Test Bank for Stanhope and Lancaster’s Community Health Nursing in Canada,4th edition by Sandra MacDonald & Sonya (1)

TEST BANK Stanhope and Lancaster's Community Health Nursing in Canada Sandra A. MacDonald, and Sonya L. Jakubec 4th Edition extra per year? Table of Contents Chapter 01 Community Health Nursing 1 Chapter 02 The Evolution of Community Health Nursing in Canada 8 Chapter 03 Community Health Nursing in Canada-Settings, Functions, and Roles 13 Chapter 04 Health Promotion 24 Chapter 05 Evidence-Informed Practice in Community Health Nursing 30 Chapter 06 Ethics in Community Health Nursing Practice 35 Chapter 07 Diversity and Relational Practice in Community Health Nursing 43 Chapter 08 Epidemiological Applications 49 Chapter 09 Working With the Community 54 Chapter 10 Health Program Planning and Evaluation 58 Chapter 11 Working with the Individual as Client-Health and Wellness Across the Lifespan 63 Chapter 12 Working with Families 69 Chapter 13 Working with Groups, Teams, and Partners 74 Chapter 14 Indigenous Health-Working with First Nations People, Inuit, and Métis 82 Chapter 15 Working With People Who Experience Structural Vulnerabilities 86 Chapter 16 Communicable and Infectious Disease Prevention and Control 98 Chapter 17 Environmental Health 104 Chapter 18 Emergency Management and Disaster Preparedness 109 Test Bank - Stanhope and Lancaster’s Community Health Nursing in Canada, 4th Edition (MacDonald, 2022) Chapter 01: Community Health Nursing MacDonald/Jakubec: Stanhope and Lancaster's Community Health Nursing in Canada, 4th Edition MULTIPLE CHOICE 1. Which of the following best describes community health nursing? a. Giving care with a focus on the aggregate’s needs b. Giving care with a focus on the group’s needs c. Focusing on the health care of individual clients in the community d. Working with an approach of unique client care ANS: C By definition, community health nursing is the health care of individual clients in the community. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Introduction OBJ: 1.6 TOP: Safe and Effective Care Environment 2. Which of the following best describes primary health care? a. A comprehensive way to address issues of social justice b. Giving care to manage acute or chronic conditions c. Giving direct care to ill individuals within their family setting d. Having the goal of health promotion and disease prevention ANS: A By definition, primary health care is comprehensive and addresses issues of social justice and equity. Social justice in the context of health refers to ensuring fairness and equality in health services so that vulnerable individuals in society have easy access to health care. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Primary Health Care OBJ: 1.4 TOP: Health Promotion and Maintenance 3. The health of which of the following is the primary focus of public health nurses (PHNs)? a. Families b. Groups c. Individuals d. Populations ANS: D PHNs use knowledge of nursing, social sciences, and public health sciences for the promotion and protection of health and for the prevention of disease among populations. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Public Health Practice OBJ: 1.5 TOP: Health Promotion and Maintenance 4. Which change is the primary explanation for life expectancy increasing so notably since the early 1900s? a. An increase in findings from medical laboratory research 1 | P a g e b. Incredible advances in surgical techniques and procedures c. Improved sanitation and other public health activities d. Increased use of antibiotics to fight infections ANS: C Improvement in control of infectious diseases through immunizations, sanitation, and other public health activities led to the increase in life expectancy since the early 1900s. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Public Health Practice OBJ: 1.5 TOP: Health Promotion and Maintenance 5. Which community health nursing practice area receives funding from the private sector? a. Telenurses b. Corrections nurses c. Nurse entrepreneurs d. Street or outreach nurses ANS: C The nurse entrepreneur receives private funding, whereas all of the other community health nurse (CHN) roles are with provincially or federally funded positions. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Community Health Nursing Roles and Functions OBJ: 1.1 | 1.6 TOP: Safe and Effective Care Environment 6. A public health nurse (PHN) strives to prevent disease and disability, often in partnership with other community groups. Which statement is an appropriate summary of the PHN’s role? a. The PHN asks the political leaders what interventions should be chosen. b. The PHN assesses the community and decides on appropriate interventions. c. The PHN uses data from the main health care institutions in the community to determine needed health services. d. The PHN works with community members to carry out public health functions. ANS: D It is crucial that the PHN work with members of the community to carry out core public health functions. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Public Health Practice OBJ: 1.5 TOP: Health Promotion and Maintenance 7. Which of the following is used as a measurement of population health? a. Health status indicators b. The levels of prevention c. The number of memberships at the local fitness centre d. Reported provincial alcohol and tobacco sales in any given month ANS: A Population health refers to the health outcomes of a population as measured by determinants of health and health outcomes. 2 | P a g e PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Populations and Aggregates OBJ: 1.2 TOP: Health Promotion and Maintenance 8. A registered nurse (RN), has just been employed as a community health nurse (CHN). Which question would be most relevant to practice as the nurse begins her position? a. “Which community groups are at greatest risk for problems?” b. “Which patients should I see first as I begin my day?” c. “With which physicians will I be collaborating most closely?” d. “Who is the nursing assistant to whom I can refer patients?” ANS: A CHNs apply the nursing process to the entire community; asking which groups are at greatest risk reflects a community-oriented perspective. The other possible responses focus on particular individuals. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Populations and Aggregates OBJ: 1.6 TOP: Health Promotion and Maintenance 9. The community health nurse (CHN) who is working with women at the senior citizens’ centre reminds them that the only way the centre will be able to afford a driver and a van service for those who cannot drive themselves is to continue to write letters to their local city council representatives, requesting funding for such a service. What is the CHN doing? a. Ensuring that the women do not expect the CHN herself to do anything about their problem b. Demonstrating that she understands the women’s concerns and needs c. Expressing empathy, support, and concern d. Helping the women engage in political action locally ANS: D CHNs have an imperative to work with the members of the community to carry out public health functions such as political action. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Public Health Practice OBJ: 1.5 | 1.6 TOP: Safe and Effective Care Environment 10. Which activity is an example of the “advocate” role of the community health nurse? a. Organizing home care support for a newly discharged older client b. Acting as a member of a community action group for provision of accessible transit choices c. Doing prenatal assessments d. Facilitating a self-help group for smoking cessation ANS: B An advocate provides a voice to client concerns when acting as a member of a community action group for provision of accessible transit choices. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Community Health Nursing Roles and Functions OBJ: 1.6 TOP: Safe and Effective Care Environment 3 | P a g e 11. In which scenario is the public health nurse (PHN) most comprehensively practising interprofessional collaboration? a. The PHN meets with several groups about community recreation issues. b. The PHN spends the day attending meetings at various health agencies. c. The PHN talks to several people about their particular health concerns. d. The PHN watches television, including a telecast of a city council meeting on the local cable station. ANS: B Any of these might represent a public health nurse (PHN) communicating, cooperating, or collaborating with community residents or groups about health concerns. However, the PHN who spends the day attending meetings at various health agencies is most comprehensively fulfilling requirements effectively, since health is broader than recreation, individual concerns are not as important as aggregate priorities, and watching television is only one-way communication. PTS: 1 DIF: Cognitive Level: Synthesis/Synthesize REF: Collaborating in Interprofessional Teams OBJ: 1.5 TOP: Safe and Effective Care Environment 12. A community health nurse (CHN) often has to make resource allocation decisions. In such cases, which approach will most help the CHN to arrive at the decision? a. Choosing a moral or ethical principle b. Choosing the cheapest, most economical approach c. Choosing the most rational outcome d. Choosing the needs of the aggregate, rather than the needs of a few individuals ANS: D Although all of the answers represent components of the CHN’s decision-making process, the predominant needs of the population outweigh the expressed needs of one person or a few people. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Social Justice OBJ: 1.3 TOP: Safe and Effective Care Environment 13. Which situation most closely represents the focus of public health nursing? a. Assessing the services and effectiveness of the school health clinic b. Caring for patients after their outpatient surgeries c. Giving care to schoolchildren at the school clinic and to the children’s families d. Treating pediatric patients at an outpatient clinic ANS: A A public health or population-focused approach would consider the entire group of children receiving care, to see if services are effective in achieving the goal of improving the health of the school population. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Community Health Nursing Roles and Functions OBJ: 1.5 TOP: Health Promotion and Maintenance 4 | P a g e 14. Which public health service best represents primary prevention? a. Developing a health education program about the dangers of smoking b. Providing a diabetes clinic for adults in low-income neighbourhoods c. Providing an influenza vaccination program in a community retirement village d. Teaching school-aged children about the positive effects of exercise ANS: C Although all the services listed are appropriate and valuable, providing influenza vaccines to healthy adults represents the primary level of health prevention. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Principles of Public Health Practice: Levels of Intervention and Prevention OBJ: 1.5 TOP: Health Promotion and Maintenance 15. What term is used interchangeably with the term subpopulations? a. Groups b. Aggregates c. Clients d. Communities ANS: B Generally, subpopulations are referred to as aggregates within the larger community population. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Populations and Aggregates OBJ: 1.2 TOP: Health Promotion and Maintenance 16. Which public health service best represents secondary prevention? a. Administering the influenza vaccine to a community of seniors b. Initiating an infant car seat safety screening program for parents in low-income housing c. Starting a rehabilitation clinic for middle-aged adults residing in low-income housing d. Setting up a support group for teenage mothers of infants with Down syndrome ANS: B Secondary prevention seeks to detect disease early in its progression—for example, through mass screening programs. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Principles of Public Health Practice: Levels of Intervention and Prevention OBJ: 1.5 TOP: Health Promotion and Maintenance 17. Which type of thinking is most reflective of looking at a macroscopic, big-picture population focus? a. Collaborative thinking b. Upstream thinking c. Holistic thinking d. Downstream thinking ANS: B 5 | P a g e Upstream thinking uses a macroscopic, big-picture population focus, whereas downstream thinking is a microscopic, individual curative focus. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Principles of Public Health Practice: Levels of Intervention and Prevention OBJ: 1.5 TOP: Health Promotion and Maintenance 18. Which is a requirement for reaching the goal of “health for all”? a. Self-actualization b. A system for health c. Elimination of lower- and upper-class categories d. Total compliance with immunizations and vaccines with all groups ANS: B The requirements identified to reach the “health for all” goal include (1) basic needs, (2) belonging and engagement, (3) healthy living, and (4) a system for health. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Public Health Practice OBJ: 1.2 TOP: Safe and Effective Care Environment 19. Which is the simplest definition of primary health care? a. It is based on a multidisciplinary group of health care providers working as a team. b. It provides essential care that is universally accessible to persons in a community and encourages self-management, self-reliance, and competence. c. It focuses on health promotion and disease prevention among those who can afford to engage in behaviours that facilitate them. d. It is based on local efforts to meet the Declaration of Alma-Ata, known as Health for All. ANS: B Primary health care is generally defined as essential care made universally accessible to individuals and families in a community with their full participation and at a cost that the community can afford. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Primary Health Care OBJ: 1.4 TOP: Safe and Effective Care Environment 20. Which public health service best represents primary prevention? a. Administering the influenza vaccine to a group of seniors b. Initiating an infant car seat safety screening program for parents in low-income housing c. Starting a rehabilitation clinic for middle-aged adults who reside in low-income housing d. Setting up a blood pressure screening clinic at the local mall ANS: A Primary prevention activities seek to prevent the occurrence of a disease (based on the natural history of a disease) or an injury. PTS: 1 DIF: Cognitive Level: Application/Apply 6 | P a g e REF: Principles of Public Health Practice: Levels of Intervention and Prevention OBJ: 1.5 TOP: Health Promotion and Maintenance 7 | P a g e Chapter 02: The Evolution of Community Health Nursing in Canada MacDonald/Jakubec: Stanhope and Lancaster's Community Health Nursing in Canada, 4th Edition MULTIPLE CHOICE 1. Which one of the following is a reason to study nursing history? a. To fulfill provincial/territorial nursing requirements b. To help fill up the necessary credit hours for graduation c. To meet accreditation requirements d. To understand the present and plan for tomorrow ANS: D One of the best ways to make plans for today and tomorrow is to look at the past to see what did or did not work. Lessons learned through history provide direction for current and future community health nursing practice. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Introduction OBJ: 2.1 TOP: Safe and Effective Care Environment 2. Which group was the first to establish hospitals? a. Feudal lords, to keep their peons working b. Small towns, to care for their own citizens c. The military, to enable soldiers to keep fighting d. Religious orders, to care for the sick, poor, and neglected ANS: D Historically, most people were responsible for their own health care services. However, during the Middles Ages, religious convents and monasteries established hospitals to care for the aged, disabled, orphaned, sick, poor, and neglected. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: The Global Historical Roots of Public Health OBJ: 2.1 TOP: Safe and Effective Care Environment 3. The Industrial Revolution caused earlier caregiving approaches—where care was provided by families, friends, and neighbours—to become inadequate because of constantly increasing demand. Which situation also contributed to the inadequacy of caregiving approaches at this time? a. Ongoing wars, which caused frequent deaths and injuries b. Horrific plagues that swept through Europe c. Migration and urbanization d. The need to pay caregivers ANS: C Older forms of care became inadequate because of the social changes in Europe, with great advances in transportation, communication, and other technologies. Increased mobility led to increased demand for health care, migration, and urbanization. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: The Global Historical Roots of Public Health OBJ: 2.1 8 | P a g e TOP: Safe and Effective Care Environment 4. Which event most notably changed health care? a. The creation of the discipline of nursing by Florence Nightingale b. The formation of sisterhoods by nuns who gave care c. The establishment of the Sisters of Mercy in Dublin d. The formation of the Dames de la Charité by Saint Vincent de Paul ANS: A Many innovations in health care led to improvements in care, but Florence Nightingale revolutionized health care by establishing the discipline of nursing. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Evidence Informed Practice box OBJ: 2.1 TOP: Safe and Effective Care Environment 5. Eunice Dyke was a public health nursing pioneer in Canada. In which area did she play a key role at the beginning of the twentieth century? a. Decentralization of public health nursing b. Specialization of public health nursing c. Inclusion of powerful citizens on health department boards to ensure adequate funds to pay for care d. Development of a system for accurate records of births and deaths ANS: A Eunice Dyke played a key role in the decentralization of public health nursing in 1914. Before this time, public health nurses (PHNs) had been working in specialized areas of nursing, such as tuberculosis (TB) care, but now they became generalists (though they did not provide bedside nursing care in the home as community health nurses [CHNs] or visiting nurses would). PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Eunice Dyke OBJ: 2.2 TOP: Safe and Effective Care Environment 6. Which was a very important factor in the success of early visiting nurses? a. The care they provided that served as a model for all later hospitals b. The more economical care they provided to families c. Their role model, Edna Moore d. The superb publicity campaign that was created by the health departments ANS: B Visiting nurses, who provided care wherever the client was located—at home, work, or school— took care of several families in one day (rather than taking care of only one patient or family as the private duty nurse did), which made their care more economical. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: The Late 1800s to the Early 1900s OBJ: 2.2 TOP: Safe and Effective Care Environment 7. Which public health nurse leader was instrumental in establishing the first integrated basic nursing degree program in Canada? a. Florence Nightingale 9 | P a g e b. Kathleen Russell c. Edna Moore d. Lillian Wald ANS: B In 1920, Kathleen Russell, Director of the Department of Public Health Nursing at the University of Toronto, was instrumental in establishing the first integrated basic degree nursing program, a major milestone in nursing education, including public health nursing education. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Post–World War I: 1918 to the Early 1940s OBJ: 2.2 TOP: Safe and Effective Care Environment 8. Which argument was used to convince the Metropolitan Life Insurance Company to establish the first community health nursing program for workers in 1909? a. Creating such a service was the morally right thing to do. b. Employing nurses directly would be less expensive than paying taxes to the city to provide nursing services. c. Having the company’s nurses make home visits would increase morale among workers. d. Using PHNs would keep workers healthier, which would increase worker productivity. ANS: D Lillian Wald argued that it would be more economical to use the services of a PHN than to employ the company’s own nurses and that keeping workers healthier would increase their productivity. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Lillian Wald OBJ: 2.2 TOP: Safe and Effective Care Environment 9. What is the main achievement of the Community Health Nurses Association of Canada (CHNAC)? a. Licensed practical nurses (LPNs) as well as registered nurses (RNs) were allowed to join the association. b. Nurses who were not PHNs were encouraged to join. c. National standards of practice were developed. d. A process was developed to choose the organization’s leaders and officers. ANS: C In 1987, the CHNAC, an interest group of the Canadian Nurses Association (CNA), was formed. This association developed the national standards of practice (published in 2003) for CHNs. These standards of practice have helped establish the term community health nursing as the umbrella term for all nurses working in and with communities and defined the minimum scope of practice for CHNs. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: 2000 to the Present OBJ: 2.3 TOP: Safe and Effective Care Environment 10 | P a g e 10. Following the release of the Romanow Report in 2002, which type of care was identified as the most rapidly growing area of community health care? a. Home care b. Community problems c. Immunization d. Women’s issues ANS: A The Romanow Report (2002) identified home care as the most rapidly growing area of community health care. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: 2000 to the Present OBJ: 2.3 TOP: Safe and Effective Care Environment 11. In which practice area were the first public health nurses (PHNs) in Canada employed? a. Healthy baby clinics b. Outpost nursing c. School health programs d. Tuberculosis education, prevention, and treatment ANS: D From the 1920s to the 1940s, nurses specializing in tuberculosis (TB) care were replaced by PHNs, as it was believed that visiting nurses would be more effective and efficient if they moved to general nursing care. Therefore, PHNs became specialists in TB education, prevention, and treatment. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Post–World War I: 1918 to the Early 1940s OBJ: 2.3 TOP: Safe and Effective Care Environment 12. What was the main reason for the brief existence of the nurse practitioner–model educational program? a. Inadequate assessment and planning in the local area b. Insufficient provincial/territorial funding c. The large number of primary care physicians practising in urban areas d. The need for nursing expertise and skills in other practice settings ANS: C In Ontario, the nurse practitioner model for alternative health care delivery was initiated with the educational program offered by McMaster University. However, its existence was short-lived because of a perceived duplication of services and a lack of career opportunities for nurse practitioners, partly because there were too many primary care physicians practising in urban areas. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: 1970 to 1999 OBJ: 2.3 TOP: Safe and Effective Care Environment 13. Which was the first province in Canada to establish a public health nursing service? a. Nova Scotia b. Ontario 11 | P a g e c. British Columbia d. Manitoba ANS: D In 1917, Manitoba became the first province in Canada to establish a public health nursing service. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Kate Brighty Colley OBJ: 2.3 TOP: Safe and Effective Care Environment 12 | P a g e Chapter 03: Community Health Nursing in Canada: Settings, Functions, and Roles MacDonald/Jakubec: Stanhope and Lancaster's Community Health Nursing in Canada, 4th Edition MULTIPLE CHOICE 1. Which statement best describes the concept of public health? a. A population health approach designed to prevent disease, promote health, and protect populations b. Health care provision offered in primary and secondary institutions or in clients’ homes c. Provision of health care services in institutions located in the community but outside the hospital d. Use of the nursing process and evidence-informed practice to meet the objectives for community health improvement ANS: A In Canada, public health takes a population health approach to protecting and promoting health and preventing disease for all Canadians. Public health nurses (PHNs) work with many partners, both within the public health unit or health authority (e.g., nutritionists, epidemiologists, dental hygienists, health inspectors) and external to the health unit (e.g., community coalitions for heart health, cancer screening, diabetes, and obesity prevention; school and hospital administrators; regional planners; social service and child-care workers; lobbyists for health issues such as antismoking legislation and homelessness). PTS: 1 DIF: Cognitive Level: Comprehension/Understand REF: The Public Health Nurse OBJ: 3.10 TOP: Health Promotion and Maintenance 2. The increasing complexity of societal needs and rapid changes in public health no longer allow for adequate time for on-the-job training and education. As a result, what is the current minimum level of educational preparation for a public health nurse? a. Training as a registered practical nurse b. Training as a registered nurse c. A baccalaureate degree in nursing d. A master of science degree in nursing ANS: C Educational preparation for public health nurses should be at least a baccalaureate degree. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Definitions in Public Health Nursing OBJ: 3.1 TOP: Safe and Effective Care Environment 3. What is a core competency required of public health nurses (PHNs)? a. Advanced knowledge in the use of high-technology diagnostics b. Familiarity with current life-support technology c. Highly tuned skills for assessment of critically ill clients d. Skill in developing policy and planning programs to improve health 13 | P a g e ANS: D Skill in developing policy and planning programs to improve health is part of the set of core public health competencies, which are divided into the following eight domains: (1) Public Health and Nursing Sciences; (2) Assessment and Analysis; (3) Policy and Program Planning, Implementation, and Evaluation; (4) Partnerships, Collaboration, and Advocacy; (5) Diversity and Inclusiveness; (6) Communication; (7) Leadership and Professional Responsibility; and (8) Accountability. The other competencies listed are better suited to nurses who work in tertiary facilities, such as hospitals. PTS: 1 DIF: Cognitive Level: Comprehension/Understand REF: The Public Health Nurse OBJ: 3.1 TOP: Safe and Effective Care Environment 4. A health centre administrator is in the process of hiring a new community health nurse (CHN). Which statement by a potential employee would raise the greatest concern for the employer? a. “I like to be the only person working on a project because individual team members have their own ideas and plans, and the resulting debate slows progress.” b. “I prefer to work in teams because no single person has too much responsibility and the burden is shared.” c. “Teamwork is better than work done by individuals because teamwork incorporates different perspectives.” d. “Whether teamwork is better than work done by individuals depends on the nature of the work being performed.” ANS: A Working in collaborative partnerships is an essential routine function of any community health nurse. Partnerships and collaboration among groups are much more powerful in making changes than are the individual client and the CHN working separately. Part of the reason for this is that multiple perspectives are examined in the process of arriving at the best solution. PTS: 1 DIF: Cognitive Level: Analysis/Analyze REF: The Public Health Nurse OBJ: 3.4 TOP: Safe and Effective Care Environment 5. Which one of the following is a primary prevention activity for decreasing the incidence of communicable diseases? a. Identifying and treating clients in a clinic for sexually transmitted infections (STIs) b. Partnering with schoolteachers to teach handwashing to elementary school children and observe their techniques c. Providing case management services that link clients with communicable diseases to health care and community support services d. Providing directly observed therapy (DOT) to clients with active tuberculosis (TB) ANS: B An example of primary prevention is to educate daycare centres, schools, and the general community about the importance of hand hygiene to prevent transmission of communicable diseases. PTS: 1 DIF: Cognitive Level: Comprehension/Understand REF: Box: Levels of Prevention Related to Health Education OBJ: 3.3 14 | P a g e TOP: Health Promotion and Maintenance 6. What activity is the public health nurse (PHN) participating in when tracing the sexual contacts of clients with sexually transmitted infections (STIs) for potential screening purposes? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Secondary and tertiary prevention ANS: B Secondary prevention activities include contacting and tracing individuals exposed to a client with an active case of TB or an STI. Once contact has been made, the actual screening is another secondary prevention activity. PTS: 1 DIF: Cognitive Level: Comprehension/Understand REF: Box: Levels of Prevention Related to Public Health Nursing OBJ: 3.3 TOP: Health Promotion and Maintenance 7. Which community health nursing activity demonstrates tertiary prevention related to mental health? a. Disseminating information about mental health to community organizations b. Partnering with public health nurses (PHNs) for early identification of children with mental health challenges c. Providing case management services that link clients with serious mental illnesses to mental health and community support services d. Screening clients at high risk for mental disorders ANS: C An example of tertiary prevention is the provision of case management services that link clients identified with serious mental illnesses to mental health and community support services. PTS: 1 DIF: Cognitive Level: Comprehension/Understand REF: Box: Levels of Prevention Related to Health Education OBJ: 3.8 TOP: Health Promotion and Maintenance 8. Which of the following represents the main difference between parish nursing and all other fields of nursing? a. Affiliation with a church or congregation b. Incorporation of spiritual aspects into nursing care c. Provision of holistic nursing care d. Residence within the community of service ANS: A Parish nurses are found in faith congregations, including communities that serve diverse cultures. Parish nurses also serve faith communities in other countries. PTS: 1 DIF: Cognitive Level: Comprehension/Understand REF: The Parish Nurse OBJ: 3.16 TOP: Safe and Effective Care Environment 15 | P a g e 9. Which statement by a parish nurse exhibits a misunderstanding of the concept of pastoral care? a. “By working with my clients to help them identify their spiritual strengths, I am drawing on the pastoral care aspects of practice.” b. “I incorporate pastoral care in my practice when I involve the pastor in ministering to the members of the congregation.” c. “I