Global and Population Health (D224)

Correct Answer:

C. Advocates for patient, arranges outpatient dietician services at home

Explanation:

The nurse's role in addressing malnutrition in patients with chronic gastrointestinal issues involves advocating for the patient's needs and ensuring they have access to appropriate care. Arranging outpatient dietician services is a proactive approach to help the patient manage their nutrition and address concerns about malnutrition. This ensures the patient receives professional guidance on improving their diet and nutritional intake, which is vital for their overall health.

Why other options are wrong:

A. Refers the patient to another facility. This is incorrect. While referrals to specialists may be necessary, simply referring the patient without addressing the immediate concerns or arranging relevant services would not fully address the patient’s nutritional needs.

B. Ignores the patient's concerns. This is incorrect. Ignoring a patient's concerns, particularly about malnutrition, would be an inappropriate response and could negatively impact the patient’s care and well-being.

D. Provides medication without collaboration. This is incorrect. While medications may be part of the treatment plan, providing them without collaboration with a dietitian or other healthcare professionals could overlook the critical role of nutrition in managing the patient’s condition.

Correct Answer:

A. Provision of health services, financing, and stewardship

Explanation:

According to the World Health Report, health systems have key functions that include the provision of health services, ensuring proper financing, and the stewardship of health systems and policies. These components are critical to ensuring that the health system is effective in delivering care, managing resources, and implementing policies for the benefit of the population.

Why other options are wrong:

B. Provide health services, govern NGOs, generate resources

This statement is incorrect because health systems are focused on providing health services and managing resources, but they do not typically govern NGOs. NGOs may work alongside health systems, but they are not part of the core functions of health systems.

C. Generate resources, financing, lobby for legislative change

While financing is a critical component, health systems are not specifically focused on lobbying for legislative change. The main goals are to provide services and manage resources within the system rather than engaging in political lobbying.

D. Govern NGOs, raise taxes, and develop pharmaceuticals

This statement is incorrect. Health systems do not govern NGOs or directly raise taxes. While pharmaceutical development is part of the broader health landscape, the core functions of health systems are centered on service delivery, financing, and stewardship.

Correct Answer:

B. To combat global HIV/AIDS and improve health outcomes

Explanation:

PEPFAR (President’s Emergency Plan for AIDS Relief) is a U.S. government initiative focused primarily on combating the global HIV/AIDS epidemic, improving prevention efforts, and providing treatment and support to individuals affected by the virus. It is one of the largest global health initiatives in the world, with a focus on improving health outcomes related to HIV/AIDS, particularly in sub-Saharan Africa and other high-risk regions.

Why other options are wrong:

A. To provide financial aid for global education initiatives. This is incorrect. While PEPFAR does improve health outcomes that may indirectly impact education, its main focus is HIV/AIDS, not education.

C. To promote economic development in low-income countries. This is incorrect. While PEPFAR’s work may contribute to economic development by improving public health, its primary goal is focused on health care related to HIV/AIDS rather than broad economic development.

D. To support environmental sustainability projects worldwide. This is incorrect. PEPFAR’s mission is centered on public health and HIV/AIDS, not on environmental sustainability initiatives.

Correct Answer:

B. Governments need to allocate resources to meet the needs of those who have retired.

Explanation:

The "graying" of the population refers to the increasing proportion of older individuals within a population, often due to lower birth rates and longer life expectancy. This demographic shift means that governments must allocate more resources to support the elderly, including retirement benefits, healthcare services, and other resources for aging populations.

Why other options are wrong:

A. Government's need to allocate resources to meet the needs of the younger population.

This is incorrect. "Graying" of the population specifically refers to the aging of the population, which calls for a focus on the elderly rather than the younger generation.

C. Governments need to allocate resources to create jobs for the working class.

This option is not related to the "graying" of the population. While creating jobs for the working class is important, the graying of the population is about addressing the needs of the elderly, not the working population.

D. None of the above.

This option is incorrect because answer B accurately describes the concept of the "graying" of the population, so "None of the above" is not a correct choice.

Correct Answer:

D. He reports having receptive condomless anal intercourse with two different men on the same night 6 weeks ago.

Explanation:

The 2017 USPHS HIV PrEP Clinical Practice Guidelines recommend initiating pre-exposure prophylaxis (PrEP) in individuals who are at substantial risk of acquiring HIV. This includes individuals who engage in high-risk sexual behaviors such as unprotected anal sex with multiple partners, particularly if one of them is HIV-positive or of unknown HIV status. The scenario described in option D indicates recent risky sexual behavior with multiple partners and no condom use, which would make the individual eligible for PrEP.

