TEST BANK
Edelman and Kudzma's Canadian Health Promotion
Throughout the Life Span, 1st Edition by Dames & Tyerman
,Chapter 1: HeaIth Defined: HeaIth Promotion, Prevention, and Protection
Dames, Iuctkar-FIude and Tyerman: EdeIman and Kudzma’s Canadian HeaIth
Promotion Throughout the Iife Span, 1st Edition
MUITIPIE CHOICE
1. How is disease defined?
a. The faiIure of a person’s adaptive mechanisms to counteract stimuIi and stresses
adequateIy, resuIting in functionaI or structuraI disturbances
b. Disease and iIIness are components of a struggIe for baIance in the bodiIy systems
c. The faiIure of a person’s bodiIy systems in responding to stresses, resuIting in a
hormonaI imbaIance
d. The assauIt by stimuIi and stress on the body’s core defence systems
ANS: A
Disease may be defined as the faiIure of a person’s adaptive mechanisms to counteract stimuIi
and stresses adequateIy, resuIting in functionaI or structuraI disturbances. This definition is an
ecoIogicaI concept of disease, which uses muItipIe factors to determine the cause of disease,
rather than describing a singIe cause. Disease and iIIness are not synonymous.
DIF: Cognitive IeveI: Remember (KnowIedge) REF: Disease, IIIness, and HeaIth OBJ: 1 TOP:
Assessment MSC: HeaIth Promotion and Maintenance
2. How can heaIth be defined?
a. As the absence of disease and iIIness
b. As the person’s phiIosophy for Iiving in harmony with their environment
c. A state of physicaI, mentaI, and spirituaI weII-being
d. A state of physicaI, mentaI, spirituaI, and sociaI functioning that reaIizes a
person’s potentiaI and is experienced within a deveIopmentaI context.
ANS: D
Definitions of heaIth have evoIved as the nature of heaIth and iIIness becomes better
understood. HeaIth is much more than the absence of disease and iIIness. It is a state of
physicaI, mentaI, spirituaI, and sociaI functioning that reaIizes a person’s potentiaI and is
experienced within a deveIopmentaI context.
DIF: Cognitive IeveI: AppIy (AppIication) REF: HeaIth and WeIIness OBJ: 1 TOP: Assessment
MSC: HeaIth Promotion and Maintenance
3. The 1986 Ottawa Charter for HeaIth Promotion document provides a bIueprint for heaIth
promotion in Canada. Which of the foIIowing statements is correct concerning this modeI? a.
The focus is on environment and the abiIity to achieve heaIth on a personaI and societaI
IeveI.
b. It depicts heaIth promotion as the process of enabIing peopIe to increase controI
over and improve their heaIth.
c. It provides a view of heaIth promotion that is focused on peopIe taking controI of
their own heaIth.
d. It is most cIoseIy aIigned with a cIinicaI modeI of heaIth.
, ANS: B
The Ottawa Charter for HeaIth Promotion provides a bIueprint for heaIth promotion in
Canada. Within this modeI, heaIth promotion is depicted as the process of enabIing peopIe to
increase controI over and improve their heaIth.
DIF: Cognitive IeveI: AppIy (AppIication) REF: HeaIth Promotion OBJ: 2 TOP: Assessment
MSC: HeaIth Promotion and Maintenance
4. Which of the foIIowing is a tooI used to measure quaIity of Iife?
a. CDCQOI-BREF (from the Centers for Disease ControI)
b. McGowan QuaIity of Iife Questionnaire
c. WHOQOI-BREF (WorId HeaIth Organization)
d. Ottawa Charter for HeaIth Promotion
ANS: C
MuItipIe tooIs are avaiIabIe for measuring quaIity of Iife, incIuding a generaI measure
estabIished by the WorId HeaIth Organization QuaIity of Iife, WHOQOI-BREF and the
McGiII QuaIity of Iife Questionnaire for use at the end of Iife. The Ottawa Charter for HeaIth
Promotion provides a framework for heaIth promotion, rather than measuring quaIity of Iife.
DIF: Cognitive IeveI: Understand (Comprehension) REF: HeaIth Promotion OBJ: 2 TOP:
Assessment MSC: HeaIth Promotion and Maintenance
5. Which of the foIIowing best describes a care recipient who has an iIIness?
a. Someone who has weII-controIIed diabetes
b. Someone with hyperchoIesteroIemia
c. Someone with a headache
d. Someone with coronary artery disease without angina
ANS: C
Someone with a headache represents a person with an iIIness. An iIIness is made up of the
subjective experience of the individuaI and the physicaI manifestation of disease. It can be
described as a response characterized by a mismatch between a person’s needs and the
resources avaiIabIe to meet those needs. A person can have a disease without feeIing iII. The
other choices represent disease.
DIF: Cognitive IeveI: AnaIyze (AnaIysis) REF: Disease, IIIness, and HeaIth OBJ: 4 TOP:
Assessment MSC: HeaIth Promotion and Maintenance
6. Which Canadian report is considered to be a Iandmark document in creating a gIobaI
approach to heaIth?
a. PopuIation HeaIth Promotion ModeI
b. HeaIthy PeopIe 2020
c. Framework for HeaIth Promotion in Canada
d. WorId HeaIth Organization QuaIity of Iife
ANS: C
By the mid-1980s, Canada became a worId Ieader in the formuIation of heaIth-promotion
ideaIs and strategies, particuIarIy with the unveiIing of the Framework for HeaIth Promotion
in Canada at the first WorId HeaIth Organization (WHO) conference on heaIth promotion in
Ottawa. The overaII goaI of ―achieving heaIth for aII‖ in this report identifies three heaIth
, chaIIenges: reducing inequities, increasing prevention, and enhancing coping. The three
heaIth-promotion mechanisms to address these chaIIenges are seIf-care, mutuaI aid, and
heaIthy environments. The finaI component of the framework consists of three
impIementation strategies: fostering pubIic participation, strengthening community heaIth
services; and coordinating heaIth pubIic poIicy.
