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Read: Module IV Case Study Quiz Assignment InstructionsRead the Module IV Case Study and take assessment quiz based on information presented in the case study, and course content.
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Populations and Global Health Module IV Case Study
Case study
This case study was adapted from the Christian Medical and Dental Association Trafficking in
Persons primer for the health care professionals. After reviewing the case study presented, take
assessment quiz.
Initial Case Presentation – Jill’s story
Jill was a runaway teen at the age of 14, escaping sexual and physical abuse at home. She was
homeless until she was approached in a suburban mall by a man named Bruce. He promised to
help her and provide work. With few options available, Jill agreed to go with Bruce.
She was taken to his “office” which was the basement in his home. There he hung her by her
wrists from the ceiling with leather straps. She was stripped, beaten, and tortured until she
agreed to work as a prostitute. The torture included being hung by her neck.
Once she agreed to work as a prostitute, Bruce brought paying clients into his home to have sex
with Jill. Some clients would “pay extra” to do unusual things to Jill.
During the next 3 years, Jill suffered horrible torture, and repeated rapes by clients of Bruce. Jill
eventually became pregnant. Bruce attempted unsuccessful to perform an abortion. Jill began
to hemorrhage.
Encounter with Healthcare Services
Bruce took Jill to the Emergency Department in Los Angeles for her to receive health care.
History
When in the ED, Bruce claimed he was Jill’s older brother, and that both of their parents had
been killed in 1-year prior in an automobile accident. Bruce stated that as a result of the
accident and unexpected loss of their parents, Jill suffered from schizophrenia. Bruce told the
nurses he was the only relative she had, and he often had to “tie her down” so she wouldn’t run
away. He also reported to the nurse that because of her schizophrenia, Jill often hallucinated
about very strange things, like being held captive.
Assessment – key findings
1
Populations and Global Health Module IV Case Study
Permanent scars were noted on the wrist and ankle. On her neck there is a permanent scar and
damage to her vocal cords affecting her speech.
Jill was actively hemorrhaging from her uterus
Course of hospitalization
Jill was hospitalized for 3 days
She was taken to the OR for uterine curettage to remove remaining products of conception.
She received several units of blood as a result of prior blood loss. She received a course of
antibiotics to prevent infection.
Jill is 17 years old.
She was never questioned regarding injuries without Bruce present. No consults were made for
mental health or social services. She was discharged after 3 days without having the ability to
become free from her captor.
2
Module IV Case Study Quiz Assignment Instructions
Purpose:
Student will read a case study presented to then and take assessment quiz based on
information presented in the case study, and their learnings in the course
Student Learning Outcome:
1. Apply knowledge of liberal arts and sciences in combination with the evolving body of
nursing knowledge to develop and refine clinical judgment as the foundation of the practice of
nursing.
3. Apply knowledge of health promotion strategies to promote the delivery of just and
equitable care that reflects cultural humility, inclusivity, consideration of social determinants of
health, and advocacy.
6. Support and develop collaborative intraprofessional and interprofessional relationships that
lead to the development of highly effective teams and improved patient outcomes.
Course Objective:
Apply concepts of population health to reduce health disparities and improve health
outcomes of communities.
Utilize the principles of servant leadership, and the Catholic Health Ministry to promote
culturally sensitive nursing care of vulnerable populations
Evaluate one’s own unconscious bias, culture, social, and economic factors on health
beliefs and disparities related to nursing care for vulnerable populations.
Instructions:
1. Read the case study information provided to you in Blackboard
2. Log into Blackboard and take assessment quiz
See Blackboard for grading rubric.
1.
Question 1
4 Points
After reading the human trafficking case study, what was your initial reaction? (i.e. focus on how
this case study made you feel and whether or not you discovered any biases about this patient)
2.
Question 2
4 Points
Trafficking victims may suffer from a range of physical injuries, which injuries did Jill have in
this case study? (select all that apply)
1. Neck strangulation scars
2. Blunt force trauma – active hemorrhaging
3. Fracture
4. Scars on wrists and ankles
3.
Question 3
4 Points
Based on your week 9 content, what “push” and “pull” risk factors are present for Jill in this
human trafficking case study? (select all that apply)
1. Young age
2. Physical and sexual abuse at home
3. Homeless
4. Religious persecution
5. Peer influences
6. Promise of employment
4.
Question 4
4 Points
Reflect on Jill’s Case Study and match her factors/influences with the determinants of health.
Prompts
Answers
1.
2.
3.
4.
Biological determinant
Sociocultural determinant
Behavioral determinant
Environment determinant
A. age
B. sexual activity
C. adolescent pregnancy
D. unsafe working conditions
5.
Question 5
4 Points
After reading the human trafficking case study, reflect on what happened to Jill in the ED. What
“Red Flag” clues were missed? (Select all that apply.)
1.
2.
3.
4.
5.
6.
7.
Reluctance to speak for one’s self
Mechanical history
Companion refuses to leave
Evidence of physical violence
Chemical exposure
Tattoos
Delayed presentation for medical care
6.
Question 7
4 Points
What signs might you observe in a person who is a victim of trafficking? (select all that apply)
1. Patient presents to the emergency department for complaint of running out of insulin
2. Patient appears withdrawn, fearful or nervous and may avoid eye contact. He or she
could also display distrusting and disruptive behavior.
