1. Question: What does "OECD" stand for?
2. Question: The Commonwealth Fund's Biennial Health Insurance Survey assesses the extent and quality of coverage for U.S. working-age
3. Question: In 2018, adults aged 18 to 64 in states with a(n) -----------  marketplace were more likely to be uninsured than those in states with a state-based marketplace or states with a hybrid marketplace.
4. Question: The reader learns how to identify population parameters, the potential impact of a population-based approach to care, and the importance of designing nursing interventions at the population level in ---------- nursing practice.
5. Question: What does "ANA" stand for?
6. Question: For 20 years, the -------------------------- has been advocating for healthcare reforms that would guarantee access to high-quality healthcare for all.
7. Question: As with any potential threat to health, education of our youth and 9adult populations regarding the deleterious effects of hookahs is paramount to reducing the potential ------------------- and mortality of long-term exposure to these flavored tobaccos.
8. Question: During the same time period, no change was found in the use of other ----------------

products (including cigarettes) (CDC, 2019d). 2

9. Question: The same answer also completes the following sentence: The ------------ and smoke from hookahs have toxic properties and have been linked to various cancers, including lung and oral cancers.
10. Question: The implementation of standard or proven (evidence-based) strategies to prevent illness and/or improve the health of targeted groups of people can have the effect of ameliorating health problems at the population and/or ---------------- level.
11. Question: Building on earlier studies that linked smoking in adulthood with ACEs, Brown et al. (2010) discovered a relationship between a history of ACEs and the risk of dying from --------------------
12. Question: More and more studies are being conducted to look at the relationship of sustained --------------- to toxic stress to a variety of poor health outcomes and high-risk behaviors.
13. Question: The same answer also completes the following sentence: Many additional studies have been conducted that demonstrate the destructive effects of _____________ to toxic stress.
14. Question: The APRN needs to take into consideration the many facets of health and disease, genetics and ___________, including human attitudes, attributes, and behavior when determining how to implement a population-based intervention.
15. Question: The same answer also completes the following sentence: Several factors, such as the physical ___________, healthcare systems, personal behaviors, and the social ______________, can have a deleterious impact on individual and community health.
16. Question: Outcomes ______________ in population-based care begins with the identification of the population and the problem, followed by the generation of a clinical question related to outcomes.
17. Question: ______________ and superutilization of services are costly in dollars to both consumers and hospitals and negatively impact the quality of life for patients.
18. Question: ___________ goals are to equip care providers with tools, information, and other interventions to help people with MCC and to support targeted research about individuals with MCC and effective interventions.

Chapter 2

19. Question: By comparing outcomes, APRNs can advocate for needed resources and changes in policies at local, regional, state, and/or national levels by identifying areas for improvement in practice, by comparing evidence needed for effective practice, and by better understanding health __________.
20. Question: Establishing the impact takes time and requires using an evaluation that is able to link interventions to long-term outcomes such as reducing disease ________ and mortality at the population level.
21. Question: Identifying population-level healthcare needs and healthcare disparities can improve

________ in health outcomes at all levels.

22. Question: Vital ____________ provide important outcome measures that APRNs can monitor and compare over time and analyze by demographic _________ to detect such things as health _____________.
23. Question: The National Vital Statistics System provides information about state and local vital statistics, including teen birth rates, prenatal care, birth weights, risk factors related to poor pregnancy outcomes, __________ mortality rates, life expectancy, and leading causes of death (www.cdc.gov/nchs/nvss).
24. Question: The redesign emphasized content with a strong link to public health, such as intermediate health outcomes for leading causes of _________/mortality.
25. Question: When combined with an evidence-based practice approach, outcomes can help provide standards or parameters for developing innovative interventions, instituting approaches more likely to impact the problem, and/or developing new practice _______ or protocols.
26. Question: In 1994, the American Nurses Association (ANA) developed Nursing's Safety and Quality Initiative, which initiated studies of patient safety with the goal of advocating _____ change.
27. Question: The TFAH's work is centered on three main principles (prevention, protection, and communities) and is a resource for issues such as public health funding, obesity, substance abuse and misuse, and health _______.
28. Question: In addition to ethnicity, other characteristics contribute to the presence of disparities or the achievement of good health such as gender; sexual orientation; geographic location; working environment; cognitive, sensory, or physical disability; and ______ status.
29. Question: The ___________ examines quality through six priority areas; person-centered care, patient

safety, healthy living, effective treatment, care coordination, and care affordability.