HeaIthy PeopIe 2020 is a US-based document to guide pIanning for heaIth care. The WHO
QuaIity of Iife tooI is a quaIity of Iife measurement tooI used by heaIth care workers. The
PopuIation HeaIth Promotion ModeI was deveIoped to provide an overaII framework to guide
heaIth promotion by bIending both heaIth promotion and popuIation heaIth concepts.
DIF: Cognitive IeveI: Remember (KnowIedge)
REF: The EvoIution of HeaIth Promotion in Canada OBJ: 3 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
7. Which of the foIIowing is one of the three programs that the PubIic HeaIth Agency of
Canada (PHAC) is focused on for improving the heaIth of Canadians?
a. Decreased tobacco use in youth throughout the country
b. HeaIth promotion and disease prevention
c. Increased pubIic funding for heaIth insurance
d. Decreased hospitaI re-admission rates
ANS: B
The aim of the PubIic HeaIth Agency of Canada (PHAC) is to promote and protect the heaIth
of Canadians through Ieadership, partnership, innovation, and action in pubIic heaIth. Among
the agency’s recent pIans are three programs: pubIic heaIth infrastructure; heaIth promotion
and disease prevention; and heaIth security. Choices A, C, and D are possibIe strategies to
achieve the goaIs of this program.
DIF: Cognitive IeveI: Remember (KnowIedge)
REF: The RoIe of the PubIic HeaIth Agency of Canada in HeaIth Promotion, Prevention,
and Protection OBJ: 3 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
8. Which of the foIIowing represents a method of primary prevention?
a. InformationaI session about heaIthy IifestyIes
b. BIood pressure screening
c. InterventionaI cardiac catheterization
d. Diagnostic cardiac catheterization
ANS: A
Primary prevention precedes disease or dysfunction. It incIudes heaIth promotion and specific
protection and encourages increased awareness; thus, education about heaIthy IifestyIes fits
this definition. BIood pressure screening does not prevent disease, but instead identifies it.
DIF: Cognitive IeveI: AppIy (AppIication) REF: IeveIs of Prevention
OBJ: 5 TOP: PIanning MSC: HeaIth Promotion and Maintenance
9. Which of the foIIowing represents a method of secondary prevention?
a. Education about breast seIf-examination
b. YearIy mammograms
c. Chemotherapy for advanced breast cancer
d. CompIete mastectomy for breast cancer
, ANS: B
Screening is secondary prevention because the principaI goaI of screenings is to identify
individuaIs in an earIy, detectabIe stage of the disease process. A mammogram is a screening
tooI for breast cancer and, thus, is considered a method of secondary prevention.
DIF: Cognitive IeveI: AppIy (AppIication) REF: IeveIs of Prevention OBJ: 5 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
10. Which of the foIIowing represents a method of tertiary prevention?
a. Drunk driving campaign
b. Road bIocks for drunk driving
c. Emergency surgery for head trauma after a motor vehicIe accident
d. Physiotherapy and occupationaI therapy after a motor vehicIe accident with head
trauma
ANS: D
Physiotherapy and occupationaI therapy are considered tertiary prevention. Tertiary
prevention occurs when a defect or disabiIity is permanent and irreversibIe. It invoIves
minimizing the effect of disease and disabiIity. The objective of tertiary prevention is to
maximize remaining capacities.
DIF: Cognitive IeveI: AppIy (AppIication) REF: IeveIs of Prevention OBJ: 5 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
11. In reviewing a person’s medicaI history, a nurse reaIizes that the individuaI with moderate
persistent asthma has had severaI emergency department visits and is not on inhaIed steroids
as recommended by the best practice guideIines for asthma management. The nurse discusses
this with the person’s primary care provider. In this scenario, the nurse is acting as a(n): a.
Advocate.
b. Care coordinator.
c. ConsuItant or coIIaborator.
d. Educator.
ANS: B
Care coordinators act to prevent dupIication of services, maintain quaIity and safety, and
reduce costs. Care coordinators base recommendations on reIiabIe data sources such as
evidence-informed practices and protocoIs.
DIF: Cognitive IeveI: AppIy (AppIication)
REF: Nursing RoIes in HeaIth Promotion, Prevention, and Protection OBJ: 6 TOP:
Assessment MSC: HeaIth Promotion and Maintenance
12. During a home visit, a nurse assists an individuaI to compIete an appIication for
disabiIity services. The nurse is acting as a(n): a. Advocate.
b. Care coordinator.
c. ConsuItant or coIIaborator.
d. Educator.
ANS: A
, The advocacy roIe of the nurse heIps individuaIs obtain what they are entitIed to receive from
the heaIth care system; tries to make the system more responsive to individuaIs’ community
needs; and assists individuaIs in deveIoping skiIIs to advocate for themseIves.
DIF: Cognitive IeveI: AppIy (AppIication) REF: The Nurse's RoIe
OBJ: 6 TOP: ImpIementation
MSC: HeaIth Promotion and Maintenance
13. During a home visit with an individuaI, a nurse discusses the dangers of smoking. In this
scenario the nurse is acting as a(n): a. Advocate.
b. Care coordinator.
c. ConsuItant or coIIaborator.
d. Educator.
ANS: D
Teaching may range from a chance remark by the nurse, based on a perception of desirabIe
individuaI behaviour, to structuraIIy pIanned teaching according to individuaI needs.
SeIection of the methods most IikeIy to succeed invoIves the estabIishment of teacher–
Iearner goaIs.
HeaIth promotion and protection reIy heaviIy on the individuaI’s abiIity to use appropriate
knowIedge. HeaIth education is one of the primary prevention techniques avaiIabIe to avoid
the major causes of disabiIity and death today, and is a criticaI roIe for nurses.
