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Test Bank for Canadian Fundamentals of Nursing 6th

Edition by Potter

Chapter 01: Health and Wellness

Potter et al: Canadian Fundamentals of Nursing, 6th Edition

MULTIPLE CHOICE

1. The nurse is using the population health promotion model to develop actions for

improving health. After asking, “On what should we take action?”; “How should we take

action?”; and “Why should we take action?” the nurse will ask which of the following

questions?

a. “With whom should we act?”

b. “When should we take action?”

c. “Which government should take action?”

d. “Where should we first act?”

ANS: A

The next question to ask when using the population health model approach is “With whom

should we act?” The other choices are not questions included in this model.

DIF: Apply REF: 13 (Figure 1-5)

OBJ: Contrast distinguishing features of health promotion and disease prevention.

TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance

2. The principle “Health promotion is multisectoral” means which of the following?

a. Relationships between individual, social, and environmental factors must be

recognized.

b. Physical, mental, social, ecological, cultural, and spiritual aspects of health must

be recognized.

c. In order to change unhealthy living and working conditions, areas other than health

must also be involved.

d. Health promotion uses knowledge from disciplines such as social, economic,

political, environmental, medical, and nursing sciences, as well as from first-hand

experience.

ANS: C

The statement “Health promotion is multisectoral” is the principle explained by the

necessity to involve areas other than health in order to change unhealthy living and

working conditions.

DIF: Understand REF: 11

OBJ: Contrast distinguishing features of health promotion and disease prevention.

TOP: Planning MSC: NCLEX: Health Promotion and Maintenance

3. According to the World Health Organization, what is the best description of “health”?

a. Simply the absence of disease.

b. Involving the total person and environment.

c. Strictly personal in nature.

d. Status of pathological state.

ANS: B

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WHO defines health as “. . .the extent to which an individual or group is able, on the one

hand, to realize aspirations and satisfy needs; and, on the other hand, to change or cope

with the environment. Health is, therefore, seen as a resource for everyday life, not the

objective of living; it is a positive concept emphasizing social and personal resources, as

well as physical capacities.” Nurses’ attitudes toward health and illness should consider

the total person, as well as the environment in which the person lives. People free of

disease are not equally healthy. Views of health have broadened to include mental, social,

and spiritual well-being, as well as a focus on health at family and community levels.

Conditions of life, rather than pathological states, are what determine health.

DIF: Knowledge REF: 2

OBJ: Discuss ways that definitions of health have been conceptualized.

TOP: Evaluate MSC: NCLEX: Health Promotion and Maintenance

4. What priority strategy for health promotion in Canada is optional but seen as important to

incorporate in nursing education curricula?

a. Knowledge of disease prevention.

b. Strategies for health promotion.

c. Policy advocacy.

d. Concepts of determinants of health.

ANS: C

Increasingly, policy advocacy is incorporated into nursing role statements and nursing

education curricula. Nurses should think about policies that have contributed to health

problems, policies that would help alleviate health problems, and how nurses champion

public policies. Disease prevention, health promotion, and concepts of determinants of

health are integral parts of nursing curricula.

DIF: Understand REF: 11| 12

OBJ: Analyze how the nature and scope of nursing practice are influenced by different

conceptualizations of health and health determinants. TOP: Planning

MSC: NCLEX: Health Promotion and Maintenance

5. Which of the following is a prerequisite for health, as identified by the Ottawa Charter for

Health Promotion?

a. Education.

b. Social support.

c. Self-esteem.

d. Physical environment.

ANS: A

Education is one of the nine prerequisites for health that were identified in the Ottawa

Charter for Health Promotion. Lack of social support and low self-esteem were identified

as psychosocial risk factors by Labonte (1993). Dangerous physical environments were

identified as socioenvironmental risk factors by Labonte (1993).

DIF: Understand REF: 4

OBJ: Discuss contributions of the following Canadian publications to conceptualizations of

health and health determinants: Lalonde Report, Ottawa Charter, Epp Report, Strategies for

Population Health, Jakarta Declaration, Bangkok Charter, Toronto Charter. TOP: Planning

MSC: NCLEX: Health Promotion and Maintenance

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6. The determinant of health with the greatest effect on the health of Canadians is which of

the following?

a. Education.

b. Health services.

c. Social support networks.

d. Income and social status.

ANS: D

Income, income distribution, and social status constitute the greatest determinant of health

because they influence most other determinants. Some investigators suggest that literacy

and education are important influences on health status because they affect many other

health determinants. Approximately 25% of a population’s health status is attributed to the

quality of its health care services. Social support affects health, health behaviours, and

health care utilization but is not the greatest determinant of health.

DIF: Understand REF: 6

OBJ: Discuss key health determinants and their interrelationships and how they influence health.

