Realities of Canadian Nursing: Professional, Practice, and
Power Issues
Carol McDonald, and Marjorie McIntyre
5th Edition
,Table of Contents
Chapter 01 Nursing Issues: A Call to Political Action 1
Chapter 02 Race and Racialization in Health, Healthcare, and Nursing Education 7
Chapter 03 Homelessness as a Health Equity and Social Justice Concern in Nursing 13
Chapter 04 Inviting Compassionate Conversations About End of Life: Medical Assistance
in Dying (MAiD) in Canada 19
Chapter 05 The Legacy of Colonization for the Health and Well-being of Indigenous
People: Toward Reconciliation 26
Chapter 06 Canadian Healthcare 34
Chapter 07 Canadian Nurses Association and International Council of Nurses 41
Chapter 08 Canadian Provincial and Territorial Nursing Organizations 48
Chapter 09 Canadian Federation of Nurses’ Unions: Standing for Workplace Safety 55
Chapter 10 Challenges and Change in Undergraduate Nursing Education 63
Chapter 11 Graduate Education 70
Chapter 12 The Political Nature of Knowledge Generation and Utilization: Nursing
Research in Canada 77
Chapter 13 Nursing Informatics: A Growing Field of Science and Practice 83
Chapter 14 Influencing Policy and Leading Change: Essential Steps in Successful
Transformations 90
Chapter 15 Issues in Contemporary Nursing Leadership 96
Chapter 16 The Gendered Nature of Nursing 102
Chapter 17 Issues in Interprofessional Practice 107
Chapter 18 Issues Arising from the Nature of Nurses’ Work and Work Environments 113
Chapter 19 The Nursing Shortage: Assumptions and Realities 118
Chapter 20 Rural Nursing in Canada: Issues of Access 124
Chapter 21 Ethical and Legal Issues in Nursing 130
Chapter 22 Issues in Healthcare for an Aging Population 136
Chapter 23 Orientating to Difference: Beyond Heteronormative Sexualities 142
Chapter 24 Environment: An Issue for Nurses 148
Chapter 25 Interpersonal Violence and Abuse: Ending the Silence 154
Chapter 26 Onward to 2030: Nursing’s Momentum for Global Health Equity 160
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Test Bank - Realities of Canadian Nursing: Professional, Practice, and Power Issues, 5th Edition (McDonald, 2019)
Chapter 01 Nursing Issues: A Call to Political Action
Multiple Choice
1. A nurse wishes to take political action to influence healthcare policy. How can the nurse best
take political action?
A) Begin an active letter-writing campaign to policy creators.
B) Encourage colleagues to promote quality client care.
C) Address unit-level issues to create short-term change.
D) Speak to the nursing union representative about the policy.
Ans: A
2. A nurse wants to address chronic nursing shortages in a region. In what order should the
nurse complete the steps for an inductive approach to addressing this issue?
1. Articulate the issue.
2. Analyze the issue.
3. Identify barriers to resolution.
4. Create strategies for resolution.
5. Create a lobbying approach.
A) 1,2, 3,4, 5
B) 1,5, 3,2,4
C) 2, 3, 4, 1,5
D) 2, 1,3, 4, 5
Ans: A
3. How can individual nurses best assist in the clear articulation of nursing issues?
A) Speak in unison and be collectively organized.
B) Support union activities that promote nursing's image.
C) Speak out on a wide variety of healthcare issues.
D) Write letters and lobby the government.
Ans: A
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Test Bank - Realities of Canadian Nursing: Professional, Practice, and Power Issues, 5th Edition (McDonald, 2019)
4. A nurse is concerned about the quality of education being delivered and the preparedness of
new graduate nurses. What should the nurse do first in addressing these concerns?
A) Speak to a nurse who teaches in a nursing program.
B) Investigate the issue exploring various contexts.
C) Write a letter to the Minister of Health outlining the concerns.
D) Survey other nurses to determine if they share the same concerns.
Ans: B
5. A nursing colleague tells the nurse that being politically active is not something worth the
effort since there is no extra pay for this involvement. How should the nurse respond?
A) “You could lobby for increased nursing pay and better working conditions by being
politically active, so it could pay off!”
B) “You are obligated to be politically active according to the provincial standards of practice
so you are jeopardizing your license if you are not.”
