Community Public Health Nursing 7th Edition Nies Test Bank

Chapter 24: Rural and Migrant Health Nies: Community/Public Health Nursing, 7th Edition MULTIPLE CHOICE 1. Which best describes the recent population trend in rural America? a. The number of residents in rural areas of the United States is at one of its lowest levels ever recorded. b. Urban population rates increased from 2010 to 2015 as agricultural opportunities diminished. c. Nonmetro population rates have been steadily increasing because of increasing job growth. d. Population growth or loss in rural areas varies widely depending on available economic opportunities. ANS: D Although the urban growth rate has been steadily climbing since 1890, with numbers of urban dwellers surpassing those in rural areas around 1920, the number of rural residents is the highest in the country’s history (U.S. Department of Agriculture [USDA], 2016). In 2010 to 2015 population loss in nonmetro areas occurred in the United States as a whole. In 2014 nonmetro populations stabilized after 4 years of decline, likely related to improved rural employment growth (USDA, 2016). Opportunities for population growth and economic expansion vary widely from one nonmetro county to the next, and new regional patterns of growth and decline have emerged in recent years. DIF: Cognitive Level: UndersNtandR(CoImpGreheBns.ioCn) M U S N T O 2. Which best explains why there are so few hospitals in rural areas? a. Few nurses and physicians enjoy the rural lifestyle. b. Historically, hospitals began in large urban areas and have slowly expanded outward but have not yet reached all rural areas. c. Rural areas have very low population density. d. Rural residents do not trust hospitals, preferring to receive care from neighbors and friends. ANS: C Although 75% of U.S. counties are classified as rural, they contain only 20% of the U.S. population. The population density is too low to support a large hospital. There are providers available to serve the population and residents are accepting of health care services, but not as many services are needed because of the lower population density. DIF: Cognitive Level: Remember (Knowledge) 3. From which causes are rural residents twice as likely to die from in comparison with urban residents? a. Chronic diseases, especially cardiac problems and cancers b. Diabetes from the higher incidence of obesity c. Respiratory diseases (from pesticides and herbicides) d. Unintentional injuries Community Public Health Nursing 7th Edition Nies Test Bank ANS: D Residents of rural areas are nearly twice as likely to die of unintentional injuries, including motor vehicle accidents, when compared with their urban counterparts. The rates of chronic diseases, diabetes, and respiratory diseases are more similar to that of urban residents. DIF: Cognitive Level: Remember (Knowledge) 4. Which factor would cause a geographic area to be called a frontier area? a. Arbitrary distinction recognizing the Great Plains, Intermountain areas, and Alaska b. Geographically located in the West, specifically the Great Plains states c. High death rate from use of guns (homicide or suicide) d. Population of fewer than six persons per square mile ANS: D Areas are classified as rural for populations with fewer than 45 persons per square mile and as frontier for geographic areas with fewer than six people per square mile. Many counties of the Great Plains, Intermountain West, and Alaska are designated frontier. Not all mountain areas are rural (the Appalachian mountain area is not), and geographic location alone does not make an area rural. DIF: Cognitive Level: Understand (Comprehension) 5. Which best describes the purpose of the core-based statistical areas (CBSA) system? a. To reflect trends in population distribution across the county b. To differentiate between urban and metropolitan areas c. To emphasize the importance of noncare areas d. To report the demographic characteristics of those living in the area ANS: A y In June 2003, the Office of Management and Budget (OMB) released a new classification scheme to better reflect trends in population distribution across the nation (OMB, 2016). The MSA designation has been replaced by county-level core-based statistical areas (CBSAs) to simplify the multilevel designations. Within CBSAs, metropolitan areas are those counties that contain at least one urbanized area of 50,000 or more people. A micropolitan area contains a cluster of 10,000 to 50,000 persons. Counties that are neither metropolitan nor micropolitan are called “outside CBSAs,” also known as noncare areas (U.S. Census, 2013). DIF: Cognitive Level: Understand (Comprehension) 6. Which compositional factor influences rural health needs? a. Demographics of the people living in an area b. Local environment c. The geography of the area d. The political and social institutions in the community ANS: A