TOP: Planning MSC: NCLEX: Health Promotion and Maintenance

7. A paraplegic patient in the hospital for an electrolyte imbalance is receiving care at which

prevention level?

a. Primary prevention level.

b. Secondary prevention level.

c. Tertiary prevention level.

d. Health promotion level.

ANS: B

The secondary prevention level focuses on early detection of disease once pathogenesis

has occurred, so that prompt treatment can be initiated to halt disease and limit disability.

The primary prevention level focuses on health promotion, specific protection measures

such as immunizations, and the reduction of risk factors such as smoking. The tertiary

prevention level focuses on minimizing residual disability.

DIF: Apply REF: 11

OBJ: Contrast distinguishing features of health promotion and disease prevention.

TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance

8. The nurse incorporates levels of prevention on the basis of patient needs and the type of

nursing care provided. Which of the following is an example of tertiary level preventive

caregiving?

a. Teaching a patient how to irrigate a new temporary colostomy.

b. Providing a lesson on hygiene for an elementary school class.

c. Informing a patient that immunizations for her infant are available through the

health department.

d. Arranging for a hospice nurse to visit with the family of a patient with cancer.

ANS: D

 3 / 4

Tertiary prevention is provided when a defect or disability is permanent and irreversible.

At this level, the hospice nurse aims to help the patient and his or her family to achieve a

high level of function, despite the limitations caused by the patient’s illness. Teaching a

patient how to irrigate a new colostomy is an example of secondary prevention. If the

colostomy is to be permanent, care may later move to the tertiary level of prevention.

Providing a lesson on hygiene for an elementary school class and informing a patient

about available immunizations are examples of primary prevention.

DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention.

TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance

9. The nurse is working on a committee to evaluate the need for increasing the levels of

fluoride in the drinking water of the community. In doing so, the nurse is fostering which

concept?

a. Anticipatory prevention.

b. Primary prevention.

c. Secondary prevention.

d. Tertiary prevention.

ANS: B

Fluoridation of municipal drinking water and fortification of homogenized milk with

vitamin D are examples of primary prevention strategies. With active strategies of health

promotion, individuals are motivated to adopt specific health programs such as weight

reduction and smoking cessation programs. “Anticipatory prevention” is not a known

concept. Secondary prevention promotes early detection of disease (e.g., screening).

Tertiary prevention activities are initiated in the convalescence phase of disease.

DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention.

TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance

10. The nurse is working in a clinic that is designed to provide health education and

immunizations. As such, this clinic focuses on which type of prevention?

a. Primary prevention.

b. Secondary prevention.

c. Tertiary prevention.

d. Diagnosis and prompt intervention.

ANS: A

Primary prevention precedes disease or dysfunction and is applied to people considered

physically and emotionally healthy. Health promotion includes health education programs,

immunizations, and physical and nutritional fitness activities. Secondary prevention

focuses on individuals who are experiencing health problems or illnesses and who are at

risk for developing complications or worsening conditions; activities are directed at

diagnosis and prompt intervention. Tertiary prevention is provided when a defect or

disability is permanent and irreversible. It involves minimizing the effects of long-term

disease or disability through interventions directed at preventing complications and

deterioration.

DIF: Understand REF: 11 OBJ: Discuss the three levels of disease prevention.

TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance

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Test Bank for Canadian Fundamentals of Nursing 6th Edition by Potter Test Bank for Canadian Fundamentals of Nursing, 6th Edition A Complete Test Bank for Canadian Fundamentals of Nursing, 6th Edition Authors: Patricia A. Potter, Anne Griffin Perry, Patricia Stockert, Amy Hall, Barbara J. Astle, Wendy Duggle This is a Test Bank for Canadian Fundamentals of Nursing, 6th Edition. This is not the textbook. A Test Bank is a collection of exam questions with solutions based on the textbook. However it is not from the textbook. Test Banks or exam guides are useful in test preparation, revisions and self-study. A Solution Manual is a book guide. It has detailed solutions to end of the chapter questions and projects or case studies may be included as well in some guides. These solutions can assist with assignments, homework and book-based learning. Test Bank Canadian Fundamentals of Nursing, 6th Edition by Patricia A. Potter Chapter 01: Health and Wellness Potter et al: Canadian Fundamentals of Nursing, 6th Edition MULTIPLE CHOICE The nurse is using the population health promotion model to develop actions for improving health. After asking, “On what should we take action?”; “How should we take action?”; and “Why should we take action?” the nurse will ask which of the following questions? “With whom should we act?” “When should we take action?” “Which government should take action?” “Where should we first act?” ANS: A The next question to ask when using the population health model approach is “With whom should we act?” The other choices are not questions included in this model. DIF: Apply REF: 13, Figure 1-5 OBJ: Contrast distinguishing features of health promotion and disease prevention. TOP: Implementation MSC: CPNRE: Foundations of Practice The principle “Health promotion is multisectoral” means which of the following? Relationships between individual, social, and environmental factors must be recognized. Physical, mental, social, ecological, cultural, and spiritual aspects of health must be recognized. In order to change unhealthy living and working conditions, areas other than health must also be involved. Health promotion involves the use of knowledge from disciplines such as social, economic, political, environmental, medical, and nursing sciences, as well as from first-hand experience. ANS: C The statement “Health promotion is multisectoral” is the principle explained by the necessity to involve areas other than health in order to change unhealthy living and working conditions. DIF: Understand REF: 11 OBJ: Contrast distinguishing features of health promotion and disease prevention. TOP: Planning MSC: CPNRE: Foundations of Practice According to the World Health Organization, what is the best description of “health”? Simply the absence of disease. Involving the total person and environment. Strictly personal in nature. Status of pathological state. ANS: B The WHO defines health as “…the extent to which an individual or group is able, on the one hand, to realize aspirations and satisfy needs; and, on the other hand, to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living; it is a positive concept emphasizing social and personal resources, as well as physical capacities.”Nurses’ attitudes toward health and illness should account for the total person, as well as the environment in which the person lives. People free of disease are not equally healthy. Views of health have broadened to include mental, social, and spiritual well-being, as well as a focus on health at family and community levels. Conditions of life, rather than pathological states, are what determine health. DIF: Knowledge REF: 2 OBJ: Discuss ways that definitions of health have been conceptualized. TOP: Evaluate MSC: CPNRE: Foundations of Practice What priority strategy for health promotion in Canada is optional but seen as important to incorporate in nursing education curricula? Knowledge of disease prevention. Strategies for health promotion. Policy advocacy. Concepts of determinants of health. ANS: C Increasingly, policy advocacy is incorporated into nursing role statements and nursing education curricula. Nurses should think about policies that have contributed to health problems, policies that would help to alleviate health problems, and how nursing champions public policies. Disease prevention is an integral part of nursing curricula. Health promotion is a fundamental part of nursing curricula. DIF: Understand REF: 11 | 12 OBJ: Analyze how the nature and scope of nursing practice are influenced by different conceptualizations of health and health determinants. TOP: Planning MSC: CPNRE: Foundations of Practice Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 1 Which of the following is a prerequisite for health, as identified by the Ottawa Charter for Health Promotion? Education. Social support. Self-esteem. Physical environment. ANS: A Education is one of the nine prerequisites for health that were identified in the Ottawa Charter for Health Promotion. Lack of social support and low self-esteem were identified as a psychosocial risk factors by Labonte (1993). Dangerous physical environments were identified as socioenvironmental risk factors by Labonte (1993). DIF: Understand REF: 4 OBJ: Discuss contributions of the following Canadian publications to conceptualizations of health and health determinants: Lalonde Report, Ottawa Charter, Epp Report, Strategies for Population Health, Jakarta Declaration, Bangkok Charter, Toronto Charter. TOP:Planning MSC: CPNRE: Foundations of Practice The determinant of health with the greatest effect on the health of Canadians is which of the following? Education. Health services. Social support networks. Income and social status. ANS: D Income, income distribution, and social status are the determinants of health that influence most other determinants. Some investigators suggest that literacy and education are important influences on health status because they affect many other health determinants. Approximately 25% of a population’s health status is attributed to the quality of its health care services. Social support affects health, health behaviours, and health care utilization but is not