Test Bank for Canadian Community as Partner Theory & Multidisciplinary Practice 5th edition By Ardene R. Vollman

Test Bank for Canadian Community as Partner Theory & Multidisciplinary Practice 5th edition By Ardene R. Vollman Chapter 1, Population Health Promotion: Essentials and Essence of Practice 1. The 20th century saw numerous improvements in the health status of people in the developed world. This was primarily attributable to what phenomenon? A. Steady declines in the rate of tobacco consumption B. The development of vaccines against many communicable diseases C. Eradication of microorganisms responsible for infectious diseases D. Government policies that prioritized health promotion over disease treatment ANS: B Rationale: Health status gains in the developed world during the 20th century were a result of (1) advances in knowledge about the causes of disease, (2) development of new technologies and pharmaceuticals to treat and cure many diseases, (3) creation of vaccines and environmental solutions to prevent disease transmission and acquisition, and (4) innovations in surveillance techniques to measure health status. PTS: 1 DIF: Easy REF: Page and Header: 3, Introduction OBJ: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 2. What document is recognized as laying the foundation for the transition in the focus of Canadian health policy from disease to health? A. The Ottawa Charter for Health Promotion B. The Epp Framework (A Framework for Health Promotion) C. The WHO Declaration of Alma-Ata D. The Lalonde Report (A New Perspectives on the Health of Canadians) ANS: D Rationale: The publication in 1974 of the Lalonde Report (A New Perspective on the Health of Canadians) heralded a change in the focus of health on disease to a focus on health. The Ottawa Charter, the WHO Declaration, and the Epp Framework were each subsequent to the Lalonde Report. PTS: 1 DIF: Easy REF: Page and Header: 5, The Lalonde Report OBJ: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 3. The Lalonde Report of 1974 is recognized as one of the seminal publications that has shaped the character and direction of public health policy in Canada. What change in policy is attributed to the Lalonde Report? A. A shift from collective responsibility for the health of Canadians to an individual focus B. A change in focus from the treatment of illness to the promotion of health C. A change from private funding for health to a combination of provincial and federal funding D. A recognition of the importance of determinants of health ANS: B Rationale: The Lalonde Report is credited with initiating a change in the policy from a focus on disease to a focus on health. The report did not promote a change in funding, a change to individual responsibility, or a formal recognition of the determinants of health. PTS: 1 DIF: Easy REF: Page and Header: 5, The Lalonde Report OBJ: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 4. The publication of the World Health Organization’s Declaration of Alma-Ata is acknowledged to be a key event in the development of contemporary public health policy. The Declaration prioritized: A. collaboration among individuals and health care providers to impact health decisions. B. increased funding for the education of nurses, physicians, and allied health workers in member nations. C. cooperation between developed nations and developing nations to eradicate global health inequities. D. the removal of class-based barriers to health decision making. ANS: A Rationale: The Declaration of Alma-Ata called for health providers to work with people to assist them in making decisions about their health and how to meet health challenges in ways that are affordable, acceptable, and sustainable in the long term. It did not specifically prioritize education funding, international cooperation, or the removal of class-based barriers to health. PTS: 1 DIF: Easy REF: Page and Header: 5, Declaration of Alma-Ata OBJ: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 5. A public health worker is participating in the creation of a health promotion initiative that aims to address many of the poor health outcomes in a city’s homeless population. The success or failure of this initiative is likely to depend on what factor? A. Accessibility and the perceived credibility of the planned initiative B. The provision of incentives and immediate benefits for participants in the program C. Providing safe and supportive housing for homeless people before addressing their health needs D. Redressing the disparities based on gender, socioeconomic status, and education ANS: A Rationale: The Declaration of Alma-Ata called for health providers to work with people to assist them in making decisions about their health and how to meet health challenges in ways that are affordable, acceptable, and sustainable in the long term. In facing the health challenges posed by homelessness, it is imperative that programs, policies, and interventions ensure accessibility by the members of this population. As well, it is necessary to present initiatives in a way that promotes their credibility. Short-term benefits are not a prerequisite and the resolution of disparities and lack of housing need not precede health promotion. PTS: 1 DIF: Moderate REF: Page and Header: 5, Declaration of Alma-Ata OBJ: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze 6. Which issue is recognized as being inadequately addressed by current Canadian health policy? A. Canadians are not aware of the impact that their behaviours have on their health status. B. Utilization of the health care system is insufficient to ensure the health of the population. C. Members of disadvantaged groups are less healthy than other Canadians. D. The interests of the health care industry are at odds with the long-term health of Canadians. ANS: C Rationale: Among the major issues that are not being adequately addressed by current health policies and practices is the fact that disadvantaged groups have significantly lower life expectancy, poorer health, and a higher prevalence of disability than the average Canadian. A knowledge deficit, underutilization, and the interests of the health care industry are not noted as core problems in Canadian public health. PTS: 1 DIF: Moderate REF: Page and Header: 6, A Framework for Health Promotion in Canada OBJ: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 7. Which client typifies the health problems that began to predominate in Canada during the late 20th century? A. A young man who incurred a spinal cord injury while playing sports B. An elementary school student who developed measles because she was not vaccinated C. An older adult client who had type 2 diabetes that resulted in vascular and cardiac complications D. A child who was born HIV-positive to a mother who was an intravenous substance user ANS: C Rationale: During the late 20th century, the effects of chronic conditions such as diabetes began to overshadow other health problems such as communicable diseases and injuries. PTS: 