3. Signs of physical abuse and injuries which are inconsistent with the explanation
provided for how the injuries were sustained.
4. Person accompanying the patient does all the talking and does not want to leave and
allow for privacy.
5. Low body weight and signs of malnutrition
7.
Question 8
4 Points
Every year, millions of men, women, and children are trafficked worldwide. What are some ways
human trafficking may be observed? (select all that apply)
1. Forced or bonded labor
2. Domestic servitude and forced marriage
3. Organ removal
4. Volunteering in the community creating a community garden
5. Exploitation of children in begging, the sex trade
8.
Question 11
4 Points
What are some interventions that could have been implemented in the emergency room in Jill’s
case study? (select all that apply)
1. Effective care coordination with the emergency rooms’ social worker
2. Request a mental health consult for Jill.
3. Demand that Bruce tell you why he is keeping her hostage.
4. Ask Jill – where do you live, sleep and eat?
5. Push Bruce out of the emergency room.
6. Develop a safety plan
Question 13
4 Points
It is easy for professionals who interact with minors to recognize victims, survivors, and youth
at risk of commercial sexual exploitation and sex trafficking. (True or False)
7. True
8. False
9.
Question 14
4 Points
A population health nurse is developing strategies to prevent or improve awareness of human
trafficking in the local area. In which of the following situations is a nurse implementing a
tertiary prevention strategy?
1. Providing support programs for new parents.
2. Screening a patient whose child recently died as a result of human trafficking.
3. Teaching adolescents about local resources after being identified as being part of human
trafficking.
4. Discussing stress reduction techniques with newly identified victims
10.
Question 15
4 Points
A nurse is preparing to conduct a windshield survey/community health needs assessment to
learn more about human trafficking in the local area. Which of the following data should the
nurse collect as a component of this assessment? (select all that apply)
1. Ethnicity of individuals involved
2. Individuals who hold power within the community
3. Data on human trafficking from the Health Department
4. Presence of public protection
11.
Question 16
4 Points
A nurse wants to conduct a community health needs assessment on human trafficking. Which of
the following data collection methods would the nurse use if direct conversation with a Human
trafficking victim occurred?
1. Victim interview
2. Victim observation
3. Focus groups
4. Filling out health surveys
12.
Question 17
4 Points
What nursing priority action is essential to identifying victims of human trafficking?
1. Developing a rapport with the victim and establish confidentiality
2. Identify and document all possible injuries
3. Consult with social work
4. Have forensic team conduct the patient history
13.
Question 18
4 Points
The next seven (7) questions will focus on the following case study:
Older Adult Case Study
A 68-year-old adult male and recent Afghanistan refugee to the USA, was recently seen in the
emergency department for an uncomplicated laceration to his right hand. He presents for a
wound check in which possible infection is noted. His blood pressure is 160/90, Temperature
98.9 degrees F, pulse 88 beats per minute, pulse oximetry is 97% and blood glucose is 90 non
fasting. He has a family history of diabetes and hypertension. He states he does not take any
medications. No additional testing or treatment is required at this time. The provider learns that
the patient cannot cleanse the wound at home because his water has been shut off. He also
states he cannot afford any medications prescribed by the clinic.
What influences or factors are impacting this older adult? (Select all that apply)
1. Mental illness
2. Refugee
3. Hypertension
4. Diabetes
5. Affordability
6. Age
14.
Question 19
4 Points
Identify nursing interventions needed to minimize the impact of adverse outcomes for the older
adult? (select all that apply)
1. Connect the older adult with appropriate resources to promote maximum self-care
ability.
2. Connect older adult with home care services.
3. Identify disability as early as possible
4. Implement primary prevention measures to prevent infection.
15.
Question 20
4 Points
As a refugee, the nurse realizes this older adult may have been force to leave his place of origin
due to disaster, war or threatening environment. (True or False)
1. True
2. False
16.
Question 21
4 Points
To promote a better outcome for this older adult, you refer him to a home health agency to help
improve his health outcome with the following care coordination interventions (select all that
apply)
1.
2.
3.
4.
Blood glucose and diabetics diet instruction
Monitoring blood pressure
Teach wound care and monitor healing progress
Increase accessibility to medications
17.
Question 22
4 Points
To help this older adult, the population health nurse is developing strategies to prevent or
improve health care access to obtaining needed medications in the local area. In which of the
following situations is the nurse implementing a tertiary prevention strategy?
1. Teaching a patient with a chronic disease how to access needed medications
2. Screening older adults for high blood pressure
3. Glucose screening
4. Discussing stress reduction techniques
18.
Question 23
4 Points
In this older adult case study, you realize this patient is from a different culture. From the
following actions, which should the nurse do first to learn more ?
1. Determine the older patient’s perception of his current health
2. Gather data about the patient’s cultural beliefs
3. Determine how the patient’s culture can effective of nursing action.
4. Gather information about previous patient visits
19.
Question 24
4 Points
As an older adult, which of the following may influence his health care outcome if he develops
hypertension or diabetes?
1. Rural residency
2. Chronic Stress
3. Environmental factors
4. Veteran status
20.
Question 25
4 Points
What is one thing you learned in Module IV that you, as a future nurse, will remember when
caring for vulnerable patients? (Please provide an evidenced based rationale – use intext citation
and a reference)
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