the most influential determinant of health. DIF: Understand REF: 6 OBJ: Discuss key health determinants and their interrelationships and how they influence health. TOP: Planning MSC: CPNRE: Foundations of Practice A paraplegic patient in the hospital for an electrolyte imbalance is receiving care at which prevention level? Primary prevention. Secondary prevention. Tertiary prevention. Health promotion. ANS: B The secondary prevention level focuses on early detection of disease once pathogenesis has occurred, so that prompt treatment can be initiated to halt disease and limit disability. The primary prevention level focuses on health promotion, specific protection measures such as immunizations, and the reduction of risk factors such as smoking. The tertiary prevention level focuses on minimizing residual disability. DIF: Apply REF: 11 OBJ: Contrast distinguishing features of health promotion and disease prevention. TOP: Implementation MSC: CPNRE: Foundations of Practice The nurse incorporates levels of prevention on the basis of patient needs and the type of nursing care provided. Which of the following is an example of tertiary level preventive caregiving? Teaching a patient how to irrigate a new temporary colostomy. Providing a lesson on hygiene for an elementary school class. Informing a patient that immunizations for her infant are available through the health department. Arranging for a hospice nurse to visit with the family of a patient with cancer. ANS: D Tertiary prevention is provided when a defect or disability is permanent and irreversible. At this level, the hospice nurse aims to help the patient and his or her family to achieve a high level of function, despite the limitations caused by the patient’s illness. Teaching a patient how to irrigate a new colostomy is an example of secondary prevention. If the colostomy is to be permanent, care may later move to the tertiary level of prevention. Providing a lesson on hygiene for an elementary school class and informing a patient about available immunizations are examples of primary prevention. DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention. TOP: Implementation MSC: CPNRE: Foundations of Practice The nurse is working on a committee to evaluate the need for increasing the levels of fluoride in the drinking water of the community. In doing so, the nurse is fostering which concept? Anticipatory prevention. Primary prevention. Secondary prevention. Tertiary prevention. ANS: B Fluoridation of municipal drinking water and fortification of homogenized milk with vitamin D are examples of primary prevention strategies. With active strategies of health promotion, individuals are motivated to adopt specific health programs such as weight reduction and smoking cessation programs. Anticipatory prevention is not a known concept. Secondary prevention promotes early detection of disease (e.g., screening). Tertiary prevention activities are initiated in the convalescence phase of disease. DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention. TOP: Implementation MSC: CPNRE: Foundations of Practice Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 2 The nurse is working in a clinic that is designed to provide health education and immunizations. As such, this clinic focuses on which type of prevention? Primary prevention. Secondary prevention. Tertiary prevention. Diagnosis and prompt intervention. ANS: A Primary prevention precedes disease or dysfunction and is applied to people considered physically and emotionally healthy. Health promotion includes health education programs, immunizations, and physical and nutritional fitness activities. Secondary prevention focuses on individuals who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions; activities are directed at diagnosis and prompt intervention. Tertiary prevention is provided when a defect or disability is permanent and irreversible. It involves minimizing the effects of long-term disease or disability through interventions directed at preventing complications and deterioration. DIF: Understand REF: 11 OBJ: Discuss the three levels of disease prevention. TOP: Implementation MSC: CPNRE: Foundations of Practice The patient is admitted to the emergency department of the local hospital from home with reports of chest discomfort and shortness of breath. She is administered oxygen and breathing treatments, laboratory tests and blood gas measurements are performed, and electrocardiography is conducted. What level of preventive care is this patient receiving? Primary prevention. Secondary prevention. Tertiary prevention. Health promotion. ANS: B Secondary prevention focuses on individuals who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions. Activities are directed at diagnosis and prompt intervention. Primary prevention precedes disease or dysfunction and is applied to people considered physically and emotionally healthy. Health promotion includes health education programs, immunizations, and physical and nutritional fitness activities. Tertiary prevention is provided when a defect or disability is permanent and irreversible. It involves minimizing the effects of long-term disease or disability through interventions directed at preventing complications and deterioration. DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention. TOP: Implementation MSC: CPNRE: Foundations of Practice A patient is admitted to a rehabilitation facility after a stroke. The patient has right-sided paralysis and is unable to speak. The patient will be receiving physiotherapy and speech therapy. What are these examples of? Primary prevention. Secondary prevention. Tertiary prevention. Health promotion. ANS: C Tertiary prevention is provided when a defect or disability is permanent and irreversible. It involves minimizing the effects of long-term disease or disability through interventions directed at preventing complications and deterioration. Secondary prevention focuses on individuals who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions. Activities are directed at diagnosis and prompt intervention. Primary prevention precedes disease or dysfunction and is applied to people considered physically and emotionally healthy. Health promotion includes health education programs, immunizations, and