1 DIF: Moderate REF: Page and Header: 7, A Framework for Health Promotion in Canada OBJ: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze 8. Which statement best captures the concept of population health? A. Population health is the median life expectancy within a defined group of people. B. Population health is citizens’ subjective perceptions of their physical, mental, and spiritual well-being. C. Population health is the health status of a group of individuals that is considered as a whole, coherent unit. D. Population health is the relative risk of premature death that exists within a specified group of residents. ANS: C Rationale: Population health focuses on the health status of populations, which are conceptualized as coherent entities that are not simply the sum of individuals. Components and considerations include measures such as life expectancy and health risks, but the concept supersedes these finite indicators. PTS: 1 DIF: Moderate REF: Page and Header: 12, Population Health OBJ: 6 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 9. A tobacco educator is working with a group of adults who have a history of cigarette smoking. The group comprises immigrants to Canada from an ethnic group whose members have a smoking rate higher than that of the Canadian population as a whole. Which determinant of health does not have a significant impact on the group members’ tobacco use? A. Culture B. Social environment C. Personal health practices D. Physical environment ANS: D Rationale: The influence of client’s culture, social environment (peers), and personal health practices can be seen as factors that affect his tobacco use. The client’s physical environment does not have a clear and direct bearing on this health behaviour. PTS: 1 DIF: Moderate REF: Page and Header: 12, Population Health OBJ: 5 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply 10. A community health worker is collaborating with educators and school administrators to spearhead a new program for elementary students that aims to prevent children from beginning to smoke in junior high. This effort most clearly exemplifies what element of the population health approach? A. Focusing on the health of populations B. Addressing the determinants of health C. Increasing accountability for health outcomes D. Investing upstream ANS: D Rationale: Investing upstream means directing attention at the root causes of illness and injury, rather than at the symptoms that are evident. Influencing tobacco use before it begins is an example of such upstream thinking. This does not preclude a focus on the health of populations, consideration of the determinants of health, or increased accountability, but the structure and timeline of the program is a clear example of investing upstream. PTS: 1 DIF: Moderate REF: Page and Header: 13, Population Health OBJ: 6 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze 11. Which action best demonstrates the element of collaboration in the population health approach? A. A community health worker liaises with municipal leaders and social services representatives during the planning of a program. B. A community health worker adopts a multidisciplinary approach to the provision of care in a community. C. A community health worker forms a committee of fellow community health workers when weighing the costs and benefits of a proposed program. D. A community health worker consults published evidence when planning an intervention and integrates the evidence into practice. ANS: A Rationale: Collaboration is the active engagement between and across levels and sectors. It is not synonymous with multidisciplinary care or evidence-based practice. PTS: 1 DIF: Difficult REF: Page and Header: 14, Population Health OBJ: 6 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze 12. Knowing that health is a result of a complex interplay among numerous factors, the community health worker is careful to make a distinction between risk factors and risk conditions. What factor would be considered a risk condition? A. A community hospital has been closed due to budgetary pressures and consolidation with a larger, more distant hospital. B. The community’s alcohol purchases have increased to very high levels since the loss of a key employer in the community several months ago. C. A group of local middle-aged factory workers have avoided going to their primary care providers for the past 4 years for the fear of digital rectal examinations. D. A group of women attending a community centre art class has been encouraged to increase their activity level but most women continue to maintain a sedentary lifestyle. ANS: A Rationale: Risk conditions, on the other hand, are general circumstances over which people have little or no control that are known to affect health status. Examples include the specific delivery of health care and changes that have the potential to negatively impact health. Risk factors are elements, often behaviour patterns, that tend to dispose people to poorer health and are modifiable through strategies that create individual behaviour change. PTS: 1 DIF: Moderate REF: Page and Header: 15, Population Health Promotion OBJ: 6 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze 13. Which population group is considered to be the most vulnerable in Canadian society? A. The Aboriginal population B. People who are homeless C. Female lone parenting families D. Children with chronic diseases ANS: B Rationale: People who are homeless are one of the most vulnerable population groups in society, exposed to multiple hazards in a nonsupportive environment, diminishing their ability to stay healthy or to take the necessary steps to seek the services they need to become healthy. The threats to health of the homeless population exceed those faced by nearly every other group in Canadian society. PTS: 1 DIF: Moderate REF: Page and Header: 14, Target Populations OBJ: 5 NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Remember 14. The Epp Framework (A Framework for Health Promotion) of 1986 is acknowledged as a milestone in the development of public health policy in Canada. What was the primary goal in this framework? A. Encouraging Canadians to become more aware of international health disparities B. Empowering Canadians to exercise control over and improve their own health C. Fostering a sense of pride in the health care system that Canadians created D. Promoting a reduction in known health risk factors ANS: B Rationale: The Epp Framework reaffirmed the WHO definition of health promotion as “the process of enabling people to increase control over, and to improve, their health.” The focus of the framework was not on international health disparities or promoting a sense of pride in the health care system. The framework went beyond narrow approaches such as reducing risk factors. PTS: 1 DIF: Easy REF: Page and Header: 6, A Framework for Health Promotion in Canada OBJ: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 15. One of the key mechanisms of health