Test bank for community health nursing a canadian perspective 5th edition by stamler yiu (1).pdf
Test bank for community health nursing a canadian perspective 5th edition by stamler yiu (1).pdf
Environmental Health Indicator is : An expression of the link between environment and health, targeted at an issue of specific policy or management concern and presented in a form, which facilitates interpretation for effective decision ”
Many Models as PSR , DSR, DPSIR, & DPSEEA models
Presentation delivered during the 4th National Convention and General Assembly of the Alliance of Young Nurse Leaders & Advocates-International with the theme "MDGs and Beyond: Positioning the Role of Nurses in Global Health." December 14, 2013, Cabanatuan City, Nueva Ecija, Philippines.
Universal health coverage was established in the WHO constitution of 1948 declaring health a fundamental human right.The goal of universal health coverage is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them.
Environmental Health Indicator is : An expression of the link between environment and health, targeted at an issue of specific policy or management concern and presented in a form, which facilitates interpretation for effective decision ”
Many Models as PSR , DSR, DPSIR, & DPSEEA models
Presentation delivered during the 4th National Convention and General Assembly of the Alliance of Young Nurse Leaders & Advocates-International with the theme "MDGs and Beyond: Positioning the Role of Nurses in Global Health." December 14, 2013, Cabanatuan City, Nueva Ecija, Philippines.
Universal health coverage was established in the WHO constitution of 1948 declaring health a fundamental human right.The goal of universal health coverage is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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A Test bank is a ready-made electronic Q&A testing resource that is tailored to the contents of an individual textbook. Feedback is often provided on answers given by students, containing page references to the book.
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Test bank for community public health nursing evidence for practice 4TH editi...robinsonayot
Test bank for community public health nursing evidence for practice 4TH edition demarco walsh - Copy.pdf
Test bank for community public health nursing evidence for practice 4TH edition demarco walsh - Copy.pdf
Online Journal of Rural Nursing and Health Care, 17(1) ht.docxAASTHA76
Online Journal of Rural Nursing and Health Care, 17(1)
http://dx.doi.org/10.14574/ojrnhc.v17i1.452 1
Editorial
Social Determinants of Health and Rural Nursing
Pamela Stewart Fahs, PhD, RN, Editor
Social determinants of health is a term defined by the Healthy People 2020 (Office of
Disease Prevention and Health Promotion, n.d., section Understanding) as “…conditions in the
environment in which people are born, live, learn, work, play, worship and age that affect a wide
range of health, functioning, and quality of life outcomes and risks”. In this definition “place”
matters, as does race/ethnicity, age, education, social support etc. – all of the factors that are part
of one’s socio-economic status. Thus being a rural dweller alone does not put your health at risk
but if you are a rural dweller with little social and economic resources you will have a higher risk
for ill health. You may need to use more resources to access health care than someone in a more
urban place, simply because of limited accessibility. For those living in a rural setting without
reliable transportation being able to access health care is more arduous than for those with access
to transportation as well as health care.
Anyone with even a modicum of knowledge on the history of nursing can connect the
profession and past efforts and successes in enhancing population health through work on the
social determinants of health. This work can be seen in urban areas by nurses such as Lillian
Wald at Henry House in New York and rural areas in the work of Mary Breckenridge and the
Frontier Nursing Service. In both cases nursing was caring for individuals and families but also
looking at the macro level problems of poverty, lack of formal education, poor housing, lack of
access to health care; all of which would be deemed today as improving the social determinants
of health. Since the 1920’s with the work of Wald and Breckinridge we have made inroads into
the health status of people in the US. In general we have better living situations for individuals
Online Journal of Rural Nursing and Health Care, 17(1)
http://dx.doi.org/10.14574/ojrnhc.v17i1.452 2
and families, more education and more wealth. However, the upward trajectory in health status
over the years is not carrying all and Healthy People 2020 (n.d.) promotes a place based
organizing framework that addresses five major determinants of health: a) Economic Stability, b)
Education, c) Social and Community Context, d) Health and Health Care, and e) Neighborhood
and Built Environment. Nursing has a clear role in providing health care beyond care of the
individual. Flynn (2016) writes that “…nursing may have more potential than other health
professions in bringing power and authority to the idea of.