physical and nutritional fitness activities. DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention. TOP: Implementation MSC: CPNRE: Foundations of Practice Risk factors can be placed in the following interrelated categories: genetic and physiological factors, age, physical environment, and lifestyle. The presence of any of these risk factors means which of the following? A person with the risk factor will get the disease. The chances of getting the disease are increased. The disease is guaranteed not to develop if the risk factor is controlled. Risk modification will have no effect on disease prevention. ANS: B The presence of risk factors does not mean that a disease will develop, but risk factors increase the chances that the individual will experience a particular disease or dysfunction. Control of risk factors does not guarantee that a disease will not develop. However, risk factor identification assists patients in visualizing areas in life that can be modified or even eliminated to promote wellness and prevent illness. DIF: Knowledge REF: 3 OBJ: Identify factors that have led to each approach to health. TOP: Assessment MSC: CPNRE: Foundations of Practice Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 3 Since the early 1990s, which group has had the highest amount of absenteeism of all workers in Canada? “White collar sector” workers. Nurses. Workers in the trades. Transport and equipment operators. ANS: B There is considerable concern regarding negative workplace conditions in the health care sector. Nurses have had the highest or second-highest rate of absenteeism of all workers in Canada since the early 1990s. Rates of absenteeism for the “white collar sector,” for workers in the trades, and for transport and equipment operators are not available. DIF: Analyze REF: 7 OBJ: Analyze how the nature and scope of nursing practice are influenced by different conceptualizations of health and health determinants. TOP: Planning MSC: CPNRE: Foundations of Practice Which of the following is a true statement about nutrition in Canada, according to the research? Canadians have increased their total fat and salt consumption. Canadians report that their children eat the recommended daily number of fruits and vegetables. Fifty percent of children aged 2 to 17 years were overweight or obese. The 2004 Canadian Community Health Survey (CCHS) revealed that 40% of adult Canadians were obese (body mass index of 30 or more) and 50% were overweight. ANS: A One quarter of Canadians overall, and one third of teenagers aged 14 to 18 years, reported eating at a fast-food outlet the previous day; such foods are high in fats and salts. Of children aged 4 to 8, 70% ate fewer than the minimum servings of fruits and vegetables daily. Of children aged 2 to 17 years, 26% were overweight or obese, not 50%. The 2004 Canadian Community Health Survey (CCHS) revealed that 23% of adult Canadians were obese (body mass index of 30 or more), not 40%, and 36% were overweight, not 50%. DIF: Apply REF: 8|9 OBJ: Discuss key health determinants and their interrelationships and how they influence health. TOP: Planning MSC: CPNRE: Foundations of Practice One of the five health promotion strategies, as identified by the Ottawa Charter for Health Promotion, is which of the following? Creating supportive environments. Strengthening educational opportunities. Developing a medical approach. Minimizing stressful situations. ANS: A “Creating supportive environments” is one of the five broad health promotion strategies identified by the Ottawa Charter for Health Promotion. The other strategies are building healthy public policy, creating supportive environments, strengtheningcommunity action, developing personal skills, and reorienting health services. “Strengthening educational opportunities,” “Developing a medical approach,” and “Minimizing stressful situations” are not among the five strategies. DIF: Apply REF: 11 | 12 OBJ: Discuss contributions of the following Canadian publications to conceptualizations of health and health determinants: Lalonde Report, Ottawa Charter, Epp Report, Strategies for Population Health, Jakarta Declaration, Bangkok Charter, Toronto Charter. TOP:Planning MSC: CPNRE: Foundations of Practice Which of the following is an example of tertiary prevention? Reduction of risk factors, such as smoking. Breast self-examination and testicular self-examination. Cardiac rehabilitation programs. Blood pressure screening to detect hypertension. ANS: C Tertiary prevention activities are provided in the convalescence stage of disease and are directed toward minimizing residual disability and helping people live productively with limitations. An example is a cardiac rehabilitation program after a myocardial infarction. Breast self-examination and testicular self-examination are examples of secondary prevention, as is blood pressure screening to detect hypertension. Reducing risk factors, such as smoking, is an example of primary prevention. DIF: Understand REF: 11 OBJ: Describe the three levels of disease prevention. TOP: Implementation MSC: CPNRE: Foundations of Practice Copyright © 2019 Elsevier Canada, a division of Reed Elsevier Canada, Ltd. 4 When the nurse is educating an adult patient about health promotion activities, which of the following is the most important internal patient factor for the nurse to consider? Emotional wellness. Developmental stage. Professed spirituality. Levels of education and literacy. ANS: D Levels of education and literacy are important influences to consider when the nurse is educating an adult patient concerning health promotion activities. Literacy can influence health both directly (e.g., medication use, safety practices) and indirectly through use of services, lifestyles, income, work environments, and stress levels. Spirituality is reflected in how a person lives his or her life, including the values and beliefs exercised, the relationships established with family and friends, and the ability to find hope and meaning in life; however, it is not the most important factor to consider. The nurse must consider the patient’s level of growth and development when using the patient’s health beliefs and practices as a basis for planning care, but this is not the most important patient factor to consider. In