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Table of Contents
Chapter 01 Health and Wellness 2
Chapter 02 The Canadian Health Care Delivery System 11
Chapter 03 The Development of Nursing in Canada 19
Chapter 04 Community Health Nursing Practice 25
Chapter 05 Theoretical Foundations of Nursing Practice 34
Chapter 06 Evidence-Informed Practice 40
Chapter 07 Nursing Values and Ethics 48
Chapter 08 Legal Implications in Nursing Practice 56
Chapter 09 Global Health 67
Chapter 10 Indigenous Health 75
Chapter 11 Nursing Leadership, Management, and Collaborative Practice 83
Chapter 12 Critical Thinking in Nursing Practice 91
Chapter 13 Nursing Assessment, Diagnosis, and Planning 99
Chapter 14 Implementing and Evaluating Nursing Care 110
Chapter 15 Documenting and Reporting 121
Chapter 16 Nursing Informatics and Canadian Nursing Practice 135
Chapter 17 Communication and Relational Practice 142
Chapter 18 Patient-Centred Care Interprofessional Collaborative Practice 154
Chapter 19 Family Nursing 161
Chapter 20 Patient Education 175
Chapter 21 Developmental Theories 187
Chapter 22 Conception Through Adolescence 196
Chapter 23 Young to Middle Adulthood 206
Chapter 24 Older Persons 215
Chapter 25 The Experience of Loss, Death, and Grief 226
Chapter 26 Self-Concept 236
Chapter 27 Sexuality 244
Chapter 28 Spirituality in Health and Health Care 253
Chapter 29 Stress and Adaptation 261
Chapter 30 Vital Signs 269
Chapter 31 Pain Assessment and Management 286
Chapter 32 Health Assessment and Physical Examination 302
Chapter 33 Infection Control 317
Chapter 34 Medication Administration 335
Chapter 35 Complementary and Alternative Approaches in Health Care 350
Chapter 36 Activity and Exercise 358
Chapter 37 Quality and Patient Safety 370
Chapter 38 Hygiene 382
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Chapter 39 Cardiopulmonary Functioning and Oxygenation 401
Chapter 40 Fluid, Electrolyte, and Acid–Base Balances 417
Chapter 41 Sleep 433
Chapter 42 Nutrition 441
Chapter 43 Urinary Elimination 457
Chapter 44 Bowel Elimination 472
Chapter 45 Mobility and Immobility 485
Chapter 46 Skin Integrity and Wound Care 503
Chapter 47 Sensory Alterations 523
Chapter 48 Care of Surgical Patients 534
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Test Bank - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
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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Test Bank - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
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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Test Bank - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
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
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Test Bank - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
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 - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
11. 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?
a. Primary prevention.
b. Secondary prevention.
c. Tertiary prevention.
d. 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: NCLEX: Health Promotion and Maintenance
12. 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?
a. Primary prevention.
b. Secondary prevention.
c. Tertiary prevention.
d. 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: NCLEX: Health Promotion and Maintenance
13. 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. A person with the risk factor will get the disease.
b. The chances of getting the disease are increased.
c. The disease is guaranteed not to develop if the risk factor is controlled.
d. Risk modification will have no effect on disease prevention.
______________________________________________________________________________________________
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Test Bank - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
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 those 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: NCLEX: Health Promotion and Maintenance
14. Since the early 1990s, which group has had the highest amount of absenteeism of all
workers in Canada?
a. “White collar sector” workers.
b. Nurses.
c. Workers in the trades.
d. 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: NCLEX: Health Promotion and Maintenance
15. Which of the following is a true statement about nutrition in Canada, according to the
research?
a. Canadians have increased their total fat and salt consumption.
b. Canadians report that their children eat the recommended daily number of fruits
and vegetables.
c. Fifty percent of children aged 2 to 17 years are overweight or obese.
d. 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. Seventy
percent of children aged 4 to 8 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: NCLEX: Health Promotion and Maintenance
______________________________________________________________________________________________
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Test Bank - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
16. One of the five health promotion strategies, as identified by the Ottawa Charter for Health
Promotion, is which of the following?
a. Creating supportive environments.
b. Strengthening educational opportunities.
c. Developing a medical approach.
d. 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, strengthening community 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: NCLEX: Health Promotion and Maintenance
17. Which of the following is an example of tertiary prevention?
a. Reduction of risk factors, such as smoking.
b. Breast self-examination and testicular self-examination.
c. Cardiac rehabilitation programs.
d. Blood pressure screening to detect hypertension.
ANS: C
Tertiary prevention activities occur in the convalescence stage of disease and are directed
toward minimizing residual disability and helping people to 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: NCLEX: Health Promotion and Maintenance
18. 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?
a. Emotional wellness.
b. Developmental stage.
c. Professed spirituality.
d. Levels of education and literacy.