30. Question: The resulting objectives, whether on the county, state, or national level, are intended for use by broad audiences and stakeholders to help motivate, guide, and focus action for a(n) _____ nation.
31. Question: Social _____ of health is extensively described, along with related objectives and an interventions and resources webpage.

Chapter 3

32. Question: _____ rate describes the occurrence of new disease cases in a community over a period of time relative to the size of the population at risk.
33. Question: The numerator is the number of events and the _______ is the average population size (usually estimated as a midyear population).
34. Question: The ______ and Mortality Weekly Report (MMWR; located at www.cdc.gov/mmwr) is a publication of the CDC and contains updated information on incidence and prevalence of many diseases and conditions.
35. Question: The use of a web is helpful for visualizing how difficult it is to untangle the many events that can precede the onset of a chronic_____.
36. Question: The time from which a patient is diagnosed earlier from screening is the lead time, and the _____ is the error that occurs as a result of concluding that screening leads to a longer _____ after ____.
37. Question: Survival time is generally calculated from the time of ______ or from the start of treatment.
38. Question: By comparing _____ rates among population groups that vary in one or more risk factors, the APRN can begin to get some idea of the association between risk factors and disease.
39. Question: The importance of having the knowledge and skills to interpret and ______ survival data cannot be understated.
40. Question: ______, whether point or period, cannot give us an estimate of the risk of disease; it can only tell us about the burden of disease for a specified period of time.
41. Question: Those diseases that are rapidly fatal may not necessarily be beneficial to screen unless the _____ will allow for a cure or treatment to change the overall outcome or to prevent unnecessary spread of the disease.
42. Question: Correlation studies must be interpreted with caution, but important information can be obtained from the ______ that could identify disparities and lead to further studies and hypothesis testing.
43. Question: The _____ led the authors to conclude that it is important to develop a predictive model for fall risk in the community-dwelling elderly.
44. Question: In ecologic studies, rates are ______for characteristics that describe populations and are used to compare frequencies between different groups at the same time or the same group at different times.
45. Question: If an association exists between the exposure and the outcome, then the _______

rate in the exposed group will be greater than that in the nonexposed group.

46. Question: The longer the time period, the more likely participants will be lost to follow-up, and multiple exposures can potentially _______ the relationship.
47. Question: In case–control studies, the _______ begins with cases and controls and goes back retrospectively to look for exposures.
48. Question: One of the recommendations for cervical _________ is that women aged 21 to 65 should get a Pap smear every 3 years.
49. Question: The preclinical period should be sufficient to allow treatment before symptoms appear so that early ______ and treatment make a difference in terms of outcome.
50. Question: Screening is a tool used to detect disease in groups of asymptomatic individuals with the goal of reducing and/or preventing _______ and mortality.
51. Question: _______ prevention measures are carried out during the preclinical or presymptomatic stage of disease.
52. Question: APRNs can use their understanding of _______l methods in concert with their clinical expertise to develop policies and implement and evaluate new programs and interventions to improve population outcomes.