promotion is self-care. What is an example of this mechanism in action? A. A group of construction workers choose to pack healthy lunches to work rather than buying fast food each day. B. A community centre resolves to increase the activity level of the children by purchasing outdoor toys. C. A school participates in a regional tobacco prevention campaign. D. The leadership of a church organizes a drop-in exercise program for parishioners. ANS: A Rationale: Self-care refers to the decisions made and the behaviours practised by individuals specifically for the preservation of health. Decisions made in order to benefit others can improve public health but they are not considered to be self-care. PTS: 1 DIF: Moderate REF: Page and Header: 7, A Framework for Health Promotion in Canada OBJ: 3 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze 16. Which is an example of a limitation of the 1974 Lalonde Report (A New Perspectives on the Health of Canadians)? A. Blaming victims if they got sick or injured B. Not addressing the social conditions that affect health C. An overemphasis on lifestyle D. Focus of attention on sectors other than health ANS: A Rationale: Lalonde’s approach was directed primarily toward individuals taking control of their health, and if people got sick or injured it was assumed they had not carried out recommended health behaviours (or did not do them enough). PTS: 1 DIF: Moderate REF: Page and Header: 5, The Lalonde Report OBJ: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 17. One of the modes of collaboration is horizontal. What activity best demonstrates collaboration in action? A. A public health clinical specialist partnering with the Board of Education and Health Canada to develop recommendations for gender-safe schools B. A school nurse, environmental health officer, and a teacher engaged together in a head lice program in a local elementary school C. A sexual health nurse, the head of the Boys and Girls Club, and the Chief of Police working on a bullying prevention program for transgendered high school students D. A Medical Officer of a health region partnering with a provincial Pharmacy Association and Public Health Agency to develop guidelines for influenza immunization ANS: B Rationale: Horizontal collaboration is when partnerships are formed at the same level. The other examples have different jurisdictions in policy and enforcement and are therefore examples of vertical collaboration. PTS: 1 DIF: Moderate REF: Page and Header: 4, Introduction OBJ: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze 18. The Declaration of Alma-Ata placed the greatest emphasis on: A. prevention. B. expertise-driven programs. C. low-technology options. D. social justice. ANS: D Rationale: The Declaration focused on social justice and equity that was framed in the context of public participation and appropriate use of technology. PTS: 1 DIF: Easy REF: Page and Header: 5, Declaration of Alma-Ata OBJ: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Remember 19. The Epp Framework (A Framework for Health Promotion in Canada) of 1986 defines health promotion. Which best captures that definition? A. A person who does not have a disease, illness, or injury B. The opportunity for people to exercise control over their health C. Education programs that inform people about how to be healthy D. Individual Canadians taking responsibility for their health ANS: B Rationale: Health promotion is the process of enabling people to increase control over, and to improve, their health. PTS: 1 DIF: Moderate REF: Page and Header: 6, A Framework for Health Promotion in Canada OBJ: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 1: Population Health Promotion: Essentials and Essence of Practice KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze Chapter 2, Public Health in Canada 1. What is the best description of public health? A. The organized efforts of society to promote health and prevent disease B. The development and delivery of vaccines to prevent communicable diseases C. The work of the government to ensure the health of youth and families D. Government policies that prioritize health promotion and injury prevention ANS: A Rationale: Public health is “the science and art of promoting health, preventing disease, prolonging life and improving quality of life through the organized efforts of society” (Last, 2001, p. 145). Public health transcends the use of vaccines, government efforts, and policies. PTS: 1 DIF: Easy REF: Page and Header: 18, Introduction OBJ: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 2. What is the best description of the mission of Canada’s public health system? A. To organize societal efforts to promote health and prevent disease B. To create the societal conditions for all Canadians to be healthy C. To ensure the health of individuals such as youth D. To carry out actions that address the determinants of health ANS: B Rationale: The mission of the public health system is to help society to create the conditions in which all people can be healthy. The system does not directly create health. Addressing the determinants of health and organizing societal efforts are actions that take place within the public health system, but they are not the overall mission of the system. PTS: 1 DIF: Easy REF: Page and Header: 18, Introduction OBJ: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 3. What is the best description of the goal of Canada’s public health system? A. To organize efforts to promote Canadians’ health and prevent disease B. To create the societal conditions for all Canadians to be healthy C. To minimize health disparity and preventable death and disability for all Canadians D. To carry out actions that address the Canadian determinants of health ANS: C Rationale: The goal of public health—to minimize health disparity and preventable death and disability for all Canadians—is integral to social justice. Actions such as health promotion and addressing the determinants of health take place within the system, but they are not the ultimate goal of the system. PTS: 1 DIF: Easy REF: Page and Header: 18, Introduction OBJ: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 4. How does the Canadian public health system ensure social justice in its various activities? A. By making certain its programs are based on epidemiologic evidence B. By ensuring there is clean drinking water and safe workplaces for all Canadians C. By making sure those Canadians in the greatest need receive the most services D. By being certain that its programs address the Canadian determinants of health ANS: C Rationale: Public health is committed to social justice: the concept of a society that gives individuals and groups fair treatment and an equitable (fair) share of the benefits of society. Using a social justice perspective for public health interventions means ensuring that those in greatest need of public health services, or those most vulnerable or at risk, receive more attention. PTS: 1 DIF: Moderate REF: Page and Header: 18, Introduction OBJ: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 5. Canada’s public health history was affected by the fur trade that began in the 1600s. How did the introduction of European fur traders affect the health of the Indigenous peoples living in Canada during that time? A. The fur trade brought economic growth and wealth to the Indigenous population. B. European fur traders brought infectious diseases to Canada’s Indigenous people. C. European fur traders married Indigenous women and improved their living conditions. D. The Indigenous population began living on reserves and were protected by the government. ANS: B Rationale: The North American continent was home to Indigenous peoples for thousands of years. Beginning in the 1600s, their health, economy, and social conditions were negatively affected by European immigration. The fur trade brought with it smallpox, measles, tuberculosis, and influenza that destroyed many Indigenous lives and in some cases wiped out entire villages. The Indian Act was not created until 1876. PTS: 1 DIF: Moderate REF: Page and Header: 19, History of Public Health in Canada OBJ: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 6. Canada’s public health history was affected by cholera that arrived on ships to what was then Upper and Lower Canada in the 1830s. What was the response to the epidemic this caused? A. Over 6,000 people died from cholera in Montreal and Quebec City. B. Local boards of health were established and medical officers appointed. C. Immigrants were required to live in less crowded homes and keep the streets clean. D. Sick immigrants were quarantined on islands outside of Canadian port cities. ANS: B Rationale: Even though a quarantine station was established near Quebec City, immigrants that appeared healthy but were in fact infected with cholera had entered Lower Canada in the 1830s. The disease spread, and by the time the epidemic was over, cholera had killed about 2,300 people (10% of the population) in Quebec City and 4,000 (15% of the population) in Montreal. As cholera spread to Upper Canada, local boards of health were established and medical officers appointed to handle the epidemic; streets were cleaned of filth, pools of stagnant water were drained, and blocked sewers were cleared, particularly where poor immigrants lived in crowded housing conditions. PTS: 1 DIF: Easy REF: Page and Header: 19, History of Public Health in Canada OBJ: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 7. By the early 1860s, vaccination against smallpox became available and mandatory vaccination was introduced. How was this vaccine delivered to the Indigenous people for whom smallpox had been devastating in terms of lives lost and entire villages wiped out? A. The priests and nuns went from village to village to vaccinate children. B. The gold rush in coastal British Columbia required all miners be vaccinated. C. The Hudson’s Bay Company provided vaccinations to Indigenous people. D. Vaccinations were provided to children and families at residential schools. ANS: C Rationale: By the early 1860s, vaccination against smallpox became available, and mandatory vaccination was introduced in the colonies. In the West, the Hudson’s Bay Company provided vaccinations in an effort to protect Indigenous communities. The Gold Rush in British Columbia, however, imported smallpox that devastated the coastal people. PTS: 1 DIF: Moderate REF: Page and Header: 19, History of Public Health in Canada OBJ: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Remember 8. By the mid-1950s, the public health system was well developed in Canada. Nevertheless, there are still concerns about the health of Canadians. What are the biggest challenges that the public health system is facing today? A. Viral infections related to injectable substance abuse B. Chronic diseases and mental health issues C. Immigration and refugee health conditions D. Families who do not vaccinate their children ANS: B Rationale: New infections emerged in the form of HIV/AIDS, and the incidence of other viral infections (e.g., hepatitis C) grew along with the increasing injectable substance use in the country. Today, much as in the early days of Canada, we remain concerned about immigrant health, Aboriginal health, and the health of people living in poverty. While much of our history is linked to infectious diseases (Brunham, 2009), current and future challenges relate to chronic disease, mental health, and the determinants of health. PTS: 1 DIF: Moderate REF: Page and Header: 19 History of Public Health in Canada | Page and Header: 20, History of Public Health in Canada OBJ: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 9. The last century brought many achievements in public health in Canada in addition to vaccination and control of infectious diseases. Of these achievements, which ones best protected the health of Canadians? A. Family planning and safer workplaces B. Motor-vehicle policies and tobacco reduction C. Healthy eating and physical activity D. Universal health insurance ANS: B Rationale: Policies about drinking and driving, seat belts and child restraints, vehicle emission standards, and speed control policies have decreased motorvehicle--related deaths. Once tobacco was recognized as a health hazard, public health initiatives to reduce smoking, prevent second-hand smoke in public places, and prevent youth from starting to smoke have significantly reduced tobacco-related morbidity and mortality in Canada. PTS: 1 DIF: Moderate REF: Page and Header: 20, Public Health Achievements in the Past Century (Table 2.1) OBJ: 1 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 10. The programs, services, and institutions within Canada’s public health system are focused on prevention and promotion, and consideration of the health status and needs of the whole population. What essential functions of public health are needed to achieve these? A. Epidemiology and clinical assessment and risk assessments B. Coordination and collaboration with other sectors C. Health assessment, surveillance, disease prevention, and health promotion D. Advocacy and social marketing ANS: C Rationale: The essential functions of the public health system are population and community health assessment, surveillance, injury and disease prevention, health promotion, health protection, and emergency and disaster preparedness. PTS: 1 DIF: Moderate REF: Page and Header: 21, Public Health Achievements in the Past Century (Table 2.2) OBJ: 2 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 11. Which represents a function of emergency and disaster preparedness? A. Safe housing for people who are homeless B. Coordinating an HPV immunization program in local schools C. Advocating for the legalization of marijuana D. Influenza pandemic planning and preparation ANS: D Rationale: The essential functions of the public health system are population and community health assessment, surveillance, injury and disease prevention, health promotion, health