ANS: D
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Table of Contents
Chapter 01 Health and Wellness 2
Chapter 02 The Canadian Health Care Delivery System 11
Chapter 03 The Development of Nursing in Canada 19
Chapter 04 Community Health Nursing Practice 25
Chapter 05 Theoretical Foundations of Nursing Practice 34
Chapter 06 Evidence-Informed Practice 40
Chapter 07 Nursing Values and Ethics 48
Chapter 08 Legal Implications in Nursing Practice 56
Chapter 09 Global Health 67
Chapter 10 Indigenous Health 75
Chapter 11 Nursing Leadership, Management, and Collaborative Practice 83
Chapter 12 Critical Thinking in Nursing Practice 91
Chapter 13 Nursing Assessment, Diagnosis, and Planning 99
Chapter 14 Implementing and Evaluating Nursing Care 110
Chapter 15 Documenting and Reporting 121
Chapter 16 Nursing Informatics and Canadian Nursing Practice 135
Chapter 17 Communication and Relational Practice 142
Chapter 18 Patient-Centred Care Interprofessional Collaborative Practice 154
Chapter 19 Family Nursing 161
Chapter 20 Patient Education 175
Chapter 21 Developmental Theories 187
Chapter 22 Conception Through Adolescence 196
Chapter 23 Young to Middle Adulthood 206
Chapter 24 Older Persons 215
Chapter 25 The Experience of Loss, Death, and Grief 226
Chapter 26 Self-Concept 236
Chapter 27 Sexuality 244
Chapter 28 Spirituality in Health and Health Care 253
Chapter 29 Stress and Adaptation 261
Chapter 30 Vital Signs 269
Chapter 31 Pain Assessment and Management 286
Chapter 32 Health Assessment and Physical Examination 302
Chapter 33 Infection Control 317
Chapter 34 Medication Administration 335
Chapter 35 Complementary and Alternative Approaches in Health Care 350
Chapter 36 Activity and Exercise 358
Chapter 37 Quality and Patient Safety 370
Chapter 38 Hygiene 382
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Chapter 39 Cardiopulmonary Functioning and Oxygenation 401
Chapter 40 Fluid, Electrolyte, and Acid–Base Balances 417
Chapter 41 Sleep 433
Chapter 42 Nutrition 441
Chapter 43 Urinary Elimination 457
Chapter 44 Bowel Elimination 472
Chapter 45 Mobility and Immobility 485
Chapter 46 Skin Integrity and Wound Care 503
Chapter 47 Sensory Alterations 523
Chapter 48 Care of Surgical Patients 534
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______________________________________________________________________________________________
Test Bank - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
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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______________________________________________________________________________________________
Test Bank - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
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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Test Bank - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
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
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Test Bank - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
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 - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
11. 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?
a. Primary prevention.
b. Secondary prevention.
c. Tertiary prevention.
d. 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: NCLEX: Health Promotion and Maintenance
12. 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?
a. Primary prevention.
b. Secondary prevention.
c. Tertiary prevention.
d. 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: NCLEX: Health Promotion and Maintenance
13. 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. A person with the risk factor will get the disease.
b. The chances of getting the disease are increased.
c. The disease is guaranteed not to develop if the risk factor is controlled.
d. Risk modification will have no effect on disease prevention.
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Test Bank - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
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 those 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: NCLEX: Health Promotion and Maintenance
14. Since the early 1990s, which group has had the highest amount of absenteeism of all
workers in Canada?
a. “White collar sector” workers.
b. Nurses.
c. Workers in the trades.
d. 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: NCLEX: Health Promotion and Maintenance
15. Which of the following is a true statement about nutrition in Canada, according to the
research?
a. Canadians have increased their total fat and salt consumption.
b. Canadians report that their children eat the recommended daily number of fruits
and vegetables.
c. Fifty percent of children aged 2 to 17 years are overweight or obese.
d. 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. Seventy
percent of children aged 4 to 8 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: NCLEX: Health Promotion and Maintenance
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Test Bank - Canadian Fundamentals of Nursing, 6e (Potter, Perry, 2019)
16. One of the five health promotion strategies, as identified by the Ottawa Charter for Health
Promotion, is which of the following?
a. Creating supportive environments.
b. Strengthening educational opportunities.
c. Developing a medical approach.
d. 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, strengthening community 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: NCLEX: Health Promotion and Maintenance
17. Which of the following is an example of tertiary prevention?
a. Reduction of risk factors, such as smoking.
b. Breast self-examination and testicular self-examination.
c. Cardiac rehabilitation programs.
d. Blood pressure screening to detect hypertension.
ANS: C
Tertiary prevention activities occur in the convalescence stage of disease and are directed
toward minimizing residual disability and helping people to 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: NCLEX: Health Promotion and Maintenance
18. 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?
a. Emotional wellness.
b. Developmental stage.
c. Professed spirituality.
d. Levels of education and literacy.
ANS: D
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