Test Bank for Canadian Fundamentals of Nursing 6th WHO defines health as “. . .the extent to which an individual or group is able, on the one
Edition by Potter hand, to realize aspirations and satisfy needs; and, on the other hand, to change or cope
Chapter 01: Health and Wellness 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
Potter et al: Canadian Fundamentals of Nursing, 6th Edition
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
MULTIPLE CHOICE 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.
1. The nurse is using the population health promotion model to develop actions for Conditions of life, rather than pathological states, are what determine health.
improving health. After asking, “On what should we take action?”; “How should we take
DIF: Knowledge REF: 2
action?”; and “Why should we take action?” the nurse will ask which of the following
OBJ: Discuss ways that definitions of health have been conceptualized.
questions?
TOP: Evaluate MSC: NCLEX: Health Promotion and Maintenance
a. “With whom should we act?”
b. “When should we take action?”
4. What priority strategy for health promotion in Canada is optional but seen as important to
c. “Which government should take action?” incorporate in nursing education curricula?
d. “Where should we first act?” a. Knowledge of disease prevention.
ANS: A b. Strategies for health promotion.
The next question to ask when using the population health model approach is “With whom c. Policy advocacy.
should we act?” The other choices are not questions included in this model. d. Concepts of determinants of health.
ANS: C
DIF: Apply REF: 13 (Figure 1-5)
OBJ: Contrast distinguishing features of health promotion and disease prevention.
Increasingly, policy advocacy is incorporated into nursing role statements and nursing
TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance education curricula. Nurses should think about policies that have contributed to health
problems, policies that would help alleviate health problems, and how nurses champion
2. The principle “Health promotion is multisectoral” means which of the following? public policies. Disease prevention, health promotion, and concepts of determinants of
a. Relationships between individual, social, and environmental factors must be health are integral parts of nursing curricula.
recognized.
b. Physical, mental, social, ecological, cultural, and spiritual aspects of health must DIF: Understand REF: 11| 12
OBJ: Analyze how the nature and scope of nursing practice are influenced by different
be recognized. conceptualizations of health and health determinants. TOP: Planning
c. In order to change unhealthy living and working conditions, areas other than health
MSC: NCLEX: Health Promotion and Maintenance
must also be involved.
d. Health promotion uses knowledge from disciplines such as social, economic, 5. Which of the following is a prerequisite for health, as identified by the Ottawa Charter for
political, environmental, medical, and nursing sciences, as well as from first-hand Health Promotion?
experience. a. Education.
ANS: C b. Social support.
The statement “Health promotion is multisectoral” is the principle explained by the c. Self-esteem.
necessity to involve areas other than health in order to change unhealthy living and d. Physical environment.
working conditions. ANS: A
Education is one of the nine prerequisites for health that were identified in the Ottawa
DIF: Understand REF: 11
Charter for Health Promotion. Lack of social support and low self-esteem were identified
OBJ: Contrast distinguishing features of health promotion and disease prevention.
TOP: Planning MSC: NCLEX: Health Promotion and Maintenance as psychosocial risk factors by Labonte (1993). Dangerous physical environments were
identified as socioenvironmental risk factors by Labonte (1993).
3. According to the World Health Organization, what is the best description of “health”?
a. Simply the absence of disease. DIF: Understand REF: 4
OBJ: Discuss contributions of the following Canadian publications to conceptualizations of
b. Involving the total person and environment.
health and health determinants: Lalonde Report, Ottawa Charter, Epp Report, Strategies for
c. Strictly personal in nature. Population Health, Jakarta Declaration, Bangkok Charter, Toronto Charter. TOP: Planning
d. Status of pathological state. MSC: NCLEX: Health Promotion and Maintenance
ANS: B
,6. The determinant of health with the greatest effect on the health of Canadians is which of Tertiary prevention is provided when a defect or disability is permanent and irreversible.
the following? At this level, the hospice nurse aims to help the patient and his or her family to achieve a
a. Education. high level of function, despite the limitations caused by the patient’s illness. Teaching a
b. Health services. patient how to irrigate a new colostomy is an example of secondary prevention. If the
c. Social support networks. colostomy is to be permanent, care may later move to the tertiary level of prevention.
d. Income and social status. Providing a lesson on hygiene for an elementary school class and informing a patient
about available immunizations are examples of primary prevention.