Chapter 4

53. Question: Such things as how the study design is selected, how subjects are selected, how information is collected, how the study is carried out (the conduct), or how the study is interpreted by ______ are all forms of potential bias.
54. Question: _______ should be avoided when possible, but if it is recognized, it should be acknowledged in the interpretation of results and addressed in the study discussion.
55. Question: The same answer also completes the following sentence: The objective is to include a set of variables that are theoretically or actually correlated with both the intervention and the outcome to reduce the______ of treatment effect.
56. Question: Publication _____, refers to the tendency of peer-reviewed journals to publish a higher percentage of studies with significant results than those studies with nonsignificant or negative statistical results.
57. Question: The same answer also completes the following sentence: An APRN needs to be aware of both publication and citation (additional types of information, particularly when carrying out systematic reviews or meta-analyses.
58. Question: When using data or working with data sets, it is critical to understand that mistakes can occur where _______ are involved.
59. Question: The same answer also completes the following sentence: Systematic errors occur not as the result of chance but because of inherent inaccuracies in _______.
60. Question: Whenever two or more factors or exposures are being studied simultaneously, the possibility of ______ exists.
61. Question: The same answer also completes the following sentence:______ occurs when one factor impacts another such that 94one sees a greater or lesser effect than would be expected by one factor alone.
62. Question: Another problem encountered in research occurs when __________ or subjects themselves have an effect on study results.
63. Question: The method for ________ data can help reduce problems related to confounding.
64. Question: The same answer also completes the following sentence: Patients who are assigned to one group or another and crossover intentionally or accidentally to the other group should be _______ according to their original assignment.
65. Question: The _______ appears frequently in the______, and the APRN should be familiar with its use and limitations.
66. Question: Scientific ______ refers to _______ with our current body of 97knowledge as it relates to the _______ under study.
67. Question: Avoiding subjective criteria is important as it can lead to inconsistent ______ of criteria.
68. Question: To decrease the_____ of bias definite criteria should be used so that there is no

_______ about how to distinguish between a case and a control.

69. Question: The CONSORT checklist items focus on reporting how the trial was designed, analyzed, and interpreted; the flow diagram displays the progress of all ______ through the trial.
70. Question: The same answer also completes the following sentence: Inclusion and exclusion criteria for the __________ must be precise and spelled out in advance.
71. Question: In a case-control study, the______, first identifies a group of individuals with the attribute of interest (cases), and a second group is identified without the attribute of interest (controls).

Chapter 5

72. Question: Well-designed ______ and case-control studies are acceptable alternatives when RCTs are not an option.
73. Question: The same answer also completes the following sentence: A well-designed, prospective

______ study has the potential to provide better evidence than a poorly designed RCT.

74. Question: Direct care nurses use data to assess the performance of their units on important patient care indicators (such as falls) and record patient information into_______ health records that may be linked with larger databases or registries.
75. Question: Patrician, Loan, McCarthy, Brosch, and Davey (2010) described the creation of the nurse-______ indicators for the military nursing outcomes database (MilNOD).
76. Question: The search of the ______ can be conducted by the APRN or the APRN can engage the assistance of a research ______ if available.
77. Question: Nurses require several skills to become ________ of evidence-based care and to improve clinical outcomes.
78. Question: A search of electronic ______ does not complete the search for the most current known evidence about a topic.
79. Question: The same answer also completes the following sentence: A hand search of current and relevant journals may reveal information that has not yet been entered into an electronic ______
80. Question: The APRN should use at least two databases for the literature ______
81. Question: The same answer also completes the following sentence: The first step is to ______

each key term separately and then to take steps to refine the search.

82. Question: What does "EOL" stand for? ________
83. Question: An APRN who works in long-term care (LTC) may observe that the nursing staff, especially the nursing assistants, working in LTC facilities lack knowledge and training in ______ (EOL) care.
84. Question: The lack of concealed randomized _______ increases the risk of ________.
85. Question: Quasi-experimental studies The main distinction between randomized and quasi- experimental studies is the way in which ________are allocated to the intervention and control groups; quasi-experimental studies do not use random assignment to create the comparison groups.
86. Question: The same answer also completes the following sentence: The simplest form of RCTs is known as the parallel group trial, which randomizes eligible _______ to two or more groups, treats according to assignment, and compares the groups with respect to outcomes of interest.
87. Question: A hierarchical level-of-evidence approach is a useful way to rank evidence according to its strength and helps to remove subjectivity from the ______.
88. Question: In 1999, the American Society of Anesthesiology (ASA) published evidence-based

guidelines for _____ fasting in ____ patients undergoing _______ procedures.