Dear students get fully solved assignments
Send your semester & Specialization name to our mail id :
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CommunityPublic Health NursingPromoting the Health ofLynellBull52
Community/Public Health Nursing
Promoting the Health of Populations
SEVENTH EDITION
Mary A. Nies, PhD, RN, FAAN, FAAHB
Director of Nursing Research and Professor College of Nursing, Joint Appointment MPH Program, Kasiska
Division of Health Sciences, Idaho State University, Pocatello, Idaho
Melanie McEwen, PhD, RN, CNE, ANEF
Professor, University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, Texas
2
Table of Contents
Cover image
Title page
Copyright
Dedication
About the Author
Acknowledgments
Contributors
Preface
Unit 1. Introduction to Community Health Nursing
1. Health: A Community View
Definitions of Health and Community
Determinants of Health and Disease
Indicators of Health and Illness
Definition and Focus of Public Health and Community Health
Preventive Approach to Health
Definition and Focus of Public Health Nursing, Community Health Nursing, and Community-
Based Nursing
Population-Focused Practice and Community/Public Health Nursing Interventions
Public Health Nursing, Managed Care, and Health Reform
Summary
Evolve Website
2. Historical Factors: Public Health Nursing in Context
Evolution of Health in Western Populations
3
kindle:embed:0006?mime=image/jpg
Advent of Modern Health Care
Consequences for The Health of Populations
Social Challenges and Public Health Nursing
Challenges for Public Health Nursing
Summary
Evolve Website
3. Thinking Upstream: Nursing Theories and Population-Focused Nursing Practice
Thinking Upstream: Examining the Root Causes of Poor Health
Historical Perspectives on Nursing Theory
How Theory Provides Direction to Nursing
Microscopic Versus Macroscopic Approaches to the Conceptualization of Community Health
Problems
Assessing a Theory’s Scope in Relation to Community Health Nursing
Review of Theoretical Approaches
Healthy People 2020
Summary
Evolve Website
4. Health Promotion and Risk Reduction
Health Promotion and Community Health Nursing
Determinants of Health
Theories in Health Promotion
Risk and Health
The Relationship of Risk to Health and Health Promotion Activities
Summary
Evolve Website
Unit 2. The Art and Science of Community Health Nursing
5. Epidemiology
Use of Epidemiology in Disease Control and Prevention
Calculation of Rates
Concept of Risk
4
Use of Epidemiology in Disease Prevention
Use of Epidemiology in Health Services
Epidemiological Methods
Summary
Learning Activities
6. Community Assessment
The Nature of Community
Healthy Communities
Assessing the Community: Sources Of Data
Needs Assessment
Diagnosing Health Problems
Summary
Evolve Website
7. Community Health Planning, Implementation, and Evaluation
Overview of Health Planning
Health Planning Model
Health Planning Projects
Health Planning Models in Public Health
Health Planning Federal Legislation
Nursing Implications
Summary
Evolve Website
8. Community Health Education
Connecting With Everyday Realities
Health Education in ...
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1. Test Bank - Community Health Nursing, A Canadian Perspective,
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Chapter 1 – 33
2.
3. Chapter 1: The History of Community Health Nursing in Canada Community
Health Nursing A Canadian Perspective 5th Edition Stamler
Multiple Choice Questions
1. Who would a visiting nurse most likely work with in the early 1900s in Canada?
a. Families who could afford to pay
b. Poor and destitute families
c. The community
d. School children
Correct Answer: b (page 6)
2. Which community health nursing specialty emerged in early 20th-century Canada to combat
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a. Visiting nursing
b. District nursing
c. Private duty nursing
d. Public health nursing
Correct Answer: d (page 4)
3. In the early 20th century, health departments were dissolved after a local emergency was over. Which
statement below characterizes the social attitude of the era?
a. Public health was the responsibility of doctors
b. Visiting nurses were responsible for community health
c. The state was not responsible for health care
d. Women should not be working outside of the family
Correct Answer: c (page 3)
4. 4. What was the primary reason for the establishment of school health programs?