ANS: D
Income, income distribution, and social status constitute the greatest determinant of health DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention.
because they influence most other determinants. Some investigators suggest that literacy TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance
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 9. The nurse is working on a committee to evaluate the need for increasing the levels of
quality of its health care services. Social support affects health, health behaviours, and fluoride in the drinking water of the community. In doing so, the nurse is fostering which
health care utilization but is not the greatest determinant of health. concept?
a. Anticipatory prevention.
DIF: Understand REF: 6 b. Primary prevention.
OBJ: Discuss key health determinants and their interrelationships and how they influence health. c. Secondary prevention.
TOP: Planning MSC: NCLEX: Health Promotion and Maintenance
d. Tertiary prevention.
7. A paraplegic patient in the hospital for an electrolyte imbalance is receiving care at which ANS: B
prevention level? Fluoridation of municipal drinking water and fortification of homogenized milk with
a. Primary prevention level. vitamin D are examples of primary prevention strategies. With active strategies of health
b. Secondary prevention level. promotion, individuals are motivated to adopt specific health programs such as weight
c. Tertiary prevention level. reduction and smoking cessation programs. “Anticipatory prevention” is not a known
d. Health promotion level. concept. Secondary prevention promotes early detection of disease (e.g., screening).
ANS: B
Tertiary prevention activities are initiated in the convalescence phase of disease.
The secondary prevention level focuses on early detection of disease once pathogenesis DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention.
has occurred, so that prompt treatment can be initiated to halt disease and limit disability. TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance
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 10. The nurse is working in a clinic that is designed to provide health education and
prevention level focuses on minimizing residual disability. immunizations. As such, this clinic focuses on which type of prevention?
a. Primary prevention.
DIF: Apply REF: 11 b. Secondary prevention.
OBJ: Contrast distinguishing features of health promotion and disease prevention.
c. Tertiary prevention.
TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance
d. Diagnosis and prompt intervention.
8. The nurse incorporates levels of prevention on the basis of patient needs and the type of ANS: A
nursing care provided. Which of the following is an example of tertiary level preventive Primary prevention precedes disease or dysfunction and is applied to people considered
caregiving? physically and emotionally healthy. Health promotion includes health education programs,
a. Teaching a patient how to irrigate a new temporary colostomy. immunizations, and physical and nutritional fitness activities. Secondary prevention
b. Providing a lesson on hygiene for an elementary school class. focuses on individuals who are experiencing health problems or illnesses and who are at
c. Informing a patient that immunizations for her infant are available through the risk for developing complications or worsening conditions; activities are directed at
health department. diagnosis and prompt intervention. Tertiary prevention is provided when a defect or
d. Arranging for a hospice nurse to visit with the family of a patient with cancer. disability is permanent and irreversible. It involves minimizing the effects of long-term
ANS: D 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
,11. The patient is admitted to the emergency department of the local hospital from home with
ANS: B
reports of chest discomfort and shortness of breath. She is administered oxygen and The presence of risk factors does not mean that a disease will develop, but risk factors
breathing treatments, laboratory tests and blood gas measurements are performed, and increase the chances that the individual will experience a particular disease or dysfunction.
electrocardiography is conducted. What level of preventive care is this patient receiving? Control of risk factors does not guarantee that a disease will not develop. However, risk
a. Primary prevention.
factor identification assists patients in visualizing those areas in life that can be modified
b. Secondary prevention.
or even eliminated to promote wellness and prevent illness.
c. Tertiary prevention.
d. Health promotion. DIF: Knowledge REF: 3
ANS: B OBJ: Identify factors that have led to each approach to health. TOP: Assessment
Secondary prevention focuses on individuals who are experiencing health problems or MSC: NCLEX: Health Promotion and Maintenance
illnesses and who are at risk for developing complications or worsening conditions.
14. Since the early 1990s, which group has had the highest amount of absenteeism of all
Activities are directed at diagnosis and prompt intervention. Primary prevention precedes
workers in Canada?
disease or dysfunction and is applied to people considered physically and emotionally a. “White collar sector” workers.
healthy. Health promotion includes health education programs, immunizations, and b. Nurses.
physical and nutritional fitness activities. Tertiary prevention is provided when a defect or c. Workers in the trades.
disability is permanent and irreversible. It involves minimizing the effects of long-term d. Transport and equipment operators.
disease or disability through interventions directed at preventing complications and
deterioration. ANS: B
There is considerable concern regarding negative workplace conditions in the health care
DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention. sector. Nurses have had the highest or second-highest rate of absenteeism of all workers in
TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance 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.