am practising pastoral care when I emphasize the spiritual dimension of nursing while providing care.” d. “Lending support to clients during their times of joy as well as times of sorrow is part of providing pastoral care.” ANS: B Pastoral care by a parish nurse implies providing care by stressing the spiritual dimension of nursing, lending support during times of joy and sorrow, guiding the person through health and illness throughout life, and helping identify the spiritual strengths that assist in coping with particular events. The parish nurse is able to provide pastoral care; she or he does not have to involve the pastor. PTS: 1 DIF: Cognitive Level: Analysis/Analyze REF: The Parish Nurse OBJ: 3.16 TOP: Safe and Effective Care Environment 10. What is the central difference between home health care and other types of health care? a. Home health care is individualized care for the client and family. b. Home health care is provided in the client’s environment. c. Reimbursement for home health care is different from that of care provided in institutions. d. Home health care focuses on community health. ANS: B Home health care differs from other types of health care in that home health care providers practice in the client’s environment. PTS: 1 DIF: Cognitive Level: Comprehension/Understand REF: The Home Health Nurse OBJ: 3.9 TOP: Safe and Effective Care Environment 11. A community health nurse (CHN) is part of a palliative consultation team that provides care for people living on the streets, in parks, or in shelters or who are unwilling or unable to come to the clinic, hospital, or hospice to receive end of life care. How can this type of nursing service be best classified? a. Community-oriented nursing b. Home health nursing c. Outpost nursing d. Private duty nursing ANS: B Home health nursing is provided in the client’s environment, wherever that may be. “Home” may be a house, apartment, trailer, boarding and care home, shelter, car, makeshift shelter under a bridge, or cardboard box. PTS: 1 DIF: Cognitive Level: Comprehension/Understand 16 | P a g e REF: The Home Health Nurse OBJ: 3.9 TOP: Safe and Effective Care Environment 12. Which of the following is the best way for a home health nurse (HHN) to help a client who has right-sided paresis secondary to a stroke? a. Arranging for private duty nurses to assist the client with daily needs b. Assisting the client with activities of daily living (ADLs) c. Teaching self-care to the client d. Teaching the family to assist the client with ADLs ANS: C Because home health care is often intermittent, a primary objective for the HHN is to facilitate self-care. This allows clients to have some control over their lives and activities and can help prevent hopelessness and a loss of self-esteem. Although assistance may be provided occasionally, this comes after helping clients help themselves. PTS: 1 DIF: Cognitive Level: Analysis/Analyze REF: The Home Health Nurse OBJ: 3.9 TOP: Physiological Integrity 13. A home health nurse (HHN) in training states, “I don’t understand why we have to collaborate with so many other disciplines. Doesn’t this conflict with the concept of holistic nursing practice?” What would be the best response by an experienced colleague? a. “The nurse still functions holistically; however, interdisciplinary collaboration is necessary to prevent fragmentation of care.” b. “Holistic nursing is a concept applied to care in tertiary facilities such as hospitals, where materials are centrally located in one facility. In home health, this is not possible.” c. “Even though home health nursing is not as holistic as other areas of community health nursing, each discipline contributes to client needs from its special knowledge base.” d. “Yes, it does create conflict, but we as nurses are mandated to practise interdisciplinary collaboration.” ANS: A Home health nursing involves interdisciplinary care. Coordination of care provided by an interdisciplinary team is an essential indirect function of the HHN. Team conferences are an ideal time for enhancing collaboration and continuity of services for optimal client care and use of resources and services. Without effective collaboration, there would be no continuity of care and the client’s home care program would be fragmented. This does not conflict with the concept of holism, however. Holism does not require that the HHN provide all services (i.e., direct client care). Many services, such as coordination of care, provide indirect care and contribute to holistic nursing care provision. PTS: 1 DIF: Cognitive Level: Analysis/Analyze REF: The Home Health Nurse OBJ: 3.9 TOP: Safe and Effective Care Environment 14. A family member asks an home health nurse (HHN) to explain the concept of hospice care. Which action would the HHN need to include as the fundamental underlying philosophy of hospice? a. Making it possible for the client to die at home 17 | P a g e b. Ensuring that the client’s living will is honoured c. Placing experts in the position of power of attorney d. Providing respite and comfort measures before death ANS: D Hospice care refers to the delivery of palliative care to the very ill and dying, offering both respite and comfort. If the client and family agree, hospice care can be comfortably delivered at home with family involvement under the direction and supervision of health care providers, especially a home health nurse. PTS: 1 DIF: Cognitive Level: Comprehension/Understand REF: Hospice Palliative Care OBJ: 3.9 TOP: Safe and Effective Care Environment 15. In an effort to prevent drug abuse among junior high–school students, a public health nurse (PHN) has enlisted the assistance of high-school role models in the areas of both sports and scholarship for an antidrug presentation. What is the level of prevention represented by this activity? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Both primary and secondary prevention ANS: A PHNs partner with the community to develop programs in response to identified needs. Primary prevention interventions by the PHN include educating children and adolescents about the effects of illegal drugs (e.g., marijuana, cocaine, and heroin) and alcohol abuse. By educating students, the PHN helps them stay away from these harmful substances. It is not both primary and secondary because secondary prevention involves screening, which would not take place in this instance. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Box: Levels of Prevention Related to Public Health Nursing OBJ: 3.10 TOP: Health Promotion and Maintenance 16. The community health nurse (CHN) has arranged for students in all classes at the local school to receive visual acuity testing to determine if they need glasses. What is the level of prevention represented by this activity? a. Primary b. Secondary c. Tertiary d. Both primary and secondary ANS: B CHNs implement screening programs for genetic disorders or metabolic deficiencies in newborns; breast, cervical, and testicular cancers; diabetes; hypertension; and sensory impairments in children. They also ensure follow-up services for clients with positive test results. Secondary prevention involves screening children for illnesses or conditions. In this instance, visual acuity testing is being used to screen for visual problems requiring corrective lenses. PTS: 1 DIF: Cognitive Level: Application/Apply 18 | P a g e REF: Box: Levels of Prevention Related to Health Education OBJ: 3.10 TOP: Health Promotion and Maintenance 17. A community health nurse (CHN) is demonstrating the use of a peak flow meter to help children with chronic asthma recognize when they need to use a rescue inhaler. What is the level of prevention represented by this activity? a. Primary b. Secondary c. Tertiary d. Both primary and secondary ANS: C CHNs provide direct care and counselling as well as health education, and a variety of other practices for people with