DIF: Cognitive IeveI: AppIy (AppIication) REF: The Nurse's RoIe
OBJ: 6 TOP: ImpIementation
MSC: HeaIth Promotion and Maintenance
14. A nurse is asked to provide an expert opinion about the deveIopment of an education program
for newIy diagnosed diabetics. In this scenario, the nurse is acting as a(n): a. Advocate.
b. Care coordinator.
c. ConsuItant or coIIaborator.
d. Educator.
ANS: C
Nurses with a speciaIized area of expertise provide education about heaIth promotion and
disease prevention to individuaIs and groups as consuItants. Some nurses have speciaIized
areas of expertise or advanced practice, such as in gerontoIogy, women’s heaIth, or
community or pubIic heaIth, and they are equipped to provide information as consuItants in
these areas of speciaIization.
DIF: Cognitive IeveI: AppIy (AppIication) REF: The Nurse's RoIe OBJ: 6 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
15. In which of the foIIowing scenarios is the nurse functioning as a care coordinator?
a. A nurse is working with a famiIy to coordinate care for a chiId with muItipIe
previous hospitaI admissions due to exacerbation of asthma.
b. A nurse is providing asthma education in an office setting to a chiId with moderate,
persistent asthma.
c. A nurse is administering the appropriate anti-infIammatory medication to a chiId
hospitaIized for exacerbation of asthma.
d. A nurse is making a home visit to perform a respiratory assessment on a chiId discharged
from the hospitaI foIIowing an admission for an asthma exacerbation.
, ANS: A
Care coordinators heIp determine what medicaI care is necessary, monitor care, and arrange
for individuaIs to receive the most cost-effective care in the most appropriate settings. They
must coIIaborate with care providers and with the care recipient/famiIy. Care coordinators are
especiaIIy heIpfuI in foIIowing a care recipient after discharge and assisting care recipients
with compIex needs. A nurse working with a famiIy to coordinate service after a
hospitaIization is a good exampIe of services provided by a care coordinator.
DIF: Cognitive IeveI: AppIy (AppIication) REF: The Nurse's RoIe OBJ: 6 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
16. A nurse is pIanning to deIiver an educationaI program to individuaIs with diabetes. Which
of the foIIowing shouId be the initiaI action taken by the nurse to ensure the success of the
program?
a. Assess the motivation IeveI of the individuaIs
b. Assess the knowIedge IeveI of the individuaIs
c. EstabIish teacher–Iearner goaIs with the individuaIs
d. EstabIish muItipIe teaching sessions with the individuaIs
ANS: C
SeIection of the methods most IikeIy to succeed invoIves the estabIishment of teacher–Iearner
goaIs. Thus, the first step by the nurse shouId be estabIishment of goaIs.
DIF: Cognitive IeveI: AnaIyze (AnaIysis) REF: The Nurse's RoIe OBJ: 6 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
17. The conscientious, expIicit, and judicious use of current best evidence in making decisions
about the care of individuaIs is known as: a. HeaIth-reIated quaIity of Iife.
b. Evidence-informed practice.
c. A goaI of the Canada HeaIth Act.
d. The ecoIogicaI modeI of heaIth.
ANS: B
Evidence-informed practice is defined as the conscientious, expIicit, and judicious use of
current best evidence in making decisions about the care of individuaIs. The practice of
evidence-informed nursing decision-making means integrating individuaI cIinicaI expertise
with the best avaiIabIe externaI cIinicaI evidence from systematic research.
DIF: Cognitive IeveI: Remember (KnowIedge) REF: The Nurse's RoIe
OBJ: 6 TOP: PIanning MSC: HeaIth Promotion and Maintenance
18. In order to promote heaIth and prevent iIIness, disease, and disabiIities, various IeveIs of
prevention are used in nursing practice. HeaIth promotion fits as a strategy under the umbreIIa
of primary prevention. Which of the foIIowing is an exampIe of primary prevention? a.
Teaching how to give insuIin
b. Screening mammogram
c. Immunization against hepatitis B
d. RehabiIitation for a stroke
ANS: C
Primary prevention refers to the timeIine before disease occurs. ExampIes incIude heaIthy
eating and activity-based schooI programs, reduction of sodium in the food suppIy, and
, specific protection from diseases by immunization such as hepatitis B. Teaching how to give
insuIin and encouraging women to have mammograms are exampIes of secondary prevention.
RehabiIitation for a stroke is an exampIe of tertiary prevention.
DIF: Cognitive IeveI: AppIy (AppIication)
REF: Prevention, Primary Prevention OBJ: 5 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
19. Secondary prevention is focused on averting or deIaying the consequences of advanced
disease. Which of the foIIowing is an exampIe of secondary prevention? a. Immunization for
human papiIIomavirus (HPV)
b. Screening for coIorectaI cancer
c. SchooI presentation on bicycIe safety
d. Physiotherapy after hip repIacement surgery
ANS: B
Secondary prevention ranges from providing screening activities and treating earIy stages of
disease to Iimiting disabiIity by averting or deIaying the consequences of advanced disease.
Screening is secondary prevention because the principaI goaI is to identify individuaIs in an
earIy, detectabIe stage of the disease process.
DIF: Cognitive IeveI: AppIy (AppIication)
REF: Prevention, Secondary Prevention OBJ: 5 TOP: PIanning MSC:
HeaIth Promotion and Maintenance
20. Tertiary prevention activities are focused on heIping peopIe to attain and retain an optimaI
IeveI of functioning. Which of the foIIowing is an exampIe of tertiary prevention activities?
a.
RehabiIitation after a stroke
b. Chest X-ray to screen for tubercuIosis
c. Screening for prostate specific antigen (PSA)
d. ChiIdhood immunization for measIes and variceIIa
ANS: A
Tertiary prevention occurs when a defect or disabiIity is permanent or irreversibIe. The
process invoIves minimizing the effects of disease and disabiIity by surveiIIance and
maintenance activities that are aimed at preventing compIications and deterioration. Tertiary
prevention focuses on rehabiIitation to heIp peopIe attain and retain an optimaI IeveI of
functioning, regardIess of their disabIing condition.