this case, the patient is at the adult developmental stage. The patient’s emotional wellness—degree of stress, depression, or fear, for example—can influence health beliefs and practices. The manner in which a person handles stress throughout each phase of life will influence the way he or she reacts to illness. However, this is not the best available option. DIF: Analyze REF: 7 OBJ: Discuss key health determinants and their interrelationships and how they influence health. TOP: Implementation MSC: CPNRE: Foundations of Practice When discussing the effect of a known risk factor on a patient’s health, what would the nurse say? “It doesn’t mean that you’ll get the disease, just that the odds are greater for you.” “Now that you know the possibility is there, you can take steps to prevent it.” “This risk factor can be managed by making a change to your lifestyle.” “You’re lucky because you have the benefit of being able to do something about it.” ANS: A The presence of risk factors does not mean that a disease will develop, but risk factors increase the chances that the individual will experience a particular disease or dysfunction. While the statement, “Now that you know the possibility is there, you can take steps to prevent it” is not incorrect; it does not address the impact of the risk factor on the patient’s health. It is not always true that a risk factor can be managed by making lifestyle changes. The strategy of telling the patient that he or she is lucky and has the benefit of being able to do something about a risk factor minimizes the patient’s concern, and does not address the effect of the risk factor on the patient’s health. DIF: Apply REF: 3 OBJ: Describe key characteristics of medical, behavioural, and socioenvironmental approaches to health. TOP:Implementation MSC: CPNRE: Foundations of Practice Classifications of health conceptualizations occur in which following way? Health as stability and actualization. Health as individual and wellness. Health as universal and being free from illness. Health as empowerment and absence of disease. Health and wellness. ANS: A Health can be conceptualized (Pender, 2006) in three ways: health as stability, as actualization, and health as both of these together. DIF: Understand REF: 2 OBJ: Discuss ways that definitions of health have been conceptualized. TOP: Assessment MSC: CPNRE: Foundations of Practice Chapter 02: The Canadian Health Care Delivery System Potter et al: Canadian Fundamentals of Nursing, 6th Edition MULTIPLE CHOICE 1. What is the fastest growing component of the health care system? a. Primary care. b. Respite care. c. Home care. d. Palliative care. ANS: C Canadian health care is shifting from an institution-based system to one in which community care is playing a greater role. Home care is one of the fastest growing components of the health care system, partly because patients are sent home from hospital sooner than they used to be. Primary care, respite care, and palliative care are not the fastest growing components of the health care system. DIF: Apply REF: 27 OBJ: Describe five levels of health care and associated types of services. TOP: Assessment MSC: CPNRE: Foundations of Practice 2. Which of the following is a contributing factor to the shortage of nurses in Canada? a. Increased birth rate, which creates a greater demand for nursing services. b. New technology, which replaces nurses at the bedside. c. Fewer people wishing to practise as nurses because health trends are focusing on natural and alternative therapies. d. Retirement of a large percentage of nurses. ANS: D The nursing workforce is currently challenged by the aging of workers, high retirement rates, ethical problems in international recruitment, and lack of full-time positions. The average age of RNs in Canada is 44.6 years; for LPNs, it is 41, and for RPNs, it is 46. The aging population is creating the greater demand for nursing services. Neither the replacement of nurses at the bedside by new technology nor the focus of health trends on natural and alternative therapies is a factor identified as contributing to the shortage of nurses. DIF: Apply REF: 19, Box 2-1 OBJ: Discuss principal factors influencing health care reform and the current health care delivery system. TOP: Planning MSC: CPNRE: Foundations of Practice 3. A nurse working with a group of Indigenous parents refers to Treaty 6, which includes a provision for health care services and is often referred to as which of the following? a. The Truth and Reconciliation Act. b. The “medicine chest” clause. c. The Indigenous band agreements. d. The land and relationship understanding. ANS: BTreaty 6 was often referred to as the “medicine chest” clause, as it included a provision for health care services to be provided to Indigenous communities. The Indian Act, the Indian band agreements (signed with the British government before Confederation), and relationship agreements do not refer to Treaty 6. DIF: Understand REF: 20 OBJ: Identify initiatives related to enhancing quality of the Canadian health care delivery system. TOP: Planning MSC: CPNRE: Foundations of Practice 4. Which of the following is an example of a true health promotion service provided by a nurse? a. An immunization clinic. b. A diabetic support group. c. A prenatal nutrition class. d. A smoking cessation clinic. ANS: C Community clinics offer prenatal nutrition classes that promote the health of the woman, fetus, and infant. Building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health services are part of health promotion service. An immunization clinic is an example of disease and injury prevention. A diabetic support group may be an example of a rehabilitation service, to help patients adapt to a change in lifestyle. A smoking cessation clinic may be offered as part of a rehabilitation service or as a disease and injury prevention intervention. DIF: Apply REF: 28 OBJ: Describe five levels of health care and associated types of services. TOP: Implementation MSC: CPNRE: Foundations of Practice 5. When conducting a health care system class for immigrants to Canada, the nurse informs them that the federal government is responsible for which of the following? a. Providing health care insurance plans. b. Managing and planning insurable health