protection, and emergency and disaster preparedness. PTS: 1 DIF: Moderate REF: Page and Header: 21, Public Health Achievements in the Past Century (Table 2.2) OBJ: 2 NAT: Client Needs: Safe and Effective Care Environment: Safety and Infection Control TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 12. While Canadians today are healthier than ever and have a longer life expectancy than previously, the risks to health have changed over the past decades. What is today’s special public health concern? A. New and reemerging infectious diseases B. The battle against youth obesity and diabetes C. Falls and other injuries in the elderly and children D. Health disparity and inequity ANS: D Rationale: Today the leading causes of disability and death for all ages are injuries and chronic diseases. Today the health system battles obesity, tobacco, diabetes, mental illness, falls in the elderly, and childhood injuries. The challenge of infectious diseases remains, however, as old foes reemerge (e.g., syphilis, tuberculosis, community waterborne disease, influenza) and new ones appear (e.g., West Nile virus, Middle Eastern respiratory syndrome [MERS], bioterrorism). Of special concern are the inequalities in life circumstances that lead certain population groups to have poorer health status than those with more advantages—this is termed health disparity. PTS: 1 DIF: Moderate REF: Page and Header: 21, Emerging Threats to the Health of Canadians OBJ: 2 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 13. Following Canada’s Severe Acute Respiratory Syndrome (SARS) outbreak in 2002, there were a number of recommendations made to improve public health capacity. Which recommendation was acted upon by the federal government? A. Create more opportunities for public health education in professional curricula. B. Create a public health agency with a chief public health officer for Canada. C. Increase funding of public health initiatives to 11.6% of Canada’s gross domestic product. D. Integrate all components of the Canadian health care system---public health, acute care, and long-term care. ANS: B Rationale: In 2004, Canada created the Public Health Agency of Canada (PHAC) separate from Health Canada and named the nation’s first Chief Public Health Officer. Masters of Public Health Schools and programs emerged after 2006. The health care system as a whole accounts for 11.6% of GDP. Health care organization is in provincial/territorial jurisdiction so only they can integrate their systems, not the federal government. PTS: 1 DIF: Moderate REF: Page and Header: 23, Key Players in Public Health in Canada OBJ: 3 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Remember 14. The Public Health Agency of Canada has recognized seven common health professionals in public health by developing discipline-specific competencies for each of them. These seven disciplines include: A. Nursing, Inspection, and Health Promotion. B. Social Work, Lactation Specialist, and Library Technician. C. Medicine, Engineering, and Waste Management. D. Nursing, Social Work, and Health Education Specialist. ANS: A Rationale: There are many other valued professionals in public health departments, including those with expertise in information management and technology, social marketing, speech--language pathology, lactation, health education, among others. In addition, many public health agencies hire others (e.g., data analysts, social workers, toxicologists, program evaluators, librarians, research coordinators) who have specific public health expertise in addition to their discipline knowledge. PTS: 1 DIF: Moderate REF: Page and Header: 25, The Intersection of Public Health and Primary Care (Tables 2.4 and 2.5) OBJ: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 15. The importance of a strong primary care system to support public health practice is well recognized. The primary care system is characterized as the key to manage public health service demand. What is the primary care system’s contribution to the health of Canadians? A. Direct and continuing care for clients B. Responding to unmet public health service needs C. Integration with home care, long-term care, and acute care facilities D. Twenty-four hour, seven days a week access to care for clients ANS: A Rationale: Two key general characteristics of the public health contributions are provision of the systems or programmatic elements and response to unmet service needs, while for primary care it is the direct and continuing contact with clients. PTS: 1 DIF: Moderate REF: Page and Header: 26, The Intersection of Public Health and Primary Care (Table 2.6) OBJ: 3 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply 16. Thoughtful collaboration between the public health system and primary care has potential benefit across which area? A. Maternal--child health and communicable disease prevention B. Improvements in public health system efficiency and effectiveness C. Reduction of injectable substance abuse and prevention of blood-borne diseases D. Decline in morbidity and mortality due to cardiovascular disease and stroke ANS: A Rationale: Valaitis (2012) found evidence of benefit across a number of areas including maternal--child programs, communicable disease prevention and control, health promotion and health protection, chronic disease prevention and management, youth health, women’s health, and working with vulnerable populations. Primary care and public health collaboration is an emerging area of research that should bear fruit in terms of improvements in overall health system efficiency and health equity. PTS: 1 DIF: Moderate REF: Page and Header: 26, The Intersection of Public Health and Primary Care (Table 2.6) OBJ: 3 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply 17. There are six key functions of the public health system. Which describes the specific outcomes of population and community health assessment? A. Surveillance reports B. Targeted services C. Safe environments D. Strong communities ANS: B Rationale: Population and community health assessment involves describing and understanding people, factors that determine health, and the distribution of wealth, health, and risk factors across geographic areas and population segments. The outcomes of this include better targeted services and healthy public policies. PTS: 1 DIF: Moderate REF: Page and Header: 21, Public Health Achievements in the Past Century (Table 2.2) OBJ: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 18. There are six key functions of the public health system. Which describes the outcomes of surveillance? A. Program planning and support B. Healthy public policies C. Healthy lifestyle promotion D. Intersectoral collaboration ANS: A Rationale: Surveillance provides the basis for program support and anticipatory planning. Healthy public policies come from assessment and health promotion actions. Injury and disease prevention promote healthy lifestyle choices. Intersectoral collaboration is required to plan effectively