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 DIF: Analyze REF: 7
therapy. What are these examples of? OBJ: Analyze how the nature and scope of nursing practice are influenced by different
a. Primary prevention. conceptualizations of health and health determinants. TOP: Planning
b. Secondary prevention. MSC: NCLEX: Health Promotion and Maintenance
c. Tertiary prevention.
d. Health promotion. 15. Which of the following is a true statement about nutrition in Canada, according to the
research?
ANS: C a. Canadians have increased their total fat and salt consumption.
Tertiary prevention is provided when a defect or disability is permanent and irreversible. It b. Canadians report that their children eat the recommended daily number of fruits
involves minimizing the effects of long-term disease or disability through interventions and vegetables.
directed at preventing complications and deterioration. Secondary prevention focuses on c. Fifty percent of children aged 2 to 17 years are overweight or obese.
individuals who are experiencing health problems or illnesses, and who are at risk for d. The 2004 Canadian Community Health Survey (CCHS) revealed that 40% of adult
developing complications or worsening conditions. Activities are directed at diagnosis and Canadians were obese (body mass index of 30 or more) and 50% were overweight.
prompt intervention. Primary prevention precedes disease or dysfunction and is applied to
people considered physically and emotionally healthy. Health promotion includes health ANS: A
education programs, immunizations, and physical and nutritional fitness activities. 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
DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention. percent of children aged 4 to 8 ate fewer than the minimum servings of fruits and
TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance 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
13. Risk factors can be placed in the following interrelated categories: genetic and Canadians were obese (body mass index of 30 or more), not 40%, and 36% were
physiological factors, age, physical environment, and lifestyle. The presence of any of overweight, not 50%.
these risk factors means which of the following?
a. A person with the risk factor will get the disease. DIF: Apply REF: 8| 9
b. The chances of getting the disease are increased. OBJ: Discuss key health determinants and their interrelationships and how they influence health.
c. The disease is guaranteed not to develop if the risk factor is controlled. TOP: Planning MSC: NCLEX: Health Promotion and Maintenance
d. Risk modification will have no effect on disease prevention.
, 16. One of the five health promotion strategies, as identified by the Ottawa Charter for Health Levels of education and literacy are important influences to consider when the nurse is
Promotion, is which of the following? educating an adult patient about health promotion activities. Literacy can influence health
a. Creating supportive environments. both directly (e.g., with regard to medication use, safety practices) as well as indirectly
b. Strengthening educational opportunities. (through use of services, lifestyles, income, work environments, and stress levels).
c. Developing a medical approach. Spirituality is reflected in a person’s values and beliefs, the relationships established with
d. Minimizing stressful situations. family and friends, and the ability to find hope and meaning in life; however, these can
change throughout life; however, it is not the most important factor to consider. The nurse
ANS: A
must consider the patient’s level of growth and development when using the patient’s
“Creating supportive environments” is one of the five broad health promotion strategies
health beliefs and practices as a basis for planning care, but this is not the most important
identified by the Ottawa Charter for Health Promotion. The other strategies are building
patient factor to consider. In this case, the patient is at the adult developmental stage. The
healthy public policy, strengthening community action, developing personal skills, and
patient’s emotional wellness—degree of stress, depression, or fear, for example—can
reorienting health services. “Strengthening educational opportunities,” “Developing a
influence health beliefs and practices. The manner in which a person handles stress
medical approach,” and “Minimizing stressful situations” are not among the five
throughout each phase of life will influence the way he or she reacts to illness. However,
strategies.
this is not the best available option.
