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