for disaster and emergency response. PTS: 1 DIF: Moderate REF: Page and Header: 21, Public Health Achievements in the Past Century (Table 2.2) OBJ: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 19. Universal programs for income maintenance, social welfare services, and health care services have helped Canadians maintain a high standard of living and of health. What describes a universal program? A. Benefits awarded to certain Canadian seniors, for example, Guaranteed Income Supplement B. Benefits awarded to all Canadian children in the form of social welfare assistance C. Benefits awarded to low-income Canadian Armed Forces veterans who are disabled D. Benefits awarded to Canadians without reference to their assets or income level ANS: D Rationale: The term “universal” generally applies to benefits that are awarded without reference to the recipient’s income or assets. PTS: 1 DIF: Moderate REF: Page and Header: 20, Public Health Achievements in the Past Century (Table 2.1) OBJ: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 20. Universal programs for income maintenance, social welfare services, and health care services have helped Canadians maintain a high standard of living and of health. What describes a targeted program? A. A social housing project to shelter vulnerable people who do not have a place to live B. A program to prevent exposure to second-hand smoke in public places C. Annual immunization against influenza free to all Canadians D. Speed restrictions for transport trucks on the Trans-Canada Highway ANS: A Rationale: The term “universal” generally applies to benefits that are awarded without reference to the recipient’s income or assets. Social housing is targeted to people who cannot afford housing and are experiencing homelessness. Second-hand smoke prevention is universal in that it is in public places. Annual flu shots are available universally free of charge to all Canadians across the country. The Trans-Canada Highway crosses all of Canada and speed levels are universally applied. PTS: 1 DIF: Moderate REF: Page and Header: 20, Public Health Achievements in the Past Century (Table 2.1) OBJ: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 21. Women’s health advocates had long been calling for legal access to contraception and sexual health education, and in 1969 contraceptives were legalized in Canada. How did access to contraception contribute to maternal and child health? A. Allowed women to space births a healthy 2 years apart. B. Allowed teens to engage in sex without fear of becoming pregnant. C. Prevented women from feeling guilty when they used contraceptive devices illegally. D. Using contraceptive devices prevented sexually transmitted infections. ANS: A Rationale: Waiting until the mother is at least 18 years old before trying to have a child improves maternal and child health and it is healthier to wait at least 2 years after a previous birth before conceiving the next child. PTS: 1 DIF: Moderate REF: Page and Header: 20, Public Health Achievements in the Past Century (Table 2.1) OBJ: 2 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 22. The community health worker who works with the residents of a low-income neighbourhood with few recreational amenities and difficult access to health and social services compared to another neighbourhood with a higher average income, good access to amenities, and understands that the residents might live with some: A. wellness disadvantages. B. health disparities. C. health flaws. D. wellness deficits. ANS: B Rationale: Inequalities in life circumstances lead certain population groups to have poorer health status than those with more advantages—this situation is termed health disparity. PTS: 1 DIF: Moderate REF: Page and Header: 22, Emerging Threats to the Health of Canadians (Box 2.1) OBJ: 2 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 2: Public Health in Canada KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand Chapter 3, Ethical Practice in Community Health 1. Which statement best reflects the ethical principle of autonomy? A. The avoidance of harm B. The desire to act in the best interest of others C. The right of individuals to self-determination D. The recognition that every person and community has intrinsic value ANS: C Rationale: Autonomy is the right of individuals to self-determination. Nonmaleficence is the avoidance of harm. Beneficence is the desire to act in the best interest of others. Respect for people is the recognition that every person and community has intrinsic value. PTS: 1 DIF: Easy REF: Page and Header: 33, Principlism OBJ: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Remember 2. Which statement best describes distributive justice? A. The commitment to tell the truth B. The arena of reward and punishment C. The fair allocation of rights and resources D. Making promises and being steadfast in keeping them ANS: C Rationale: Distributive justice is the fair distribution of potential benefits and burdens. Compensatory justice is the arena of reward and punishment. Veracity is the commitment to tell the truth. Fidelity is being faithful in making promises and steadfast in keeping them. PTS: 1 DIF: Easy REF: Page and Header: 35, Principlism OBJ: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Remember 3. A nurse is having difficulty with the family decision for aggressive cancer therapy for an individual with metastatic lung cancer. The nurse is wondering whether the cancer treatments might be more harmful than the progression of the disease because of the dangerous side effects of chemotherapy. What ethical principle is the nurse struggling with in this situation? A. Autonomy B. Beneficence C. Justice D. Nonmaleficence ANS: D Rationale: Nonmaleficence is the avoidance of harm. Autonomy is the right of individuals to self-determination. Beneficence is the desire to act in the best interest of others. Justice is the fair distribution of rights and resources. PTS: 1 DIF: Moderate REF: Page and Header: 34, Principlism OBJ: 6 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze 4. A community health nurse has to start an IV for antibiotics on a client at home. The client has never had an IV or been in a hospital. The client asks the community health nurse whether this will be a painful procedure. The nurse tells the client the truth that it will be uncomfortable while the needle is being inserted. What ethical principle is the nurse practicing? A. Autonomy B. Fidelity C. Justice D. Veracity ANS: D Rationale: Veracity is the commitment to tell the truth. Autonomy is the right of individuals to self-determination. Fidelity is being faithful in making promises and steadfast in keeping them. Justice is the fair distribution of rights and resources. PTS: 1 DIF: Moderate REF: Page and Header: 35, Principlism OBJ: 6 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze 5. When an ethical issue arises for the community health professional, the nurse should prioritize: A. being able to analyze the ethical principles