DIF: Apply REF: 11| 12
DIF: Analyze REF: 7
OBJ: Discuss contributions of the following Canadian publications to conceptualizations of
OBJ: Discuss key health determinants and their interrelationships and how they influence health.
health and health determinants: Lalonde Report, Ottawa Charter, Epp Report, Strategies for
TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance
Population Health, Jakarta Declaration, Bangkok Charter, Toronto Charter. TOP: Planning
MSC: NCLEX: Health Promotion and Maintenance
19. When discussing the effect of a known risk factor on a patient’s health, what would the
17. Which of the following is an example of tertiary prevention? nurse would say?
a. Reduction of risk factors, such as smoking. a. “It doesn’t mean that you’ll get the disease, just that the odds are greater for you.”
b. Breast self-examination and testicular self-examination. b. “Now that you know the possibility is there, you can take steps to prevent it.”
c. Cardiac rehabilitation programs. c. “This risk factor can be managed by making a change to your lifestyle.”
d. Blood pressure screening to detect hypertension. d. “You’re lucky because you have the benefit of being able to do something
about it.”
ANS: C
Tertiary prevention activities occur in the convalescence stage of disease and are directed ANS: A
toward minimizing residual disability and helping people to live productively with The presence of risk factors does not mean that a disease will develop, but risk factors
limitations. An example is a cardiac rehabilitation program after a myocardial infarction. increase the chances that the individual will experience a particular disease or dysfunction.
Breast self-examination and testicular self-examination are examples of secondary Although the statement “Now that you know the possibility is there, you can take steps to
prevention, as is blood pressure screening to detect hypertension. Reducing risk factors, prevent it” is not incorrect, it does not address the effect of the risk factor on the patient’s
such as smoking, is an example of primary prevention. 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
DIF: Understand REF: 11 OBJ: Describe the three levels of disease prevention. to do something about a risk factor minimizes the patient’s concern, and does not address
TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance the effect of the risk factor on the patient’s health.
18. When the nurse is educating an adult patient about health promotion activities, which of DIF: Apply REF: 3
the following is the most important internal patient factor for the nurse to consider? OBJ: Describe key characteristics of medical, behavioural, and socioenvironmental approaches to
a. Emotional wellness. health. TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance
b. Developmental stage.
c. Professed spirituality. MULTIPLE RESPONSE
d. Levels of education and literacy.
1. Classifications of health conceptualizations occur in which ways? (Select all that apply.)
ANS: D
a. Health as stability.
b. Health as free from illness.
c. Health as universal.
d. Health as actualization.
e. Health as individual.
Edition by Potter hand, to realize aspirations and satisfy needs; and, on the other hand, to change or cope
Chapter 01: Health and Wellness 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
Potter et al: Canadian Fundamentals of Nursing, 6th Edition
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
MULTIPLE CHOICE 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.
1. The nurse is using the population health promotion model to develop actions for Conditions of life, rather than pathological states, are what determine health.
improving health. After asking, “On what should we take action?”; “How should we take
DIF: Knowledge REF: 2
action?”; and “Why should we take action?” the nurse will ask which of the following
OBJ: Discuss ways that definitions of health have been conceptualized.
questions?
TOP: Evaluate MSC: NCLEX: Health Promotion and Maintenance
a. “With whom should we act?”
b. “When should we take action?”
4. What priority strategy for health promotion in Canada is optional but seen as important to
c. “Which government should take action?” incorporate in nursing education curricula?
d. “Where should we first act?” a. Knowledge of disease prevention.
ANS: A b. Strategies for health promotion.
The next question to ask when using the population health model approach is “With whom c. Policy advocacy.
should we act?” The other choices are not questions included in this model. d. Concepts of determinants of health.
ANS: C
DIF: Apply REF: 13 (Figure 1-5)
OBJ: Contrast distinguishing features of health promotion and disease prevention.
Increasingly, policy advocacy is incorporated into nursing role statements and nursing
TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance education curricula. Nurses should think about policies that have contributed to health
problems, policies that would help alleviate health problems, and how nurses champion
2. The principle “Health promotion is multisectoral” means which of the following? public policies. Disease prevention, health promotion, and concepts of determinants of
a. Relationships between individual, social, and environmental factors must be health are integral parts of nursing curricula.
recognized.
b. Physical, mental, social, ecological, cultural, and spiritual aspects of health must DIF: Understand REF: 11| 12
OBJ: Analyze how the nature and scope of nursing practice are influenced by different
be recognized. conceptualizations of health and health determinants. TOP: Planning
c. In order to change unhealthy living and working conditions, areas other than health
MSC: NCLEX: Health Promotion and Maintenance
must also be involved.
d. Health promotion uses knowledge from disciplines such as social, economic, 5. Which of the following is a prerequisite for health, as identified by the Ottawa Charter for
political, environmental, medical, and nursing sciences, as well as from first-hand Health Promotion?
experience. a. Education.