C) “Being politically active is the most effective way for nurses to address health- related issues
in a significant and lasting way.”
D) “It is up to you if you want to be involved, but money should not be a motivating factor in
how you use your time as a nurse.”
Ans: C
6. A nurse educator is creating a presentation about the nursing profession's obligation to
address social justice issues in order to promote health and well-being. What would be best for
the educator to cite in the presentation?
A) News articles about local social justice issues linked to poor health
B) First-hand accounts from people whose health has been affected by social issues
C) The official provincial/territorial Nursing College's Standards of Practice
D) Canadian Nurses Association's Code of Ethics for Registered Nurses
Ans: D
7. A group of nurses have decided to address an issue of health inequity in their community.
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What should the group's first step be?
A) Speak to those directly affected.
B) Identify the topic of interest.
C) Determine if it is a nursing issue.
D) Determine if it is a priority.
Ans: B
8. A nurse who is attempting to take political action to address the nursing shortage has been
told by a manager that the shortage exists as the direct result of provincial funding cuts. While
situating the topic, the nurse considers the information to be:
A) an assumption.
B) an opinion.
C) a fact.
D) misinformation.
Ans: A
9. A committee of nurses is engaged in addressing an important workplace issue and is
currently trying to articulate the issue. How can the nurses best meet this goal?
A) By eliciting input from outsiders.
B) By seeking legal counsel.
C) By asking “what and who” questions.
D) By identifying the barriers to change.
Ans: C
10. As nurses work to address health-related issues through political action, what advantages
should they consider when choosing an inductive over a deductive approach?
A) An inductive approach simplifies the process, allowing for timelier addressing of the issue.
B) The inductive approach enables the nurse to better understand the of the issue.
C) Inductive approaches involve an established framework with a single, clear path to follow.
D) Induction guarantees greater compliance with existing rules and norms compared to
deduction.
Ans: B
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Test Bank - Realities of Canadian Nursing: Professional, Practice, and Power Issues, 5th Edition (McDonald, 2019)
11. A nurse educator has been interviewing stakeholders who have been involved in previous
attempts to resolve a healthcare issue that has existed for decades. While gathering this
information, what should the nurse remember related to historical contexts?
A) History is a partial and incomplete interpretation.
B) History is completely subjective and unreliable.
C) The information will be most reliable if taken from a single stakeholder.
D) History recounted by individuals is far less reliable than written records.
Ans: A
12. A nurse has noticed that many of the clients in a particular area of the city have poor control
of their diabetes and suffer a disproportioned amount of complications. What area of intervention
should the nurse focus on to best address this issue?
A) Social determinants of health
B) Education of the individual clients
C) The quality of nursing care
D) Cost of medication and equipment
Ans: A
13. A nurse is exploring a critical feminist approach to an issue. Which line of inquiry should
the nurse employ?
A) How is male privilege over women contributing to this issue?
B) How do gender-related assumptions influence this issue?
C) How can resolution of this issue benefit women in society?
D) Does the prevailing attitude of women perpetuate this issue?
Ans: B
14. A political action committee made up of nurses and members of other health disciplines is
working to resolve an issue. What is most important for the committee to address prior to
devising strategies for resolution?
A) Ensuring there is a collaborative group process
B) Creating a focus for a letter campaign
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C) Creating a wide social media network
D) Identifying the barriers to resolution
Ans: D
Multiple Selection
15. In considering the importance of political action on the quality of healthcare delivered in
Canada, the nurse should prioritize what? Select all that apply.
A) Healthcare in Canada is publicly funded.
B) Educational standards are directed by public policy.
C) Legislation governs scope of healthcare practice.
D) Nursing comprises primarily female practitioners.
E) Canada is a diverse nation with a wide variety of client needs.
Ans: A, B, C
16. A nurse is investigating the social and cultural influences on a health issue affecting the
Indigenous population in a large urban setting. What questions should the nurse ask? Select all
that apply.
A) How are Indigenous residents generally depicted in local media?
B) How do the values of the dominant population align with Indigenous values?
C) What economic limitations are linked to the creation of this issue in this population?
D) What are the attitudes of the Indigenous people about the issue being investigated?
E) Who benefits from this issue not being addressed in this community?