89. Question: The researchers define mindlines as "internalized guidelines that are formed primarily from ____ with colleagues and people perceived as opinion leaders."
90. Question: Many national and ______ studies have explored the reasons for nurses not keeping up to date in their practice.
91. Question: The authors identified the difficulty of changing entrenched traditions as one reason that preoperative fasting in excess of evidence-based ________ persisted.
92. Question: The ______ programs must be culturally _______, and staff education is ______ to ensure effective and accurate delivery of information.
93. Question: Developed by Bernadette Melnyk and the faculty of the School of Nursing at the _______ in 1999, it was originally designed to bring academic communities together with acute and community-based healthcare organizations.
94. Question: The team created a plan to increase the _______ rates of the clinic population.

Chapter 6

95. Question: Many people are still unable to afford or access_______; those in rural areas often cite limited high-speed ________ in their community as an issue.
96. Question: The Pew Internet Project tracks Internet use in many fields and reports that social

________ influence access to and use of online searches for health information.

97. Question: Researchers studied the use of mobile technology by a population of parents using pediatric care centers that serve primarily urban, low-income, African American patients.
98. Question: The same answer also completes the following sentence: Many people are still unable to afford or access _______; those in rural areas often cite limited high-speed Internet availability in their community as an issue.
99. Question: Several factors appear to make the public more vulnerable to misinformation on such sites including the degree to which the individual may be socially isolated, dependent on the people _____, and excessively trusting in the veracity of online information.
100. Question: The same answer also completes the following sentence: Studies have shown that the_______ provides both accurate and inaccurate information.
101. Question: APRNs have an opportunity to better serve their population by helping people ______ use the Internet wisely and directing them to sites that provide evidence-based information and privacy protection.
102. Question: The same answer also completes the following sentence: There are many studies that illustrate the importance of being vigilant in knowing the patterns of Internet use by ________.
103. Question: The researchers noted that the information that was most likely to be accessed by searchers is substandard because quality sites may be posted further down in the _______.
104. Question: The same answer also completes the following sentence: Chan et al. (2012) _____ the Internet using three different Internet search engines for websites that provide health-related information for gastrointestinal cancers.
105. Question: Recognizing distance to medical clinics or hospitals was a key _____ to access for rural residents, the researchers evaluated a collaborative effort to improve ______ to services and combined this with a ________
106. Question: Many studies have been conducted to determine how the use of ______ can improve specific population outcomes and self-care behaviors alone and in combination with other interventions.
107. Question: Avdal, Kizilci, and Demirel (2011) identified transportation as an important _______

to accessing care in rural communities and in urban areas with poor public transportation.

108. Question: The same answer also completes the following sentence: Recognizing distance to medical clinics or hospitals was a key _______ to access for rural residents, the researchers evaluated a collaborative effort to improve transportation to services and combined this with a telehealth-based counseling program.
109. Question: The Internet can be a valuable tool for patient care, communication, and social ________ and for boosting one's career, but nurses have also been fired, lost their licenses, and experienced bullying, all within the context of social media.
110. Question: The same answer also completes the following sentence: Software apps that can be downloaded to mobile devices and updated on a regular basis make available immediate and important information (such as drug ________/calculations) to APRNs and other healthcare providers.
111. Question: APRNs should evaluate their _______ and other technological resources carefully and use them to advance their practices to provide the latest evidence-based care possible.
112. Question: The same answer also completes the following sentence: The _______ can be a valuable tool for patient care, communication, and social interaction and for boosting one's career, but nurses have also been fired, lost their licenses, and experienced bullying, all within the context of social media.