ANS: C b. Social support.
The statement “Health promotion is multisectoral” is the principle explained by the c. Self-esteem.
necessity to involve areas other than health in order to change unhealthy living and d. Physical environment.
working conditions. ANS: A
Education is one of the nine prerequisites for health that were identified in the Ottawa
DIF: Understand REF: 11
Charter for Health Promotion. Lack of social support and low self-esteem were identified
OBJ: Contrast distinguishing features of health promotion and disease prevention.
TOP: Planning MSC: NCLEX: Health Promotion and Maintenance as psychosocial risk factors by Labonte (1993). Dangerous physical environments were
identified as socioenvironmental risk factors by Labonte (1993).
3. According to the World Health Organization, what is the best description of “health”?
a. Simply the absence of disease. DIF: Understand REF: 4
OBJ: Discuss contributions of the following Canadian publications to conceptualizations of
b. Involving the total person and environment.
health and health determinants: Lalonde Report, Ottawa Charter, Epp Report, Strategies for
c. Strictly personal in nature. Population Health, Jakarta Declaration, Bangkok Charter, Toronto Charter. TOP: Planning
d. Status of pathological state. MSC: NCLEX: Health Promotion and Maintenance
ANS: B
,6. The determinant of health with the greatest effect on the health of Canadians is which of Tertiary prevention is provided when a defect or disability is permanent and irreversible.
the following? At this level, the hospice nurse aims to help the patient and his or her family to achieve a
a. Education. high level of function, despite the limitations caused by the patient’s illness. Teaching a
b. Health services. patient how to irrigate a new colostomy is an example of secondary prevention. If the
c. Social support networks. colostomy is to be permanent, care may later move to the tertiary level of prevention.
d. Income and social status. Providing a lesson on hygiene for an elementary school class and informing a patient
about available immunizations are examples of primary prevention.
ANS: D
Income, income distribution, and social status constitute the greatest determinant of health DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention.
because they influence most other determinants. Some investigators suggest that literacy TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance
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 9. The nurse is working on a committee to evaluate the need for increasing the levels of
quality of its health care services. Social support affects health, health behaviours, and fluoride in the drinking water of the community. In doing so, the nurse is fostering which
health care utilization but is not the greatest determinant of health. concept?
a. Anticipatory prevention.
DIF: Understand REF: 6 b. Primary prevention.
OBJ: Discuss key health determinants and their interrelationships and how they influence health. c. Secondary prevention.
TOP: Planning MSC: NCLEX: Health Promotion and Maintenance
d. Tertiary prevention.
7. A paraplegic patient in the hospital for an electrolyte imbalance is receiving care at which ANS: B
prevention level? Fluoridation of municipal drinking water and fortification of homogenized milk with
a. Primary prevention level. vitamin D are examples of primary prevention strategies. With active strategies of health
b. Secondary prevention level. promotion, individuals are motivated to adopt specific health programs such as weight
c. Tertiary prevention level. reduction and smoking cessation programs. “Anticipatory prevention” is not a known
d. Health promotion level. concept. Secondary prevention promotes early detection of disease (e.g., screening).
ANS: B
Tertiary prevention activities are initiated in the convalescence phase of disease.
The secondary prevention level focuses on early detection of disease once pathogenesis DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention.
has occurred, so that prompt treatment can be initiated to halt disease and limit disability. TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance
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 10. The nurse is working in a clinic that is designed to provide health education and
prevention level focuses on minimizing residual disability. immunizations. As such, this clinic focuses on which type of prevention?
a. Primary prevention.
DIF: Apply REF: 11 b. Secondary prevention.
OBJ: Contrast distinguishing features of health promotion and disease prevention.
c. Tertiary prevention.
TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance
d. Diagnosis and prompt intervention.