F) How did this issue for Indigenous people originate and evolve in this community?
Ans: A, B, D
17. A nurse is performing a political analysis of the nursing shortage in Canada's northern
regions. What questions should the nurse ask? Select all that apply.
A) Who benefits from keeping the nursing shortage in place?
B) Who is currently advocating for change and who is resisting this change?
C) What are the financial implications related to the nursing shortage?
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D) Are there any hidden agendas of the stakeholders involved?
E) How does the nursing shortage compare to past nursing shortages in the area?
Ans: A, B, D
18. What should nurses do to improve the chances for the success of a lobbying campaign?
Select all that apply.
A) Research the topic thoroughly and be well informed prior to meeting with key figures.
B) Include complex statistics consisting of percentages to reduce any challenge of the data.
C) Only include members of political parties that favour the initiative being lobbied.
D) Follow up with meeting attendees with a written summary of the meeting.
E) Be aware of the meeting attendees' public position on the topic being discussed.
Ans: A, D, E
19. A group has drafted a resolution to an issue that they wish to submit to the Canadian Nurses
Association (CNA) for adoption. The group will increase the likelihood of adoption if they
adhere to what guidelines? Select all that apply.
A) Submit the resolution in writing prior to the annual general meeting.
B) Prepare an informative presentation for the group.
C) Include both a preamble and the resolution in the submission.
D) Only submit the resolution once it has the support of the provincial regulatory body.
E) Be sure the resolution advances the mission of the CNA.
Ans: A, C, E
20. A group has completed their analysis of a health issue and is planning a lobbying campaign.
What should the group employ as lobbying approaches? Select all that apply.
A) Writing letters to those who are in a position to address the issue
B) Informing the affected population via social media campaigns
C) Holding regular meetings with group members to discuss progress
D) Posting flyers in the community about the issue and the group's goals
E) Drafting appropriate resolutions for the group to present to the Canadian Nurses Association
Ans: A, B, D
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Test Bank - Realities of Canadian Nursing: Professional, Practice, and Power Issues, 5th Edition (McDonald, 2019)
Chapter 02 Race and Racialization in Health, Healthcare, and Nursing Education
Multiple Choice
1. One of the significant barriers to reducing racism in healthcare and nursing practice is:
A) racism exists everywhere and will continue to exist.
B) concepts of race and racism are not integral aspects of nursing knowledge development.
C) everyone is treated the same.
D) dominant culture and values are the same for all people within the culture.
Ans: B
2. Racialization refers to:
A) identifying people with similar values and beliefs.
B) putting people into categories that help with decision making for health and well-being.
C) categorizing people with similar behaviours.
D) placing people into categories based upon their skin colour and physical attributes.
Ans: D
3. When compared with their White counterparts, all of the following are true for racialized
peoples in healthcare settings EXCEPT:
A) Receive less clinical attention and intervention
B) Have less frequent assessments
C) Feel ignored
D) Receive higher doses of analgesics to counteract tolerance to opioids
Ans: D
4. The cycle of oppression has multiple negative consequences for racialized peoples in
healthcare settings. These negative consequences result from:
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A) nurses and other healthcare professionals feeling pressured to attend to nonracialized
peoples first.
B) lack of understanding of the healthcare needs of racialized peoples.
C) long-term stereotyping of racialized people which leads to prejudice and discrimination.
D) complex healthcare needs of racialized peoples require specialized care that takes longer to
access and deliver.
Ans: B
5. The concept of the “invisible knapsack” refers to:
A) the needs of racialized peoples being ignored.
B) the challenges affecting racialized peoples who are not being acknowledged.
C) White privileges with unearned advantages and opportunities.
D) disempowerment of racialized peoples.
Ans: C
6. The progress of integrating racial and racialization concepts in nursing education has
primarily been hindered by which of the following:
A) Nurse educators are predominately racist
B) The focus on Florence Nightingale and her views on nursing practice
C) Reliance on nursing theories which are generally colonial based
D) Lack of leadership examples from racialized peoples
Ans: C
7. A significant barrier to integrating and changing attitudes to racism and racialization in
nursing education is:
A) lack of understanding of the issues.
B) lack of evidence that racialized nursing students exist.
C) lack of funding for nursing education.
D) silence of nursing educators.
Ans: D
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