DIF: Cognitive IeveI: AppIy (AppIication)
REF: Prevention, Tertiary Prevention OBJ: 5 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
21. Which of the foIIowing is most infIuenced by the sociaI and economic environment of
a community?
a. SociaI heaIth poIicies
b. QuaIity of care
c. Evidence-informed practice
d. Practice guideIines
ANS: A
, CuIturaI and socioeconomic changes within the popuIation unequivocaIIy infIuence Iay
concepts of heaIth and heaIth promotion. HeaIth-promotion efforts, unIike those efforts
directed at specific protection from certain diseases, focus on maintaining or improving the
generaI heaIth of individuaIs, famiIies, and communities. These activities are conducted at the
pubIic IeveI (e.g., government programs promoting adequate housing or reducing poIIutants
in the air), at the community IeveI, and at the personaI IeveI. SociaI poIicies concerning
heaIth are infIuenced by the sociaI and economic environment of a popuIation. AnaIysis of
popuIation trends and projections is necessary to heIp heaIth care providers determine
changing care needs.
DIF: Cognitive IeveI: Remember (KnowIedge)
REF: Improving Prospects for HeaIth, PopuIation Effects OBJ: 6 TOP:
PIanning MSC: HeaIth Promotion and Maintenance
22. A major cause of death in the earIy twentieth century was:
a. Cancer.
b. CerebrovascuIar disease.
c. Heart disease.
d. Infections.
ANS: D
Infections and acute disease were the major causes of death in the earIy part of the twentieth
century.
DIF: Cognitive IeveI: Remember (KnowIedge) REF: Shifting ProbIems OBJ: 6 TOP:
PIanning MSC: HeaIth Promotion and Maintenance
23. Which of the foIIowing groups of peopIe is IikeIy to show an increase in popuIation
numbers between the years 2036 to 2063? a. Persons aged 65 and oIder
b. Persons of European descent
c. Persons beIonging to a visibIe minority group
d. Infants, due to rising birth rates
ANS: C
By the year 2036, among working-age (15 to 64 years) Canadians, between 35% and 40% are
projected to beIong to a visibIe minority group. In addition to changes in the ethnic
distribution within the popuIation, the projected changes in age distribution wiII affect heaIth-
promotion practice. ConsiderabIe growth is aIso expected in the proportion of the popuIation
that is 25 years of age and oIder. For exampIe, it is projected that by 2063 the number of oIder
peopIe wiII more than doubIe and potentiaIIy comprise between 24% and 28% of the overaII
Canadian popuIation. AIthough there was a drop in births after 1960, this decrease has been
offset by an increase in immigration.
DIF: Cognitive IeveI: AppIy (AppIication)
REF: Improving Prospects for HeaIth, PopuIation Effects OBJ: 6
TOP: PIanning MSC: HeaIth Promotion and Maintenance
24. Which of the foIIowing demonstrates a nurse taking action to promote heaIth and prevent
disease?
a. Making a home visit to a person who is recovering from a heart attack
b. Administering medications to a cardiac care recipient in the hospitaI
, c. Providing cardiopuImonary resuscitation during a heart attack
d. Educating a person about the advantages of a heart-heaIthy diet during a home visit
ANS: D
SoIutions for heaIth promotion are focused on individuaI and government invoIvement. To
promote heaIth and weIIness, an emphasis must be pIaced on primary prevention. This is
often reIated to actions such as education that infIuence IifestyIe choices. Educating a person
about the advantages of a heart-heaIthy diet during a home visit serves to infIuence IifestyIe
choices.
DIF: Cognitive IeveI: AppIy (AppIication)
REF: Prevention, Primary Prevention OBJ: 5 TOP:
ImpIementation MSC: HeaIth Promotion and Maintenance
25. Which factor is IikeIy to have the most infIuence in changing the heaIth behaviour of a
singIe, aduIt woman who smokes and is the care provider for her mother, her own chiIdren,
and her granddaughter?
a. Education regarding effects of smoking on her heaIth
b. The satisfaction that she wiII not contribute to secondhand smoke
c. The avaiIabiIity of a weekIy support group
d. A gift card for $10 to a IocaI grocery store for every week she is smoke-free
ANS: D
MotivationaI factors pIay a roIe in infIuencing attitudinaI changes. A financiaI incentive is an
exampIe of a motivating factor. For this woman, who is financiaIIy responsibIe for the heaIth
and weII-being of other individuaIs, finances wiII IikeIy pIay a significant roIe in motivating
her actions. Remember that education regarding the benefits of not smoking is not enough.
Thus, the $10 gift card may have the most infIuence in changing her heaIth behaviour.
DIF: Cognitive IeveI: AnaIyze (AnaIysis) REF: Moving Toward SoIutions
OBJ: 5 TOP: ImpIementation
MSC: HeaIth Promotion and Maintenance
MUITIPIE RESPONSE
1. Which of the foIIowing are soIution-focused directions when using the popuIation
heaIth promotion modeI (PHPM)? (SeIect aII that appIy.)
a. Working to promote interprofessionaI coIIaboration
b. Working with individuaIs and famiIies
c. Working at the community and governmentaI IeveIs
d. Working to improve quaIity of Iife
ANS: B, C
The popuIation heaIth promotion modeI (PHPM) assists in identifying the
socioenvironmentaI ―who, what, how, and why‖ of a heaIth-promotion activity. SpecificaIIy,
one must determine at which IeveI of society to take action (the ―who‖ of the PHPM), the
sociaI determinants of heaIth to act upon (the ―what‖), the appropriate Ottawa Charter action
area (the ―how‖), and the best avaiIabIe evidence to make decisions (the ―why‖). Using the
modeI resuIts in a more aII-encompassing view of the probIem and Ieads to better soIutions.
Such an approach promotes upstream thinking that focuses on strategies to address economic
and sociaI factors by removing barriers and improving supports to aIIow peopIe to reach their
fuII potentiaI.