at stake at any given decisionmaking point. B. following the request of the community members exactly as they have verbalized what they want to be done in the situation. C. ensuring the community health care team takes ultimate responsibility for deciding the solution to the situation. D. remaining neutral and detaching all present beliefs when making ethical decisions. ANS: A Rationale: Conscious awareness of the risk and application of the principles of justice, both retributive and distributive, veracity, and fidelity will assist community health professionals to analyze the ethical principles at stake at any given decision-making point in their work within communities. By considering a variety of ethical theories and perspectives, including those of the community members, the health care team, and personal knowledge and beliefs, the nurse will be able to promote the overall health of the community. PTS: 1 DIF: Moderate REF: Page and Header: 31, Theoretical Foundations | Page and Header: 32, Theoretical Foundations OBJ: 6 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply 6. Following a motor vehicle accident, the wife of the victim requests that life support be continued in the absence of any brain function and that the client be allowed to go home on life support. The health care team believes that life support should be immediately discontinued and the client’s organs be donated. Which ethical principle most applies to this situation? A. Autonomy B. Fidelity C. Justice D. Veracity ANS: A Rationale: Autonomy is the right of individuals to self-determination. Fidelity is being faithful in making promises and steadfast in keeping them. Justice is the fair distribution of rights and resources. Veracity is the commitment to tell the truth. PTS: 1 DIF: Moderate REF: Page and Header: 33, Principlism OBJ: 6 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze 7. Which best describes Kantianism? A. Decisions are made on the basis of the greatest good for the greatest number. B. Actions are morally right when they are in accord with our nature and end as human beings. C. A system that allows social and economic positions to be for everyone’s advantage and open to all. D. A rule-based approach in which decisions are made by applying a set of rules of good conduct. ANS: D Rationale: Kantianism is an ethical perspective based on respect for persons and action based on moral duty or good will. Morality is ensured by following the rules and acting from good intentions. Kant’s work explored the relationship between morality and human reason, arguing that individuals can understand what is morally right through study. Therefore, Kantian theory is not concerned with human nature. Decisions made based on what will be of most benefit to the most people is characteristic of utilitarianism, which involves predicting the possible impact of one’s actions. Conversely, Kantian principles are based on universal laws, which must be applied regardless of the consequences. Social justice is the concept which strives to make social and economic opportunities open to all, and is ideologically neutral, not exclusive to any one theory or value system. PTS: 1 DIF: Easy REF: Page and Header: 32, Kantian Ethics OBJ: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 8. Which is an example of utilitarianism? A. All health professionals need to follow personal moral codes in their personal and professional life. B. Health professionals should subscribe to professional codes of ethics in their daily practice. C. All individuals in a research study have a complete understanding and informed consent of the study. D. Preventing communicable disease benefits many more people in the community than does caring for individual illnesses. ANS: D Rationale: The theory of utilitarianism maintains that one should strive to achieve the greatest good for the greatest number of people when making ethical decisions. A proponent of this theory might indeed argue that communicable disease prevention would be of greater benefit to more members of the community than caring for individual illnesses. Informed consent, as is given by the participants of the research study, is based on the principle of autonomy. Health professionals should consider a variety of ethical theories and practices when making decisions, and engage in critical thinking when examining personal moral codes or values. This is known as applied ethics. Many organizations have professional codes of ethics that outline expectations for members, which may or may not incorporate principles of utilitarianism. PTS: 1 DIF: Easy REF: Page and Header: 33, Utilitarianism OBJ: 3 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 9. Which statement best describes applied ethics? A. The creation and examination of ethical principles in isolation from specific scenarios B. Providing a lens for assessing the willingness and ability of individuals for change C. Addressing the moral character and professional identity of the health professional D. Utilizing ethical principles and theories in practice situations ANS: D Rationale: Applied ethics involve the use of ethical theory and methods of analysis to examine moral problems, practices, and policies. It is thus in contrast to ethical theory, which is detached from real-life scenarios. Applied ethics does not provide a framework for appraising an individual’s moral character or readiness to change. PTS: 1 DIF: Easy REF: Page and Header: 30, Historical Perspectives and Key Concepts OBJ: 1 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 10. Which phenomenon most contributes to the need for ethical pluralism? A. The decreasing emphasis placed on traditional concepts of moral character B. Social diversity and the presence of numerous ethnic and cultural groups in Canada C. Increasing numbers and varieties of treatment options in acute care settings D. Conflicts within the field of Canadian population health ANS: B Rationale: Diversity or pluralism of moral values and beliefs is characteristic of multicultural countries such as Canada. Ethical pluralism or moral diversity maintains the position that culturally diverse societies display multiple moral standards that may lead to conflicting moral realities. This position is not exclusive to any one field, but rather is applicable to the lived experiences of all people in a society. Emphasis on traditional concepts of moral character is a position of virtue ethics, which has in fact seen a resurgence in recent years. PTS: 1 DIF: Moderate REF: Page and Header: 31, Ethical Diversity and Ethical Practice OBJ: 2 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 11. The health care managers of a community outreach clinic are faced with some difficult decisions around potential service cutbacks in light of a reduction in provincial funding. Within the framework of utilitarian rule ethics, which consideration will be prioritized? A. Which socioeconomic groups will be most affected by any proposed change in service? B. What ethical