8. The nurse incorporates levels of prevention on the basis of patient needs and the type of ANS: A
nursing care provided. Which of the following is an example of tertiary level preventive Primary prevention precedes disease or dysfunction and is applied to people considered
caregiving? physically and emotionally healthy. Health promotion includes health education programs,
a. Teaching a patient how to irrigate a new temporary colostomy. immunizations, and physical and nutritional fitness activities. Secondary prevention
b. Providing a lesson on hygiene for an elementary school class. focuses on individuals who are experiencing health problems or illnesses and who are at
c. Informing a patient that immunizations for her infant are available through the risk for developing complications or worsening conditions; activities are directed at
health department. diagnosis and prompt intervention. Tertiary prevention is provided when a defect or
d. Arranging for a hospice nurse to visit with the family of a patient with cancer. disability is permanent and irreversible. It involves minimizing the effects of long-term
ANS: D 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
,11. The patient is admitted to the emergency department of the local hospital from home with
ANS: B
reports of chest discomfort and shortness of breath. She is administered oxygen and The presence of risk factors does not mean that a disease will develop, but risk factors
breathing treatments, laboratory tests and blood gas measurements are performed, and increase the chances that the individual will experience a particular disease or dysfunction.
electrocardiography is conducted. What level of preventive care is this patient receiving? Control of risk factors does not guarantee that a disease will not develop. However, risk
a. Primary prevention.
factor identification assists patients in visualizing those areas in life that can be modified
b. Secondary prevention.
or even eliminated to promote wellness and prevent illness.
c. Tertiary prevention.
d. Health promotion. DIF: Knowledge REF: 3
ANS: B OBJ: Identify factors that have led to each approach to health. TOP: Assessment
Secondary prevention focuses on individuals who are experiencing health problems or MSC: NCLEX: Health Promotion and Maintenance
illnesses and who are at risk for developing complications or worsening conditions.
14. Since the early 1990s, which group has had the highest amount of absenteeism of all
Activities are directed at diagnosis and prompt intervention. Primary prevention precedes
workers in Canada?
disease or dysfunction and is applied to people considered physically and emotionally a. “White collar sector” workers.
healthy. Health promotion includes health education programs, immunizations, and b. Nurses.
physical and nutritional fitness activities. Tertiary prevention is provided when a defect or c. Workers in the trades.
disability is permanent and irreversible. It involves minimizing the effects of long-term d. Transport and equipment operators.
disease or disability through interventions directed at preventing complications and
deterioration. ANS: B
There is considerable concern regarding negative workplace conditions in the health care
DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention. sector. Nurses have had the highest or second-highest rate of absenteeism of all workers in
TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance 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.
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 DIF: Analyze REF: 7
therapy. What are these examples of? OBJ: Analyze how the nature and scope of nursing practice are influenced by different
a. Primary prevention. conceptualizations of health and health determinants. TOP: Planning
b. Secondary prevention. MSC: NCLEX: Health Promotion and Maintenance
c. Tertiary prevention.
d. Health promotion. 15. Which of the following is a true statement about nutrition in Canada, according to the
research?
ANS: C a. Canadians have increased their total fat and salt consumption.
Tertiary prevention is provided when a defect or disability is permanent and irreversible. It b. Canadians report that their children eat the recommended daily number of fruits
involves minimizing the effects of long-term disease or disability through interventions and vegetables.
directed at preventing complications and deterioration. Secondary prevention focuses on c. Fifty percent of children aged 2 to 17 years are overweight or obese.
individuals who are experiencing health problems or illnesses, and who are at risk for d. The 2004 Canadian Community Health Survey (CCHS) revealed that 40% of adult
developing complications or worsening conditions. Activities are directed at diagnosis and Canadians were obese (body mass index of 30 or more) and 50% were overweight.
prompt intervention. Primary prevention precedes disease or dysfunction and is applied to
people considered physically and emotionally healthy. Health promotion includes health ANS: A
education programs, immunizations, and physical and nutritional fitness activities. 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
DIF: Apply REF: 11 OBJ: Discuss the three levels of disease prevention. percent of children aged 4 to 8 ate fewer than the minimum servings of fruits and
TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance 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
13. Risk factors can be placed in the following interrelated categories: genetic and Canadians were obese (body mass index of 30 or more), not 40%, and 36% were
physiological factors, age, physical environment, and lifestyle. The presence of any of overweight, not 50%.
these risk factors means which of the following?
a. A person with the risk factor will get the disease. DIF: Apply REF: 8| 9
b. The chances of getting the disease are increased. OBJ: Discuss key health determinants and their interrelationships and how they influence health.
c. The disease is guaranteed not to develop if the risk factor is controlled. TOP: Planning MSC: NCLEX: Health Promotion and Maintenance
d. Risk modification will have no effect on disease prevention.