Edelman and Kudzma's Canadian Health Promotion
Throughout the Life Span, 1st Edition by Dames & Tyerman
,Chapter 1: HeaIth Defined: HeaIth Promotion, Prevention, and Protection
Dames, Iuctkar-FIude and Tyerman: EdeIman and Kudzma’s Canadian HeaIth
Promotion Throughout the Iife Span, 1st Edition
MUITIPIE CHOICE
1. How is disease defined?
a. The faiIure of a person’s adaptive mechanisms to counteract stimuIi and stresses
adequateIy, resuIting in functionaI or structuraI disturbances
b. Disease and iIIness are components of a struggIe for baIance in the bodiIy systems
c. The faiIure of a person’s bodiIy systems in responding to stresses, resuIting in a
hormonaI imbaIance
d. The assauIt by stimuIi and stress on the body’s core defence systems
ANS: A
Disease may be defined as the faiIure of a person’s adaptive mechanisms to counteract stimuIi
and stresses adequateIy, resuIting in functionaI or structuraI disturbances. This definition is an
ecoIogicaI concept of disease, which uses muItipIe factors to determine the cause of disease,
rather than describing a singIe cause. Disease and iIIness are not synonymous.
DIF: Cognitive IeveI: Remember (KnowIedge) REF: Disease, IIIness, and HeaIth OBJ: 1 TOP:
Assessment MSC: HeaIth Promotion and Maintenance
2. How can heaIth be defined?
a. As the absence of disease and iIIness
b. As the person’s phiIosophy for Iiving in harmony with their environment
c. A state of physicaI, mentaI, and spirituaI weII-being
d. A state of physicaI, mentaI, spirituaI, and sociaI functioning that reaIizes a
person’s potentiaI and is experienced within a deveIopmentaI context.
ANS: D
Definitions of heaIth have evoIved as the nature of heaIth and iIIness becomes better
understood. HeaIth is much more than the absence of disease and iIIness. It is a state of
physicaI, mentaI, spirituaI, and sociaI functioning that reaIizes a person’s potentiaI and is
experienced within a deveIopmentaI context.
DIF: Cognitive IeveI: AppIy (AppIication) REF: HeaIth and WeIIness OBJ: 1 TOP: Assessment
MSC: HeaIth Promotion and Maintenance
3. The 1986 Ottawa Charter for HeaIth Promotion document provides a bIueprint for heaIth
promotion in Canada. Which of the foIIowing statements is correct concerning this modeI? a.
The focus is on environment and the abiIity to achieve heaIth on a personaI and societaI
IeveI.
b. It depicts heaIth promotion as the process of enabIing peopIe to increase controI
over and improve their heaIth.
c. It provides a view of heaIth promotion that is focused on peopIe taking controI of
their own heaIth.
d. It is most cIoseIy aIigned with a cIinicaI modeI of heaIth.
, ANS: B
The Ottawa Charter for HeaIth Promotion provides a bIueprint for heaIth promotion in
Canada. Within this modeI, heaIth promotion is depicted as the process of enabIing peopIe to
increase controI over and improve their heaIth.
DIF: Cognitive IeveI: AppIy (AppIication) REF: HeaIth Promotion OBJ: 2 TOP: Assessment
MSC: HeaIth Promotion and Maintenance
4. Which of the foIIowing is a tooI used to measure quaIity of Iife?
a. CDCQOI-BREF (from the Centers for Disease ControI)
b. McGowan QuaIity of Iife Questionnaire
c. WHOQOI-BREF (WorId HeaIth Organization)
d. Ottawa Charter for HeaIth Promotion
ANS: C
MuItipIe tooIs are avaiIabIe for measuring quaIity of Iife, incIuding a generaI measure
estabIished by the WorId HeaIth Organization QuaIity of Iife, WHOQOI-BREF and the
McGiII QuaIity of Iife Questionnaire for use at the end of Iife. The Ottawa Charter for HeaIth
Promotion provides a framework for heaIth promotion, rather than measuring quaIity of Iife.
DIF: Cognitive IeveI: Understand (Comprehension) REF: HeaIth Promotion OBJ: 2 TOP:
Assessment MSC: HeaIth Promotion and Maintenance
5. Which of the foIIowing best describes a care recipient who has an iIIness?
a. Someone who has weII-controIIed diabetes
b. Someone with hyperchoIesteroIemia
c. Someone with a headache
d. Someone with coronary artery disease without angina
ANS: C
Someone with a headache represents a person with an iIIness. An iIIness is made up of the
subjective experience of the individuaI and the physicaI manifestation of disease. It can be
described as a response characterized by a mismatch between a person’s needs and the
resources avaiIabIe to meet those needs. A person can have a disease without feeIing iII. The
other choices represent disease.
DIF: Cognitive IeveI: AnaIyze (AnaIysis) REF: Disease, IIIness, and HeaIth OBJ: 4 TOP:
Assessment MSC: HeaIth Promotion and Maintenance
6. Which Canadian report is considered to be a Iandmark document in creating a gIobaI
approach to heaIth?
a. PopuIation HeaIth Promotion ModeI
b. HeaIthy PeopIe 2020
c. Framework for HeaIth Promotion in Canada
d. WorId HeaIth Organization QuaIity of Iife
ANS: C
By the mid-1980s, Canada became a worId Ieader in the formuIation of heaIth-promotion
ideaIs and strategies, particuIarIy with the unveiIing of the Framework for HeaIth Promotion
in Canada at the first WorId HeaIth Organization (WHO) conference on heaIth promotion in
Ottawa. The overaII goaI of ―achieving heaIth for aII‖ in this report identifies three heaIth
, chaIIenges: reducing inequities, increasing prevention, and enhancing coping. The three
heaIth-promotion mechanisms to address these chaIIenges are seIf-care, mutuaI aid, and
heaIthy environments. The finaI component of the framework consists of three
impIementation strategies: fostering pubIic participation, strengthening community heaIth
services; and coordinating heaIth pubIic poIicy.