services. c. Delivering health services to targeted groups. d. Providing long-term care services. ANS: C The federal government is charged with delivering, or co-delivering, health care services for targeted groups. Health care insurance plans, managing and planning insurable health services, and providing long-term care services are the jurisdiction of the provinces or territories. DIF: Apply REF: 22 OBJ: Identify and define the principles of the Canada Health Act and significant legislation related to the Canadian health care system. TOP: Implementation MSC: CPNRE: Foundations of Practice 6. The nurse initiated a support group for adolescent parents and is teaching them about chlorinated water and child immunizations, which are all examples of which of the following?a. Health promotion. b. Disease and injury prevention. c. Supportive care. d. Rehabilitation. ANS: B Disease and injury prevention includes illness prevention (chlorinated water, immunizations) and support groups. Health promotion services include antismoking services, advocacy for healthy public policy, and provision of wellness services. Supportive care describes services provided over a prolonged period to people who are disabled, who have never been able to function independently, or who have a terminal disease. Rehabilitation, such as physiotherapy, involves restoring optimal health. DIF: Apply REF: 28 OBJ: Describe five levels of health care and associated types of services. TOP: Implementation MSC: CPNRE: Foundations of Practice 7. Primary care is best described as which of the following? a. Early detection and routine care, as well as prevention. b. Provision of a specialized medical service. c. Treatment of all patients with a minimum level of health insurance. d. Provision of medical services in a patient’s home. ANS: A Primary care is the first contact of a patient with the health care system that leads to a decision regarding a course of action to resolve any actual or potential health problem. The focus is on early detection and routine care, with emphasis on education to prevent recurrences. Provision of a specialized medical service by a specialist or through referral is an example of secondary care. No patient is refused treatment on the basis of level of insurance. Medical services provided in the patient’s home, although not very common, could be categorized under primary care but would not best describe primary care. DIF: Understand REF: 28 OBJ: Identify various settings and models of care delivery in the Canadian health care delivery system. TOP: Assessment MSC: CPNRE: Foundations of Practice 8. A patient comes to the ambulatory care clinic for management of a chronic condition and asks the nurse for an explanation of the Medicare system. The nurse’s response is based on the knowledge that it is which of the following? a. Canada’s national health insurance system. b. A fee-for-service insurance plan. c. A plan in which monies from provincial taxes are used for nursing homes. d. A social insurance program for low-income earners. ANS: A Medicare is a key element of Canada’s social safety net. It is Canada’s national health insurance system, in which taxes are used to finance medically necessary services for all citizens, thus providing “free” health care to all. Medicare is not a fee-for-service insurance plan, a plan in which monies from provincial taxes are used for nursing homes, or a social insurance program for low-income earners. DIF: Understand REF: 19OBJ: Discuss the evolution of Canada's social safety net and Medicare. TOP: Implementation MSC: CPNRE: Foundations of Practice 9. In teaching a group of older persons about health care spending, a nurse tells them that about 14% of the Canadian population is within their age group and that this group accounts for what percentage of health care spending? a. 25%. b. 35%. c. 45%. d. 55%. ANS: C Older persons account for 45% of health care spending in Canada, not 25%, not 35%, and not 55%. DIF: Apply REF: 22 OBJ: Discuss principal factors influencing health care reform and the current health care delivery system. TOP: Implementation MSC: CPNRE: Foundations of Practice 10. To whom do the principles of the Canada Health Act of 1984 apply? a. Members of the Canadian Armed Forces. b. Insured residents of Canada. c. Inmates of federal penitentiaries. d. Royal Canadian Mounted Police (RCMP). ANS: B The principles of the Canada Health Act apply to all insured residents of Canada (i.e., eligible residents) but exclude members of the Canadian Armed Forces, Royal Canadian Mounted Police (RCMP), eligible veterans, inmates of federal penitentiaries, and some refugee claimants. DIF: Understand REF: 20 OBJ: Identify and define the principles of the Canada Health Act and significant legislation related to the Canadian health care system. TOP: Assessment MSC: CPNRE: Foundations of Practice 11. When a mother brings her child to be seen in a nurse-managed setting, over concerns that her child’s rash could be measles, what type of care is rendered? a. Respite care. b. Primary care. c. Supportive care. d. Secondary care. ANS: B Primary care focuses on early detection and routine care and can be offered in nurse-managed clinics. Respite care is a component of supportive care. Supportive care describes services provided to disabled and terminally ill patients over a prolonged time period. Secondary care is the provision of specialized medical services by a physician specialist or through referral from a primary care provider. DIF: Understand REF: 28OBJ: Describe five levels of health care and associated types of services. TOP: Assessment MSC: CPNRE: Foundations of Practice 12. Which of the following is one of the four pillars of primary health care, as described by the National Primary Health Care Awareness Strategy (2006)? a. Teams. b. Universality. c. Health promotion. d. Immediate access to primary care. ANS: A Teams are one of the four pillars, along with access, information, and healthy living. The four pillars do not include universality, health promotion, or immediate access to primary health care. DIF: Understand REF: 25, Box 2-3 OBJ: Identify various settings and models of care delivery in the Canadian health care delivery system. TOP: Planning MSC: CPNRE: Foundations of Practice 13. Mr. Jones is 