Chapter 8

113. Question: What does "NCQA" stand for? ________

114. Question: What does "CHF" stand for? ____________

115. Question: Nash, Reifsnyder, Fabius, and Pracilio (2011) explain that the concept of population health includes an integrated system of care across the ________
116. Question: Care of a patient across the _____________ requires consistent and cogent processes and systems.
117. Question: Governance provides for a(n) ________ process to learn and apply the use of the many tools in the Six Sigma tool chest, many of which have a heavy statistical process control overlay.
118. Question: The same answer also completes the following sentence: Six Sigma leadership uses an ______ process in the form of various "belts" for certification.
119. Question: So one of the PDSA cycles included to guide the ________ of the bundle relates to the use of this checklist.
120. Question: The same answer also completes the following sentence: Other __________ strategies include developing measurement mechanisms and ensuring adequate supplies to guarantee sterile 189technique on insertion and availability of chlorhexidine and other important adjuncts to reducing the CLABSI rate in hospitals (CDC Healthcare Infection Control Practices Advisory Committee, 2018b).
121. Question: A well-defined scorecard at the enterprise level, which is balanced across several categories relating to the _______ experience, is a useful and important tool for senior leadership and governance.
122. Question: Completion of a health risk _______ is often a key component of lifestyle management programs.
123. Question: The same answer also completes the following sentence: The extent of outreach is determined by various levels of acuity, and the frequency of patient contact may depend on clinical ______and care planning.
124. Question: A plan for piloting or testing the remedies is well-defined, engages the full team, considers the cost of___________ and decision-making therein, and defines whether or not they are sufficient to achieve the desired improvement.
125. Question: The same answer also completes the following sentence: Other _______ strategies include developing measurement mechanisms and ensuring adequate supplies to guarantee sterile 189technique on insertion and availability of chlorhexidine and other important adjuncts to reducing the CLABSI rate in hospitals (CDC Healthcare Infection Control Practices Advisory Committee, 2018b).
126. Question: Patients move across a(n) _________ from good health to the end of life and enter a variety of settings in doing so.
127. Question: The emphasis from a clinical quality perspective in H&W programs is on_______ care, early recognition of emerging disease, and use of appropriately placed screening tools.
128. Question: Since the late 1990s, data sets, external comparisons, and guidance for standardized numerator and denominator have emerged across the patient ________ of care.
129. Question: The same answer also completes the following sentence: Patients move across a

_________ from good health to the end of life and enter a variety of settings in doing so.

130. Question: APRNs who have responsibilities regardless of the setting can strengthen a program design by ensuring that outcome measures are used in evaluating program _________ and incorporating a blend of process and outcome measures in quality program development.
131. Question: The same answer also completes the following sentence: The HEDIS categories include (a) _________ of care, (b) access/availability of care, (c) satisfaction with the experience of care, (d) use of services, and (e) cost of care (NCQA, 2018d).
132. Question: Many hospitals use a _________ of prominent vendors for patient ________ monitoring such as Press GaneyTM Associates (www.pressganey.com/index.aspx), Healthstream Research (www.healthstream.com/index.aspx), and many other research groups that specialize in healthcare survey processes.
133. Question: By ensuring that the patient's discharge plan coming out of the _______ setting is fully executed, one can reduce the risk of rehospitalization.
134. Question: The same answer also completes the following sentence: In the context of population health, the most expensive healthcare resources include the use of the ED and_______ stays.
135. Question: Significant efforts have been made to reduce the_________ of expensive medications in pharmacy benefit programs and specialty pharmacy programs alike.
136. Question: The same answer also completes the following sentence: An evaluation of the __________ of healthcare resources is often included in a given DM or CM contract as a "return on investment" (ROI) analysis as evidence of financial performance.
137. Question: _________, managing, and measuring complaints are additional ways to tap into the customer's experience.
138. Question: For a nurse to be effective in managing the care of an entire population of patients across the ________ of care, volume and focus matter.
139. Question: The review of the nurse's documentation from a clinical perspective is no less important in call center and field-based DM programs than it is in the hospital, in a(n) ________ setting, or in a direct-care home setting.
140. Question: The same answer also completes the following sentence: Although in hospitals, ______settings, and rehabilitation facilities there is a "hands on" nature to the care, in telephonic DM programs both "calls per nurse per day" and "talk time in minutes" are direct measures of nursing productivity.
141. Question: In general, metrics and measures should be easily found using existing ________ mechanisms and standardized data definitions, which can be compared against national standards and are representative of the nurse's role in improving the health of the population.
142. Question: The same answer also completes the following sentence: Administrative data sets have been criticized in the past for not providing useful information and for not serving as accurate measures of quality ("Case-Mix ________," 1987).
143. Question: One significant advantage of the study of health at the population level is the ample access to large populations of _______ data, allowing for a large sample size for analysis.
144. Question: The CMS has, over time, refined billing practices and requirements for appropriate documentation in the electronic invoicing processes for______ facilities and independent providers of care.
145. Question: Clearly, the information technology age and the availability of ______ data sets are related to the present state of data availability.
146. Question: Data availability, whether from ________, self-report, or hybrid data, has changed the nature of the healthcare landscape, and the accessibility and reliability of these data have been influenced by powerful market pressures.
147. Question: The same answer also completes the following sentence: _______ systems for facilitating both EMR and EHR raise the bar on the potential for outcomes research related to nursing's role in population health.
148. Question: _______ and certification programs offer a systematic review of a given organization's ability to provide evidence of compliance with standards.
149. Question: The same answer also completes the following sentence: Most ________ and certification programs provide various levels of review and accept both depth and breadth in terms of evidence permitted.
150. Question: __________ methods have the potential to supply providers with data on their care practices that may or may not demonstrate the achievement of improvements in patient outcomes.
151. Question: The same answer also completes the following sentence: Provider advisory committees provide depth to a DM program, which is not easily found through _______ methods.