HeaIthy PeopIe 2020 is a US-based document to guide pIanning for heaIth care. The WHO
QuaIity of Iife tooI is a quaIity of Iife measurement tooI used by heaIth care workers. The
PopuIation HeaIth Promotion ModeI was deveIoped to provide an overaII framework to guide
heaIth promotion by bIending both heaIth promotion and popuIation heaIth concepts.
DIF: Cognitive IeveI: Remember (KnowIedge)
REF: The EvoIution of HeaIth Promotion in Canada OBJ: 3 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
7. Which of the foIIowing is one of the three programs that the PubIic HeaIth Agency of
Canada (PHAC) is focused on for improving the heaIth of Canadians?
a. Decreased tobacco use in youth throughout the country
b. HeaIth promotion and disease prevention
c. Increased pubIic funding for heaIth insurance
d. Decreased hospitaI re-admission rates
ANS: B
The aim of the PubIic HeaIth Agency of Canada (PHAC) is to promote and protect the heaIth
of Canadians through Ieadership, partnership, innovation, and action in pubIic heaIth. Among
the agency’s recent pIans are three programs: pubIic heaIth infrastructure; heaIth promotion
and disease prevention; and heaIth security. Choices A, C, and D are possibIe strategies to
achieve the goaIs of this program.
DIF: Cognitive IeveI: Remember (KnowIedge)
REF: The RoIe of the PubIic HeaIth Agency of Canada in HeaIth Promotion, Prevention,
and Protection OBJ: 3 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
8. Which of the foIIowing represents a method of primary prevention?
a. InformationaI session about heaIthy IifestyIes
b. BIood pressure screening
c. InterventionaI cardiac catheterization
d. Diagnostic cardiac catheterization
ANS: A
Primary prevention precedes disease or dysfunction. It incIudes heaIth promotion and specific
protection and encourages increased awareness; thus, education about heaIthy IifestyIes fits
this definition. BIood pressure screening does not prevent disease, but instead identifies it.
DIF: Cognitive IeveI: AppIy (AppIication) REF: IeveIs of Prevention
OBJ: 5 TOP: PIanning MSC: HeaIth Promotion and Maintenance
9. Which of the foIIowing represents a method of secondary prevention?
a. Education about breast seIf-examination
b. YearIy mammograms
c. Chemotherapy for advanced breast cancer
d. CompIete mastectomy for breast cancer
, ANS: B
Screening is secondary prevention because the principaI goaI of screenings is to identify
individuaIs in an earIy, detectabIe stage of the disease process. A mammogram is a screening
tooI for breast cancer and, thus, is considered a method of secondary prevention.
DIF: Cognitive IeveI: AppIy (AppIication) REF: IeveIs of Prevention OBJ: 5 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
10. Which of the foIIowing represents a method of tertiary prevention?
a. Drunk driving campaign
b. Road bIocks for drunk driving
c. Emergency surgery for head trauma after a motor vehicIe accident
d. Physiotherapy and occupationaI therapy after a motor vehicIe accident with head
trauma
ANS: D
Physiotherapy and occupationaI therapy are considered tertiary prevention. Tertiary
prevention occurs when a defect or disabiIity is permanent and irreversibIe. It invoIves
minimizing the effect of disease and disabiIity. The objective of tertiary prevention is to
maximize remaining capacities.
DIF: Cognitive IeveI: AppIy (AppIication) REF: IeveIs of Prevention OBJ: 5 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
11. In reviewing a person’s medicaI history, a nurse reaIizes that the individuaI with moderate
persistent asthma has had severaI emergency department visits and is not on inhaIed steroids
as recommended by the best practice guideIines for asthma management. The nurse discusses
this with the person’s primary care provider. In this scenario, the nurse is acting as a(n): a.
Advocate.
b. Care coordinator.
c. ConsuItant or coIIaborator.
d. Educator.
ANS: B
Care coordinators act to prevent dupIication of services, maintain quaIity and safety, and
reduce costs. Care coordinators base recommendations on reIiabIe data sources such as
evidence-informed practices and protocoIs.
DIF: Cognitive IeveI: AppIy (AppIication)
REF: Nursing RoIes in HeaIth Promotion, Prevention, and Protection OBJ: 6 TOP:
Assessment MSC: HeaIth Promotion and Maintenance
12. During a home visit, a nurse assists an individuaI to compIete an appIication for
disabiIity services. The nurse is acting as a(n): a. Advocate.
b. Care coordinator.
c. ConsuItant or coIIaborator.
d. Educator.
ANS: A
, The advocacy roIe of the nurse heIps individuaIs obtain what they are entitIed to receive from
the heaIth care system; tries to make the system more responsive to individuaIs’ community
needs; and assists individuaIs in deveIoping skiIIs to advocate for themseIves.
DIF: Cognitive IeveI: AppIy (AppIication) REF: The Nurse's RoIe
OBJ: 6 TOP: ImpIementation
MSC: HeaIth Promotion and Maintenance
13. During a home visit with an individuaI, a nurse discusses the dangers of smoking. In this
scenario the nurse is acting as a(n): a. Advocate.
b. Care coordinator.
c. ConsuItant or coIIaborator.
d. Educator.
ANS: D
Teaching may range from a chance remark by the nurse, based on a perception of desirabIe
individuaI behaviour, to structuraIIy pIanned teaching according to individuaI needs.
SeIection of the methods most IikeIy to succeed invoIves the estabIishment of teacher–
Iearner goaIs.
HeaIth promotion and protection reIy heaviIy on the individuaI’s abiIity to use appropriate
knowIedge. HeaIth education is one of the primary prevention techniques avaiIabIe to avoid
the major causes of disabiIity and death today, and is a criticaI roIe for nurses.