72 years old. He is ambulatory and is to be discharged from hospital after a total hip replacement, with requirements for daily physiotherapy and respiratory therapy. What is the most appropriate facility referral for the nurse to make? a. A rehabilitation centre. b. An assisted-living facility. c. A community health clinic. d. A home care agency. ANS: D A home care agency provides health services to individuals and families in their homes. Home care was created to provide individualized care for people after hospital discharge but has increasingly included patients in a range of ages from very young to very old; those with mental, physical, or developmental challenges; and those requiring recovery to end-stage care. A rehabilitation centre is not required, as Mr. Jones is ambulatory. Assisted-living facilities are community-based residential facilities in which adults live in their own apartments and are provided with a range of support services such as meals, social and recreational programs, and laundry A community health clinic is the first point of contact, offering a range of primary services that emphasize prevention, health promotion, health education, community development, and partnerships to develop a healthy local community. DIF: Apply REF: 26 | 27 OBJ: Identify various settings and models of care delivery in the Canadian health care delivery system. TOP: Implementation MSC: CPNRE: Foundations of Practice 14. What is an appropriate referral for an older patient who requires some assistance with daily activities within a partially protective environment? a. Respite care. b. Rehabilitative care. c. Assisted living. d. Extended care.ANS: C Such a patient requires assisted living. Assisted living allows adults to receive a range of support services, including personalized assistance in achieving a level of independence. Personal assistance services are “designed to promote maximum dignity and independence,” including meal preparation, personal hygiene practice, mobility, and socialization. Respite care is a service that provides short-term relief for family caregivers or persons providing home care to the ill or disabled. Rehabilitative care provides therapy and training, with the goal of decreasing the patient’s dependence on care. An extended, or long-term, care facility provides intermediate medical, nursing, or custodial care for patients recovering from acute or chronic illness or disabilities. DIF: Apply REF: 26 | 27 OBJ: Identify various settings and models of care delivery in the Canadian health care delivery system. TOP: Implementation MSC: CPNRE: Foundations of Practice 15. The Canadian Patient Safety Institute (CPSI) provides leadership in building and advancing a safer health care system. According to the CPSI, about two thirds of preventable incidents that occur during hospitalization are related to what? a. Procedures. b. Care or medication. c. Patient accidents. d. Infection control. ANS: B According to the CPSI, about two thirds of preventable events are either care related or medication related. About one third of the events are related to procedures or patient accidents. Infections fall under the category of care. DIF: Remember REF: 30 OBJ: Discuss principal factors influencing health care reform and the current health care delivery system. TOP: Planning MSC: CPNRE: Foundations of Practice 16. “Residents temporarily absent from their home province are to have their incurred services paid for by the home province, in the same amount that would have been paid by the home province.” This statement reflects which principle of the Canada Health Act (1984)? a. Portability. b. Universality. c. Public administration. d. Accessibility. ANS: A This statement describes the principle of portability. The principle of universality means that 100% of the insured persons of a province are covered by the health care plan. The principle of public administration means that the health care plan must be administered and operated on a nonprofit basis by a public authority, responsible to the provincial government and subject to audits of its accounts and financing transactions. The principle of accessibility means that the health care plan of a province must provide for (1) insured health services and reasonable access by insured persons; (2) reasonable compensation to physicians and dentists for all insured services rendered; and (3) payments to hospitals in regard to the cost of insured health services.DIF: Understand REF: 21, Table 2-1 OBJ: Identify and define the principles of the Canada Health Act and significant legislation related to the Canadian health care system. TOP: Planning MSC: CPNRE: Foundations of Practice 17. A Canadian is explaining to a non-Canadian friend the benefits of the Canadian health care system. The Canadian discusses being able to access surgical or medical hospital-based care with no out-of-pocket charges; mentions that if he or she must travel for work to another province within Canada, he or she is still covered; and explains that it is easy to access health care services and the care received is respectful and embraces diversity. Which of the following principles of the Canada Health Act of 1984 is the Canadian describing? a. Universality, public administration, and protection. b. Comprehensiveness, public administration, and portability. c. Universality, accessibility, and protection. d. Accessibility, portability, and comprehensiveness. ANS: D The principles described by the Canadian include universality, portability, accessibility, and comprehensiveness. The ability to access surgical or medical hospital-based care with no out-of-pocket charges refers to comprehensiveness; the ability to reasonably access health care services refers to accessibility; and respectful care that embraces diversity refers to universality. Portability refers to the ability to access health care services in another province. Public administration is another principle of the Canadian Health Act but is not described by the Canadian. Protection is not a principle of the Canadian Health Act. DIF: Apply REF: 21 OBJ: Identify and define the principles of the Canada Health Act and significant legislation related to the Canadian health care system. TOP: Assessment MSC: CPNRE: Foundations of Practice