chronic conditions living in the community. Tertiary prevention includes caring for children with long-term health concerns, such as asthma, and disabling conditions. At first glance, this appears to have elements of primary and secondary prevention, but this is not the case because primary prevention aims at ensuring that a condition does not develop (whereas these children already have the disease). Furthermore, although the children are being taught techniques for recognizing respiratory danger, it is in the context of disease management (i.e., when to use an inhaler). PTS: 1 DIF: Cognitive Level: Analysis/Analyze REF: Box: Levels of Prevention Related to Health Education OBJ: 3.3 TOP: Health Promotion and Maintenance 18. What practice is being implemented by the occupational health nurse (OHN) who removes a foreign body from a client’s eye? a. Primary care b. Primary prevention c. Secondary prevention d. Tertiary prevention ANS: A The nurse is implementing primary care of the client. This action does not meet the criteria for injury prevention because the injury has already occurred and the OHN is providing treatment for the injury. Prevention strategies will need to follow treatment to prevent recurrence and to prevent development of secondary problems related to the foreign body. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Functions and Roles of Occupational Health Nurses OBJ: 3.1 | 3.11 TOP: Health Promotion and Maintenance 19. What practice is being implemented by the occupational health nurse (OHN) who periodically conducts spirometry testing of employees working with hazardous gases? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Tertiary care ANS: B 19 | P a g e Secondary prevention involves health surveillance and periodic screening to identify an illness at the earliest possible stage and elimination or modification of the hazard-producing situation. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Box: Levels of Prevention Related to Occupational Health Nursing OBJ: 3.11 TOP: Health Promotion and Maintenance 20. An employee in a laboratory drops a flask, resulting in the chemical splashing into her eyes. What is the agent in this scenario? a. Chemical b. Employee c. Flask d. Laboratory ANS: A The agents, or factors associated with illness and injury, comprise occupational exposures that are classified as biological and infectious, chemical, ergonomic, physical, or psychosocial hazards. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Practice Settings for Occupational Health Nurses OBJ: 3.11 TOP: Health Promotion and Maintenance 21. A hospital nurse working in employee health notes that several nurses from one unit are missing from work after having contracted a communicable disease from a client. In this scenario, what is considered to be the host? a. Each sick nurse b. The communicable disease c. The hospital d. The client ANS: A The host is described as any susceptible human being; each sick nurse represents a host within the worker population group. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Practice Settings for Occupational Health Nurses OBJ: 3.11 TOP: Health Promotion and Maintenance 22. What hazard tends to particularly affect employees who work in two-week shifts? a. Biological hazards b. Environmental hazards c. Physical hazards d. Psychosocial hazards ANS: D Psychosocial hazards are factors and situations encountered or associated with one’s job or work environment that create or potentiate stress, emotional strain, or interpersonal problems. PTS: 1 DIF: Cognitive Level: Comprehension/Understand REF: Practice Settings for Occupational Health Nurses OBJ: 3.11 20 | P a g e TOP: Psychosocial Integrity 23. What is the primary role of the forensic nurse in Canada? a. Health promoter b. Disaster planner c. Sexual assault nurse examiner (SANE) d. Outreach worker ANS: C In Canada, forensic nurses primarily work as sexual assault nurse examiners (SANEs). PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Practice Settings for Forensic Nurses OBJ: 3.15 TOP: Safe and Effective Care Environment - Management of Care 24. From which health care professional is a rural resident with asthma more likely to receive health care services? a. Allergist b. Nurse practitioner c. Pediatrician d. Pulmonologist ANS: B In rural communities, often a health care professional may live and practice in a community for decades, also providing care to people who live in several other communities. A limited number of CHNs, such as PHNs or nurse practitioners, may offer a full range of services for all residents in a specified area, which may span more than 150 km. Consequently, rural physicians and CHNs provide care to individuals and families with all kinds of conditions, in all stages of life, and across several generations. In urban communities, residents are more likely to seek care from a medical specialist. PTS: 1 DIF: Cognitive Level: Comprehension/Understand REF: The Nurse Practitioner OBJ: 3.12 | 3.13 TOP: Safe and Effective Care Environment 25. In addition to the common barriers faced by most rural residents, what is an additional barrier to health care that a Mexican migrant farm worker is more likely to encounter? a. Absence of culturally appropriate care b. Availability of specialists c. Distance of health care facilities from the place of residence d. Lack of anonymity ANS: A Barriers to health care affecting all rural clients may be the availability, affordability, or accessibility of services and professionals. Two pertinent identified barriers to health care in rural areas are language barriers and lack of culturally appropriate care and services. PTS: 1 DIF: Cognitive Level: Comprehension/Understand REF: Outreach OBJ: 3.12 TOP: Psychosocial Integrity 21 | P a g e 26. For the community health nurse (CHN) who plans to move from an urban centre to a rural region of the country, which one of the following statements should be included in the advice on preparing for role alterations? a. “Community members will probably hold you in higher regard and will look up to you.” b. “Expect to have less autonomy than you have working as a CHN in the city.” c. “You can expect more resources and supplies because there are fewer clinics.” d. “You will need to focus on developing specialized knowledge and skills.” ANS: A CHNs working in rural areas have a prestigious status in the community and are viewed as role models. They have greater (not less) independence and autonomy as well as fewer (not more) resources, and they need to have more generalist (not specialized) knowledge and skills. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Definitions of Rural and Outpost Nurses OBJ: 3.12 TOP: Psychosocial Integrity 27. Which of the following primarily distinguishes case management from managed care? a. Case management is a tool for health maintenance organizations. b. Case management is targeted toward a specific segment of the population. c. Case management is implemented with individual clients. d. Case management is used to monitor the health status, resources, and outcomes for an aggregate. ANS: C Case management, in contrast to managed care, comprises activities implemented with individual clients in the system. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Case Management OBJ: 3.8 TOP: Safe and Effective Care Environment 28. Research demonstrates that exercise is important for general wellness and weight control. The community health nurse (CHN) can use this information to implement primary prevention by doing which of the following? a. Developing individualized exercise programs for overweight children b. Drafting policy for increases in noncompetitive physical activity programs c. Monitoring body mass index in children to identify elevations before they become difficult to manage d. Notifying parents or guardians of their child’s height–weight scale in comparison with national norms ANS: B 22 | P a g e At the primary prevention level, campaigns to support regular exercise, greater emphasis on school-based physical education programs, and environmental and policy initiatives to create or enhance places for physical activity in communities can make significant contributions to improving the lifestyle of sedentary children. Developing individualized exercise programs for overweight children is an example of tertiary prevention. Monitoring body mass index in children to identify elevations before they become difficult to manage is an example of secondary prevention. Notifying parents or guardians of their child’s height–weight scale in comparison with national norms increases family awareness but does not meet the definition of a preventive measure. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Box: Levels of Prevention Related to Health Education OBJ: 3.3 TOP: Health Promotion and Maintenance 29. The ability to access, comprehend, evaluate, and communicate information as a way to promote, maintain and improve health in a variety of settings across the life-course is defined as: a. Health promotion b. Health literacy c. Health advocacy d. Health maintenance ANS: B Health literacy is a component of literacy that the CHN must assess. It is defined by the Public Health Agency of Canada as the ability to access, comprehend, evaluate and communicate information as a way to promote, maintain and improve health in a variety of settings across the life-course. Literacy assessment is a component of community health nursing. Many individuals are limited in their ability to read, write, and communicate clearly; however, being illiterate does not equate to cognitive or intellectual disability. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Literacy and Health Literacy Assessment OBJ: 3.3 TOP: Health Promotion and Maintenance 23 | P a g e Chapter 04: Health Promotion MacDonald/Jakubec: Stanhope and Lancaster's Community Health Nursing in Canada, 4th Edition MULTIPLE CHOICE 1. What is the focus of the definition of health in the Ottawa Charter on Health Promotion? a. Health is an outcome. b. Enjoying life is more important than the need to maintain one’s health. c. Health is incorporated into one’s activities of daily living. d. Health is a way to maintain a stable environment. ANS: C The Ottawa Charter definition of health is: “to reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment.” When using this definition, health is no longer viewed as an outcome (or a state to be reached); rather, health is incorporated into one’s activities of daily living. The view of health as a resource proposes that communities and individuals use this resource to manage and even change their environments. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Development of the Concept of Health OBJ: 4.1 TOP: Health Promotion and Maintenance 2. How is health promotion distinct from health protection? a. Health promotion focuses on assuring the highest possible quality in care. b. Health promotion is concerned with enabling increased control over determinants of health. c. Health promotion is the specific delivery of care by a group of health care providers. d. Health promotion includes the particular achievements of social marketing campaigns. ANS: B Whereas health protection focuses on maintenance and management of immediate health risks, health promotion is concerned with enabling increased control over determinants of health, thereby improving health outcomes. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Foundational Concepts in Health Promotion OBJ: 4.1 TOP: Health Promotion and Maintenance 3. In his document entitled Achieving Health for All: A Framework for Health Promotion, Epp supported a community and policy focus in health promotion. What did he recommend? a. Cooperating fully with the WHO member nations in implementing the plan internationally b. Denying that the goal of health is socially and economically productive lives for all citizens c. Taking actions that foster public participation d. Focusing primarily on disease prevention and health promotion in selected areas 24 | P a g e ANS: C Epp’s framework supported a community and policy focus in health promotion through fostering public participation (e.g., heart-healthy physical activity promotion initiatives), strengthening community health services (e.g., increasing community mental health services), and coordinating healthy public policy (e.g., a nationwide ban on the sale and use of baby walkers). PTS: 1 DIF: Cognitive Level: Application/Apply REF: Epp Report: A Canadian Framework for Health Promotion OBJ: 4.2 TOP: Health Promotion and Maintenance 4. Which of the following is an appropriate starting point for the application of a population health approach? a. Emergency life-saving care b. The determinants of health c. Health promotion models d. Risk management ANS: B The population health approach has, as its starting point, a focus on the determinants of health. Other starting points are also discussed but are not included in the above answer choices. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Population Health Promotion Model, Revisited OBJ: 4.2 TOP: Health Promotion and Maintenance 5. How is the contemplation stage for changing behaviour different from the precontemplation stage for changing behaviour? a. During the contemplation stage, the client does not yet intend to change his or her behaviour within the next 6 months. b. During the contemplation stage, there is a lack of readiness to change behaviour. c. During the precontemplation stage, there is a readiness to change behaviour. d. During the contemplation stage, the client is thinking about changing behaviour within the next 6 months. ANS: D In the precontemplation stage, an individual is not considering a change in behaviour within the next 6 months; there is no readiness for change. However, in the contemplation stage, an individual is starting to think about a change in behaviour within the next 6 months. PTS: 1 DIF: Cognitive Level: Application/Apply REF: Transtheoretical Model (or Stages of Change Model) OBJ: 4.3 TOP: Health Promotion and Maintenance 6. Which report introduced the concept of health promotion? a. Epp Report b. Black Report c. Lalonde Report d. WHO Commission Report on Social Determinants 25 | P a g e ANS: C In 1974 Marc Lalonde, then minister of Health and Welfare Canada, introduced the notion of health promotion nationally and internationally in the report titled A New Perspective on the Health of Canadians. The Lalonde Report initiated a shift, especially in Canada, from a primarily biomedical view of disease and health to a consideration of certain aspects of health promotion. It also increased the awareness of human biology, environment, and lifestyle as determinants of health and, therefore, as influencers of health. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Lalonde Report OBJ: 4.3 TOP: Health Promotion and Maintenance 7. What is the most important feature of the Diffusion of Innovation Theory? a. It avoids high-cost treatments and suggests cheaper alternatives. b. It gives members incentives to use only network providers. c. It shows that individuals adopt innovations at different rates. d. It advocates working with geographically based communities. ANS: C This theory shows that individuals adopt innovations at different rates. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Diffusion of Innovation Theory OBJ: 4.3 TOP: Psychosocial Integrity 8. The Canadian Community Health Nursing Standards of Practice identifies a community health nurse (CHN)’s role as advocate in creating public policy, as supporter of community action to influence public policy, and as instrument for societal change. What is an example of a healthy public policy? a. Immunizations b. Behaviour change c. Marketing materials d. Crib/bed safety initiatives for infants and young children ANS: D Examples of a healthy public policy include crib/bed safety for infants and young children, restraint use in long-term-care institutions, seatbelt use for populations, and a tobacco ban in communities. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Box 4.1: Canadian Community Health Nursing Standards of Practice OBJ: 4.4 TOP: Safe and Effective Care Environment 9. What is an example of self-efficacy? a. Attending a walk-in clinic for health care b. Allowing others’ input into one’s health decisions c. Paying for a fitness centre membership d. Making healthy food choices while grocery shopping ANS: D Self-efficacy refers to a belief that one can control one’s life and have the ability to carry out actions required to prevent disease; a specific example is making healthy food choices while grocery shopping. 26 | P a g e PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Summary of the Evolution of Health Promotion OBJ: 4.4 TOP: Psychosocial Integrity 10. Using the Community Mobilization Framework and the three health promotion community mobilization approaches, which element should be addressed first within the framework’s social planning component? a. Shifting power relationships b. Problem solving at the community level c. Community participation d. Community social concerns ANS: B The Community Mobilization Framework identifies the following three health promotion community mobilization approaches to bring about community change: 1) social planning (problem solving at the community level to deal with physical, mental, and social health concerns in the community), which is described as a task-oriented strategy that includes a health care professional as the “expert leader”; 2) locality development (community participation and cooperation to deal with community health concerns, with a focus on process, consensus, and community self-help), with the health care professional as facilitator; and 3) social action (a process with the focus on shifting power relationships and resources so that change occurs to the benefit of the disadvantaged in the community). PTS: 1 DIF: Cognitive Level: Analysis/Analyze REF: Community Mobilization Framework OBJ: 4.3 TOP: Safe and Effective Care Environment 11. Which main idea did Lalonde highlight in his report entitled A New Perspective in the Health of Canadians (1974)? a. Access to health care and cost and quality of health care b. Appropriate legislation to control health care organizations c. The influence of biology, environment, and lifestyle on good health d. Accessibility and health promotion ANS: C The Lalonde Report initiated a shift, especially in Canada, from a primarily biomedical view of disease and health to consideration of certain aspects of health promotion. The Lalonde Report increased the awareness of human biology, environment, and lifestyle as determinants of health and, therefore, as influencers of health. Lalonde urged improvements in the environment, increased knowledge in human biology, and modifications of self-imposed risks arising from individual health choices and related behaviours to increase the population health status of Canadians. PTS: 1 DIF: Cognitive Level: Synthesis/Synthesize REF: Lalonde Report OBJ: 4.3 TOP: Health Promotion and Maintenance 12. What is perhaps the most helpful idea among the unlimited suggestions for how to improve health care in Canadian communities? a. Increasing funding and personnel to advance new pharmaceutical interventions 27 | P a g e b. Increasing funding for further research into the most effective medical interventions c. Increasing technological advances to constantly improve surgical survival rates d. Involving communities in their health care and encouraging their participation in decisions about health care ANS: D The strategy of strengthening community action, as outlined in the Ottawa Charter, refers to empowering communities. It involves engaging communities from the grassroots, or “bottom up” (referred to as “locality development” as outlined by Rothman), so as to involve community members in identifying health issues and planning and initiating interventions specific to their communities. In this way, communities take ownership and have control over health issues affecting them and the health of their members. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Strengthening Community Action OBJ: 4.3 TOP: Health Promotion and Maintenance 13. Which of the following is the most important ingredient for effective community development? a. Adequate funding b. Appropriate location for the services provided c. Community participation d. Professional expertise ANS: C Community participation is absolutely essential to community development. The most effective changes come with active participation by the people who live in the community. Community development is a process whereby community members identify health concerns impacting their community that require the development of capacity-building skills to bring about a realization of the needed change, with the goal of a secure and healthy community that benefits all community members. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Strengthening Community Action OBJ: 4.5 TOP: Psychosocial Integrity 14. What is the focus of health promotion in Canada? a. Achieving consensus on community health needs b. Developing a population approach based on the determinants of health c. Dictating interventions that match the government’s identified priorities d. Promoting individual health status ANS: B In Canada, a population approach focusing on the determinants of health is the direction taken in health promotion, in contrast to the focus on promotion of individual health in some other countries, such as the United States. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Foundational Concepts in Health Promotion OBJ: 4.3 TOP: Health Promotion and Maintenance 28 | P a g e 15. Which of the following represents a set of strategies and ideas aimed at reducing harm to an individual or society by modifying harmful or hazardous behaviours that are difficult and, in some cases, impossible to prevent? a. Health promotion b. Harm reduction c. Tertiary care d. Risk avoidance ANS: B Harm reduction is a set of strategies and ideas aimed at reducing harm to an individual or society by modifying harmful or hazardous behaviours that are difficult and, in some cases, impossible to prevent. It is a movement for social justice built on a belief in and respect for the rights of people who engage in harmful or hazardous behaviours such as drug use. PTS: 1 DIF: Cognitive Level: Knowledge/Remember REF: Foundational Concepts in Health Promotion OBJ: 4.6 TOP: Health Promotion and Maintenance 29 | P a g e Chapter 05: Evidence-Informed Practice in Community Health Nursing MacDonald/Jakubec: Stanhope and Lancaster's Community Health Nursing in Canada, 4th Edition MULTIPLE CHOICE 1. What action by a nurse leader would best implement evidence-informed practice at a community nursing centre that serves a large Cuban immigrant population? a. Having university experts with cultural competency expertise review the centre’s policies b. Having weekly staff meetings for the purpose of determining which methods seem to work best when helping immigrants c. Including Cuban immigrants from the community on the centre’s advisory board d. Sending centre staff to conferences and seminars that focus on providing health care to immigrants from Spanish-speaking countries ANS: C Although all of the proposed options are good, in order to determine whether the centre’s practice is serving the needs of the population, the nurse executive will need to consult members of the population being served. This means that evidence would be applied to practice with input from the community. For example, decisions related to the services to be offered i