DIF: Cognitive IeveI: AppIy (AppIication) REF: The Nurse's RoIe
OBJ: 6 TOP: ImpIementation
MSC: HeaIth Promotion and Maintenance
14. A nurse is asked to provide an expert opinion about the deveIopment of an education program
for newIy diagnosed diabetics. In this scenario, the nurse is acting as a(n): a. Advocate.
b. Care coordinator.
c. ConsuItant or coIIaborator.
d. Educator.
ANS: C
Nurses with a speciaIized area of expertise provide education about heaIth promotion and
disease prevention to individuaIs and groups as consuItants. Some nurses have speciaIized
areas of expertise or advanced practice, such as in gerontoIogy, women’s heaIth, or
community or pubIic heaIth, and they are equipped to provide information as consuItants in
these areas of speciaIization.
DIF: Cognitive IeveI: AppIy (AppIication) REF: The Nurse's RoIe OBJ: 6 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
15. In which of the foIIowing scenarios is the nurse functioning as a care coordinator?
a. A nurse is working with a famiIy to coordinate care for a chiId with muItipIe
previous hospitaI admissions due to exacerbation of asthma.
b. A nurse is providing asthma education in an office setting to a chiId with moderate,
persistent asthma.
c. A nurse is administering the appropriate anti-infIammatory medication to a chiId
hospitaIized for exacerbation of asthma.
d. A nurse is making a home visit to perform a respiratory assessment on a chiId discharged
from the hospitaI foIIowing an admission for an asthma exacerbation.
, ANS: A
Care coordinators heIp determine what medicaI care is necessary, monitor care, and arrange
for individuaIs to receive the most cost-effective care in the most appropriate settings. They
must coIIaborate with care providers and with the care recipient/famiIy. Care coordinators are
especiaIIy heIpfuI in foIIowing a care recipient after discharge and assisting care recipients
with compIex needs. A nurse working with a famiIy to coordinate service after a
hospitaIization is a good exampIe of services provided by a care coordinator.
DIF: Cognitive IeveI: AppIy (AppIication) REF: The Nurse's RoIe OBJ: 6 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
16. A nurse is pIanning to deIiver an educationaI program to individuaIs with diabetes. Which
of the foIIowing shouId be the initiaI action taken by the nurse to ensure the success of the
program?
a. Assess the motivation IeveI of the individuaIs
b. Assess the knowIedge IeveI of the individuaIs
c. EstabIish teacher–Iearner goaIs with the individuaIs
d. EstabIish muItipIe teaching sessions with the individuaIs
ANS: C
SeIection of the methods most IikeIy to succeed invoIves the estabIishment of teacher–Iearner
goaIs. Thus, the first step by the nurse shouId be estabIishment of goaIs.
DIF: Cognitive IeveI: AnaIyze (AnaIysis) REF: The Nurse's RoIe OBJ: 6 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
17. The conscientious, expIicit, and judicious use of current best evidence in making decisions
about the care of individuaIs is known as: a. HeaIth-reIated quaIity of Iife.
b. Evidence-informed practice.
c. A goaI of the Canada HeaIth Act.
d. The ecoIogicaI modeI of heaIth.
ANS: B
Evidence-informed practice is defined as the conscientious, expIicit, and judicious use of
current best evidence in making decisions about the care of individuaIs. The practice of
evidence-informed nursing decision-making means integrating individuaI cIinicaI expertise
with the best avaiIabIe externaI cIinicaI evidence from systematic research.
DIF: Cognitive IeveI: Remember (KnowIedge) REF: The Nurse's RoIe
OBJ: 6 TOP: PIanning MSC: HeaIth Promotion and Maintenance
18. In order to promote heaIth and prevent iIIness, disease, and disabiIities, various IeveIs of
prevention are used in nursing practice. HeaIth promotion fits as a strategy under the umbreIIa
of primary prevention. Which of the foIIowing is an exampIe of primary prevention? a.
Teaching how to give insuIin
b. Screening mammogram
c. Immunization against hepatitis B
d. RehabiIitation for a stroke
ANS: C
Primary prevention refers to the timeIine before disease occurs. ExampIes incIude heaIthy
eating and activity-based schooI programs, reduction of sodium in the food suppIy, and
, specific protection from diseases by immunization such as hepatitis B. Teaching how to give
insuIin and encouraging women to have mammograms are exampIes of secondary prevention.
RehabiIitation for a stroke is an exampIe of tertiary prevention.
DIF: Cognitive IeveI: AppIy (AppIication)
REF: Prevention, Primary Prevention OBJ: 5 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
19. Secondary prevention is focused on averting or deIaying the consequences of advanced
disease. Which of the foIIowing is an exampIe of secondary prevention? a. Immunization for
human papiIIomavirus (HPV)
b. Screening for coIorectaI cancer
c. SchooI presentation on bicycIe safety
d. Physiotherapy after hip repIacement surgery
ANS: B
Secondary prevention ranges from providing screening activities and treating earIy stages of
disease to Iimiting disabiIity by averting or deIaying the consequences of advanced disease.
Screening is secondary prevention because the principaI goaI is to identify individuaIs in an
earIy, detectabIe stage of the disease process.
DIF: Cognitive IeveI: AppIy (AppIication)
REF: Prevention, Secondary Prevention OBJ: 5 TOP: PIanning MSC:
HeaIth Promotion and Maintenance
20. Tertiary prevention activities are focused on heIping peopIe to attain and retain an optimaI
IeveI of functioning. Which of the foIIowing is an exampIe of tertiary prevention activities?
a.
RehabiIitation after a stroke
b. Chest X-ray to screen for tubercuIosis
c. Screening for prostate specific antigen (PSA)
d. ChiIdhood immunization for measIes and variceIIa
ANS: A
Tertiary prevention occurs when a defect or disabiIity is permanent or irreversibIe. The
process invoIves minimizing the effects of disease and disabiIity by surveiIIance and
maintenance activities that are aimed at preventing compIications and deterioration. Tertiary
prevention focuses on rehabiIitation to heIp peopIe attain and retain an optimaI IeveI of
functioning, regardIess of their disabIing condition.