Why other options are wrong:

A. He reports two female sex partners in the last year and he had a diagnosis of gonorrhea 9 months ago. – While a history of gonorrhea suggests some sexual risk, the guidelines for PrEP focus more on the risk of HIV exposure through condomless sex, particularly with individuals of unknown or positive HIV status. This scenario doesn't explicitly meet the criteria for PrEP initiation based on sexual risk.

B. He regularly uses injection drugs and last shared needles 1 year ago. – Although sharing needles is a risk factor for HIV, the timing of the last needle-sharing episode (1 year ago) may not be sufficient to meet the guideline's criteria for PrEP, as current injection drug use with needle sharing is a more urgent indication.

C. He reports three female partners in the last year and one of them was diagnosed with syphilis 4 months ago. – Syphilis is a sexually transmitted infection that can increase the risk of HIV transmission, but without specifying condomless sex with partners of unknown HIV status, this situation alone does not strongly indicate the need for PrEP.

Correct Answer:

B. To finance health initiatives aimed at combating diseases such as HIV/AIDS

Explanation:

The Global Fund was established in 2002 with the primary purpose of financing health initiatives focused on combating HIV/AIDS, tuberculosis, and malaria. It provides grants to countries and organizations working to fight these diseases by improving prevention, treatment, and care strategies. The Global Fund is crucial in coordinating and funding international health efforts to address some of the world's most pressing health challenges.

Why other options are wrong:

A. To provide educational resources for global health – While education is a part of health initiatives, the Global Fund is specifically focused on providing financial support for fighting diseases, not for providing general educational resources.

C. To conduct research on population dynamics – The Global Fund's primary focus is on financing health programs, not on conducting research on population dynamics, which is outside its mandate.

D. To regulate pharmaceutical pricing worldwide – The Global Fund does not have the mandate to regulate pharmaceutical prices globally. It provides funding to combat diseases but does not have control over the global pharmaceutical market.

Correct Answer:

B. Addresses health issues that transcend national boundaries

Explanation:

Global health is a field that focuses on health issues that go beyond the borders of any one country. It includes the study, research, and practice aimed at improving health and achieving equity for all people worldwide. It deals with health problems that affect populations across countries and regions, such as pandemics, climate change, health systems strengthening, and access to healthcare.

Why other options are wrong:

A. Focuses on the health of a single country – Global health, by definition, is concerned with health issues that cross national boundaries, rather than focusing on the health of just one country.

C. Deals only with infectious diseases – While global health does include infectious diseases, it also encompasses a wide range of health issues, including non-communicable diseases, mental health, environmental health, and access to healthcare.

D. Is concerned solely with health policy – Health policy is a component of global health, but the field also includes areas such as public health practice, epidemiology, disease prevention, and social determinants of health.

E. Is unrelated to population health – Global health is inherently related to population health, as it seeks to improve the health of entire populations, especially in low- and middle-income countries, by addressing a wide range of health challenges.

Correct Answer:

C. Infectious disease

Explanation:

Migrant populations often face heightened vulnerability to infectious diseases due to factors such as overcrowded living conditions, limited access to healthcare, lack of vaccinations, and potential exposure to diseases in transit. These factors contribute to a higher risk of infectious diseases, making them a major health challenge for migrants. Poor living conditions and inadequate healthcare can further exacerbate the spread of infections within these populations.

Why other options are wrong:

A. Heart disease

While heart disease is a common health issue globally, it is not the primary health challenge for migrant populations. Infectious diseases, due to the living conditions and lack of proper healthcare, pose a more significant challenge.

B. Cancer

Cancer, although a major health concern for many populations, is not as immediately impactful on migrant health compared to infectious diseases, which are often more prevalent in transient, under-resourced settings.

D. Malnutrition

Malnutrition can be a concern in certain migrant groups, but it is generally less of a widespread health challenge compared to the risks of infectious diseases, which migrants are more exposed to due to their living and traveling conditions.

Correct Answer:

C. Increasing elderly population and declining birth rates

Explanation:

"Greying societies" refers to populations that are experiencing an increase in the proportion of elderly individuals, often accompanied by declining birth rates. This demographic shift leads to a higher dependency ratio, with fewer working-age individuals supporting a larger elderly population. This trend can have significant social and economic implications.

Why other options are wrong:

A. Increasing birth rates and a youthful population – This is the opposite of a greying society. Greying societies have declining birth rates, not increasing ones.

B. Stable population with balanced age distribution – Greying societies typically have an aging population with a growing proportion of elderly individuals, not a balanced age distribution.

D. High immigration rates and low life expectancy – Greying societies are often characterized by low birth rates and longer life expectancy, not low life expectancy or high immigration rates.