, 16. One of the five health promotion strategies, as identified by the Ottawa Charter for Health Levels of education and literacy are important influences to consider when the nurse is
Promotion, is which of the following? educating an adult patient about health promotion activities. Literacy can influence health
a. Creating supportive environments. both directly (e.g., with regard to medication use, safety practices) as well as indirectly
b. Strengthening educational opportunities. (through use of services, lifestyles, income, work environments, and stress levels).
c. Developing a medical approach. Spirituality is reflected in a person’s values and beliefs, the relationships established with
d. Minimizing stressful situations. family and friends, and the ability to find hope and meaning in life; however, these can
change throughout life; however, it is not the most important factor to consider. The nurse
ANS: A
must consider the patient’s level of growth and development when using the patient’s
“Creating supportive environments” is one of the five broad health promotion strategies
health beliefs and practices as a basis for planning care, but this is not the most important
identified by the Ottawa Charter for Health Promotion. The other strategies are building
patient factor to consider. In this case, the patient is at the adult developmental stage. The
healthy public policy, strengthening community action, developing personal skills, and
patient’s emotional wellness—degree of stress, depression, or fear, for example—can
reorienting health services. “Strengthening educational opportunities,” “Developing a
influence health beliefs and practices. The manner in which a person handles stress
medical approach,” and “Minimizing stressful situations” are not among the five
throughout each phase of life will influence the way he or she reacts to illness. However,
strategies.
this is not the best available option.
DIF: Apply REF: 11| 12
DIF: Analyze REF: 7
OBJ: Discuss contributions of the following Canadian publications to conceptualizations of
OBJ: Discuss key health determinants and their interrelationships and how they influence health.
health and health determinants: Lalonde Report, Ottawa Charter, Epp Report, Strategies for
TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance
Population Health, Jakarta Declaration, Bangkok Charter, Toronto Charter. TOP: Planning
MSC: NCLEX: Health Promotion and Maintenance
19. When discussing the effect of a known risk factor on a patient’s health, what would the
17. Which of the following is an example of tertiary prevention? nurse would say?
a. Reduction of risk factors, such as smoking. a. “It doesn’t mean that you’ll get the disease, just that the odds are greater for you.”
b. Breast self-examination and testicular self-examination. b. “Now that you know the possibility is there, you can take steps to prevent it.”
c. Cardiac rehabilitation programs. c. “This risk factor can be managed by making a change to your lifestyle.”
d. Blood pressure screening to detect hypertension. d. “You’re lucky because you have the benefit of being able to do something
about it.”
ANS: C
Tertiary prevention activities occur in the convalescence stage of disease and are directed ANS: A
toward minimizing residual disability and helping people to live productively with The presence of risk factors does not mean that a disease will develop, but risk factors
limitations. An example is a cardiac rehabilitation program after a myocardial infarction. increase the chances that the individual will experience a particular disease or dysfunction.
Breast self-examination and testicular self-examination are examples of secondary Although the statement “Now that you know the possibility is there, you can take steps to
prevention, as is blood pressure screening to detect hypertension. Reducing risk factors, prevent it” is not incorrect, it does not address the effect of the risk factor on the patient’s
such as smoking, is an example of primary prevention. 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
DIF: Understand REF: 11 OBJ: Describe the three levels of disease prevention. to do something about a risk factor minimizes the patient’s concern, and does not address
TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance the effect of the risk factor on the patient’s health.
18. When the nurse is educating an adult patient about health promotion activities, which of DIF: Apply REF: 3
the following is the most important internal patient factor for the nurse to consider? OBJ: Describe key characteristics of medical, behavioural, and socioenvironmental approaches to
a. Emotional wellness. health. TOP: Implementation MSC: NCLEX: Health Promotion and Maintenance
b. Developmental stage.
c. Professed spirituality. MULTIPLE RESPONSE
d. Levels of education and literacy.
1. Classifications of health conceptualizations occur in which ways? (Select all that apply.)
ANS: D
a. Health as stability.
b. Health as free from illness.
c. Health as universal.
d. Health as actualization.
e. Health as individual.