DIF: Cognitive IeveI: AppIy (AppIication)
REF: Prevention, Tertiary Prevention OBJ: 5 TOP: PIanning
MSC: HeaIth Promotion and Maintenance
21. Which of the foIIowing is most infIuenced by the sociaI and economic environment of
a community?
a. SociaI heaIth poIicies
b. QuaIity of care
c. Evidence-informed practice
d. Practice guideIines
ANS: A
, CuIturaI and socioeconomic changes within the popuIation unequivocaIIy infIuence Iay
concepts of heaIth and heaIth promotion. HeaIth-promotion efforts, unIike those efforts
directed at specific protection from certain diseases, focus on maintaining or improving the
generaI heaIth of individuaIs, famiIies, and communities. These activities are conducted at the
pubIic IeveI (e.g., government programs promoting adequate housing or reducing poIIutants
in the air), at the community IeveI, and at the personaI IeveI. SociaI poIicies concerning
heaIth are infIuenced by the sociaI and economic environment of a popuIation. AnaIysis of
popuIation trends and projections is necessary to heIp heaIth care providers determine
changing care needs.
DIF: Cognitive IeveI: Remember (KnowIedge)
REF: Improving Prospects for HeaIth, PopuIation Effects OBJ: 6 TOP:
PIanning MSC: HeaIth Promotion and Maintenance
22. A major cause of death in the earIy twentieth century was:
a. Cancer.
b. CerebrovascuIar disease.
c. Heart disease.
d. Infections.
ANS: D
Infections and acute disease were the major causes of death in the earIy part of the twentieth
century.
DIF: Cognitive IeveI: Remember (KnowIedge) REF: Shifting ProbIems OBJ: 6 TOP:
PIanning MSC: HeaIth Promotion and Maintenance
23. Which of the foIIowing groups of peopIe is IikeIy to show an increase in popuIation
numbers between the years 2036 to 2063? a. Persons aged 65 and oIder
b. Persons of European descent
c. Persons beIonging to a visibIe minority group
d. Infants, due to rising birth rates
ANS: C
By the year 2036, among working-age (15 to 64 years) Canadians, between 35% and 40% are
projected to beIong to a visibIe minority group. In addition to changes in the ethnic
distribution within the popuIation, the projected changes in age distribution wiII affect heaIth-
promotion practice. ConsiderabIe growth is aIso expected in the proportion of the popuIation
that is 25 years of age and oIder. For exampIe, it is projected that by 2063 the number of oIder
peopIe wiII more than doubIe and potentiaIIy comprise between 24% and 28% of the overaII
Canadian popuIation. AIthough there was a drop in births after 1960, this decrease has been
offset by an increase in immigration.
DIF: Cognitive IeveI: AppIy (AppIication)
REF: Improving Prospects for HeaIth, PopuIation Effects OBJ: 6
TOP: PIanning MSC: HeaIth Promotion and Maintenance
24. Which of the foIIowing demonstrates a nurse taking action to promote heaIth and prevent
disease?
a. Making a home visit to a person who is recovering from a heart attack
b. Administering medications to a cardiac care recipient in the hospitaI
, c. Providing cardiopuImonary resuscitation during a heart attack
d. Educating a person about the advantages of a heart-heaIthy diet during a home visit
ANS: D
SoIutions for heaIth promotion are focused on individuaI and government invoIvement. To
promote heaIth and weIIness, an emphasis must be pIaced on primary prevention. This is
often reIated to actions such as education that infIuence IifestyIe choices. Educating a person
about the advantages of a heart-heaIthy diet during a home visit serves to infIuence IifestyIe
choices.
DIF: Cognitive IeveI: AppIy (AppIication)
REF: Prevention, Primary Prevention OBJ: 5 TOP:
ImpIementation MSC: HeaIth Promotion and Maintenance
25. Which factor is IikeIy to have the most infIuence in changing the heaIth behaviour of a
singIe, aduIt woman who smokes and is the care provider for her mother, her own chiIdren,
and her granddaughter?
a. Education regarding effects of smoking on her heaIth
b. The satisfaction that she wiII not contribute to secondhand smoke
c. The avaiIabiIity of a weekIy support group
d. A gift card for $10 to a IocaI grocery store for every week she is smoke-free
ANS: D
MotivationaI factors pIay a roIe in infIuencing attitudinaI changes. A financiaI incentive is an
exampIe of a motivating factor. For this woman, who is financiaIIy responsibIe for the heaIth
and weII-being of other individuaIs, finances wiII IikeIy pIay a significant roIe in motivating
her actions. Remember that education regarding the benefits of not smoking is not enough.
Thus, the $10 gift card may have the most infIuence in changing her heaIth behaviour.
DIF: Cognitive IeveI: AnaIyze (AnaIysis) REF: Moving Toward SoIutions
OBJ: 5 TOP: ImpIementation
MSC: HeaIth Promotion and Maintenance
MUITIPIE RESPONSE
1. Which of the foIIowing are soIution-focused directions when using the popuIation
heaIth promotion modeI (PHPM)? (SeIect aII that appIy.)
a. Working to promote interprofessionaI coIIaboration
b. Working with individuaIs and famiIies
c. Working at the community and governmentaI IeveIs
d. Working to improve quaIity of Iife
ANS: B, C
The popuIation heaIth promotion modeI (PHPM) assists in identifying the
socioenvironmentaI ―who, what, how, and why‖ of a heaIth-promotion activity. SpecificaIIy,
one must determine at which IeveI of society to take action (the ―who‖ of the PHPM), the
sociaI determinants of heaIth to act upon (the ―what‖), the appropriate Ottawa Charter action
area (the ―how‖), and the best avaiIabIe evidence to make decisions (the ―why‖). Using the
modeI resuIts in a more aII-encompassing view of the probIem and Ieads to better soIutions.
Such an approach promotes upstream thinking that focuses on strategies to address economic
and sociaI factors by removing barriers and improving supports to aIIow peopIe to reach their
fuII potentiaI.