Chapter 10

152. Question: For collaboration to be successful, _______ practice registered nurses (APRNs) need specialized knowledge and skills to build rapport, foster trust, respect differences, and involve _____ community partners on a(n) _______ basis through all phases of the CHA.
153. Question: Health departments are required to conduct community _______ on a regular basis and have the expertise to do so.
154. Question: The same answer also completes the following sentence: The primary purpose of building relationships and engaging communities through collaboration is to facilitate a dialogue to aid in the _______, planning, action, and evaluation of challenging care-based issues through program design and development.
155. Question: To build relationships with communities and to be successful in population health endeavors, APRNs require skills in leadership, ________, research, and policymaking.
156. Question: The same answer also completes the following sentence: _______ is important through the entire process of conducting a CHA, from planning, data collection, analysis, and priority setting, to community validation.
157. Question: Such CHNAs are more likely to be relevant, culturally responsive, and successful in achieving high quality healthcare and reducing health _______ and inequities than those developed by less diverse working groups.
158. Question: A key function of the ________ of the CHA is to work collaboratively with a diverse group of community partners, solicit input from multiple sources, and agree on the choice of___________ methods best suited for the specific community.
159. Question: While some CHAs have a narrow focus based on specific questions, other CHAs are more ______.
160. Question: The same answer also completes the following sentence: A ______ CHA addresses the characteristics of the community's physical environment, infrastructure, and population characteristics.
161. Question: Tools exist that quickly provide data for communities, ______, states, and nations.
162. Question: The same answer also completes the following sentence: Also participating were other non-profit, faith-based, educational, government, and business organizations as well as Wake ______residents.
163. Question: The Community Health _______ outlines nine steps (and includes resources) for conducting _____.
164. Question: Numerous community health ________ resources exist to help guide CHAs and to make the process efficient.
165. Question: The same answer also completes the following sentence: The hubs of the community assessment wheel include the categories of physical environment, health and social services, safety and transportation, communication, politics and government, education, recreation, and economics (Anderson & McFarlane, 2019).
166. Question: The underlying assumptions of the CHI Navigator are that it is important to work together with diverse and numerous______, engage communities in the CHA process, keep lines of communication open, and sustain results.
167. Question: The same answer also completes the following sentence: Resources such as a list of potential _________ to consider and approaches for organizing a coalition are included as well as links to other valuable tools and resources.
168. Question: Key _____ are most often selected from people representing different _____ of the community and who have the knowledge and experience to fill in ________ from data collected using other methods.
169. 169. The APRN will have the most success with ________, conducting, and evaluating a CHA by working with and being guided by trusted members of the community rather than doing these activities without active community ________.
170. Question: The CHA team used secondary data analysis to validate_______ from the _______

and to fill in _________ in information.

171. Question: In general the focus group_______ felt that their community was a good place to live and to raise a family.
172. Question: Only then can community programs be developed and integrated into a(n)

______ healthcare plan for the community.

<