principles are best adhered to in light of any potential program changes? C. Which of the existing programs provides the most benefit to the greatest number of residents? D. How many members of the community support or oppose any particular change in programs? ANS: C Rationale: Utilitarianism is a moral perspective based on the goal of achieving the greatest good for the greatest number of people. Weighing consequences, benefits, or detriments that result from one’s actions is instrumental in determining moral conduct and course of action. PTS: 1 DIF: Difficult REF: Page and Header: 33, Utilitarianism OBJ: 4 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply 12. A nurse who provides wound care for an older adult client in her home is faced with a conflict between the client’s autonomy and the client’s son’s belief that “someone needs to take charge to get her to take better care of herself.” In this nurse’s response to this ethical conflict, the theory of virtue ethics would prioritize what consideration? A. The nurse’s moral character B. The application of the recognized principles of ethics C. The potential impact of the client’s decisions on taxpayers and other members of the community D. The dictates of the law and the nurse’s standards of practice ANS: A Rationale: While virtue ethics does not wholly reject the significance of laws, standards of practice, and principles of ethics, the primary focus in the theory is on the moral character of the individual. PTS: 1 DIF: Difficult REF: Page and Header: 36, Virtue Ethics OBJ: 6 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply 13. The health professionals who have organized a new screening program identified a feminist ethical perspective during the conceptualization and proposal of the program. This ethical theory is premised on what key consideration? A. The moral inferiority of masculinity B. The need to promote maternalism over paternalism C. The fact that conflict is unnecessary and that peace is a realizable goal D. The importance of human connectedness and personal relationships ANS: D Rationale: Feminist ethics emphasizes an ethics of care that involves human connectedness and the importance of interpersonal relationships. It is not founded on a belief that masculinity is necessarily inferior or that maternalism is more desirable than paternalism. Feminism does not deny the reality of conflict in human relationships or in nursing practice. PTS: 1 DIF: Moderate REF: Page and Header: 37, Feminist Ethics OBJ: 6 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 14. A teenage client has confided in the community health professional that she is engaging in high-risk behaviours. This knowledge has created an ethical conflict for the health professional. An application of feminist ethics to this problem should begin with: A. identifying key community stakeholders who may assist with solutions for the problem. B. enlisting community women to inform the ethical decision-making process. C. examining the social beliefs and practices that may underlie the ethical problem. D. providing client education geared to empowering the client in her health behaviours. ANS: C Rationale: As a discipline, nursing has evolved largely from feminist ethics. Feminist ethics aim to examine the moral experience of women and advocate for social change. When health care professionals apply the theories during decision making, they first must consider the client’s social beliefs and practices to properly empathize. By considering the client’s relationships and individual, group, community, and societal levels, the health care professional in this situation may better understand the reason the client engages in these behaviors. The health care professional may then determine how best to educate the client. Seeking the help of outside parties such as community stakeholders or women in the community before fully understanding the context of the ethical problem is less likely to be helpful to the client. PTS: 1 DIF: Difficult REF: Page and Header: 36, Feminist Ethics and Ethics of Care | Page and Header: 37, Feminist Ethics and Ethics of Care OBJ: 6 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply 15. In the provision of care, a community health professional considers whether entrenched, oppressive practices may contribute to the health realities of individuals or communities. In doing so, the health professional enacts the principles of which ethical theory? A. Feminist ethics B. Rule ethics C. Virtue ethics D. Kantianism ANS: A Rationale: A primary component of feminist ethics is identifying and responding to oppressive practices. This is not a central consideration of the rule ethics schools of utilitarianism and Kantianism, nor is it a core component of virtue ethics. PTS: 1 DIF: Moderate REF: Page and Header: 37, Feminist Ethics OBJ: 6 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand 16. In the process of overhauling a community health policy, the health professionals who participated in the process were conscious of the need to ensure participation and input from individuals and groups who might not otherwise participate in high-level decision making. What concept in public health and community practice have these health professionals enacted? A. Advocacy B. Empowerment C. Autonomy D. Inclusion ANS: D Rationale: The practice of inclusion ensures an opportunity for as many people and groups as possible to fully participate in the social and economic benefits of the community or the society. Empowerment may come as a result of inclusion as a community practice, when individuals gain mastery over decisions that effect them and are motivated to participate. Advocacy is the pursuit of influencing outcomes, which the health professionals might do to influence public opinion or policy in favor of the practice of inclusion. In community practice, personal autonomy may be limited when individual choices endanger the community’s well-being. In this instance, the health professionals will seek to promote individuals’ right to self-determination as much as possible, unless their actions encroach upon the needs of others. PTS: 1 DIF: Moderate REF: Page and Header: 37, Ethical Foundations of Public Health and Community Practice OBJ: 5 NAT: Client Needs: Safe and Effective Care Environment: Management of Care TOP: Chapter 3: Ethical Practice in Community Health KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze 17. A health professional who provides care in a low-income, inner-city neighbourhood is engaged in an effort to increase the public visibility and government funding of programs that have the potential to improve health outcomes for the residents. The health professional’s efforts exemplify: A. diversity. B. advocacy. C. inclusion. D. interdependence. ANS: B Rationale: Advocacy can be defined as the act of disseminating information to influence opinion, conduct, public policy, or legislation. Diversity acknowledges the heterogeneity of communities and inclusion prioritizes high prop