful to the community’s long-term health?
31. Careful assessment, diagnosis, planning, and giving care to individual patients and their families
32. Dialogue with community members concerning what health issues are of importance in that community
33. Focusing on family health through school-based neighborhood clinics
34. Helping the community create political change through organization, use of media, legislative lobbying, and mass demonstrations

31. Which of the following best describes why a nurse working in a U.S. urban area should be knowledgeable about infectious diseases common to areas of Africa?
32. Nurses have an ethical commitment to care for others throughout the world.
33. Every infectious disease is just one airplane ride away.
34. Infection could occur if a nurse goes out in public.
35. Nurses meet people who may originally have been born elsewhere.

32. Which of the following is one of the biggest threats faced by developing countries that are trying to grow economically and make a better life for their citizens?
33. Lack of education and knowledge
34. Political unrest
35. Environmental hazards
36. Large population

33. Which of the following groups makes up about 30% of the world’s population?
34. Children
35. Elderly
36. Teenaged adolescents
37. Caucasians

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34. Which of the following has been a common result in countries with a severe HIV/AIDS epidemic?
35. Birth rate is high, but life expectancy is only 35 to 40 years.
36. Free clinics have begun distributing condoms to stop the spread.
37. International aid has begun to lower the infection rates.
38. Missionaries are establishing orphanages within their churches.
39. Which of the following best explains why many people decide to move to large urban areas?
40. To be eligible for social aid
41. To be with friends
42. To join family who are already there
43. To seek employment

36. Which of the following groups of children is at the highest risk to have poor health?
37. African American children living in a suburb
38. Asian children living in an outer urban area
39. Hispanic children living in the inner city
40. White children living in a rural area

37. What proportion of U.S. citizens are children?
38. 12%
39. 16%
40. 20%
41. 24%

38. Which of the following actions should be taken by a typical community preparing for the expected demographic changes in the United States? Health Belief Model or Orem’s self-care Deficit Theory.
39. Build more elementary schools
40. Build more high schools
41. Build more colleges
42. Build more adult condominiums

39. If most students have no intention of ever leaving their local community, which of the following languages should be chosen as the required foreign language in high school?
40. French, as it is a very romantic language
41. German, because many of the students’ names are German
42. Latin, as it is the basis for many other languages
43. Spanish, to improve employment opportunities

40. Which of the following best describes why infant mortality rate is used as an international comparison of a country’s health status?
41. Every country, regardless of other priorities, focuses on care of infants and their mothers.
42. It is easy to obtain and compare such data.
43. It reflects medical care quality and access and public health practice.
44. The World Health Organization requires these data be reported to them each year. Health Belief Model or Orem’s self-care Deficit Theory.