a. Prevent ill children from becoming dependent citizens
b. Promote the health of all children
c. Provide food for children who lived in poverty
d. Treat sick children so they could work and contribute to the family income
Correct Answer: b (page 4)
5. The earliest forms for healthcare in Canada were:
a. The practices of Aboriginal people
b. European settlers who were physicians
c. The wives of surgeons
d. The Grey Nuns-first community nursing
Correct Answer: a (page 2)
6. were Canada’s first community nursing order who made significant
contributions to providing access to health services, food, shelter, and education for the most vulnerable:
a. The Victorian Order of Nurses
b. The Grey Nuns
c. Public Health Nurses
d. School Nurses
e. nursing sisters -first to provide health care in remote and frontier area)
Correct Answer: b (page 3)
7. The dual mandate of doing charitable work and providing affordable nursing care was held by which
agency?
a. The Margaret Scott Nursing Mission
b. The Victorian Order of Nurses-lady aberdeen led the development
c. Indian Health Services
d. Public Health Services
Correct Answer: b (page 4)
5. 8. How were public health nurses and home visiting nurses different from nurses employed in other
sectors of the healthcare system?
a. They received less compensation for their services
b. They were dependent on other health care professionals
c. They required post-diploma training at a university
d. They offered services to the elite living in urban districts
Correct Answer: c (page 4)
9. Which of the following were the first two public health nursing specialties?
a. TB nursing and school nursing
b. Private duty nursing and TB nursing
c. Home-visiting nursing and school nursing
d. Outpost nursing and school nursing
Correct Answer: a (page 4)
10. What was the role of the first public health nurses in Canada?
a. To assess hygiene conditions in the home
b. To conduct well baby clinics
c. To promote breastfeeding of newborn infants
d. To promote health of school children
Correct Answer: d (page 4)
11. Which organization is credited for establishing well-baby clinics?
a. The Grey Nuns
b. The Victorian Order of Nurses
c. The Red Cross
d. Provincial Health Departments
Correct Answer: c (page 5)
6. 12. Why did public health programs have limited success in rural and isolated areas?
a. There was a greater need for home care and midwifery
b. There were many physicians in the rural areas
c. There was higher need for health education and illness prevention
d. Local health departments were situated in rural areas
Correct Answer: a (page 6)
13. Which of the following roles best describes the work of the district and visiting nurse?
a. They provided home visits and well-baby clinic services
b. They provided bed-side nursing and health education
c. They provided maternal child health programs
d. They provided well-baby clinic services and health education
Correct Answer: b (page 6)
14.How did publicly funded healthcare programs change the work of visiting nursing
associations?
a. The Victorian Order of Nurses took over public health programs
b. Visiting nurses provided care to those who could not afford it
c. Hospital admission became the norm for those requiring obstetrical care
d. Chronically ill individuals no longer remained in community settings
Correct Answer: c (page 7)
15.Military nursing requires the nurse to demonstrate which of the following competencies of
community health nursing:
a. A narrow vision
b. Acute care health approaches
c. The ability to adapt practice in diverse settings
d. The ethical comportment to address simple conflicts that involve violence
Correct Answer: c (page 7)
7. 16.Which of the following types of community health nursing refers to nurses providing services in the most
remote geographic locations?
a. Visiting nursing
b. Public health nursing
c. Outpost nursing
d. District nursing
Correct Answer: c (page 7)
17.Which group played an important role in developing the social and healthcare services in smaller
communities?
a. The Victorian Order of Nurses
b. The politicians
c. District and visiting nurses
d. Women volunteers
Correct Answer: d (page 5)
18. What was the focus of the first group of public health officials in the early 20th
century?
a. Waste disposal and a safe water supply
b. Health education and disease prevention
c. Infant and child welfare
d. Social welfare programs
Correct Answer: c (page 5)
19.Which of the following programs were taken over by the health department as part of the process of
consolidating all public health programs?
a. School health programs
b. Social welfare programs
c. Well-baby programs
d. Home visiting programs
Correct Answer: a (page 5)
8. 20.Which of the following organizations is viewed as Canada’s oldest and most experienced visiting
nursing organization?
a. The Red Cross
b. The Victorian Order of Nurses
c. The Grey Nuns
d. Provincial health departments
Correct Answer: b (page 9)
21. Early school-based initiatives involved which of the following activities?
a. Immunizations at various ages
b. Medical inspections of children followed by home visits
c. Breakfast and lunch programs
d. Sanitation and access to potable water
Correct Answer: b (page 5)
22.How did the reduction in government spending in the 1980s and 1990s affect community health
nurses?
a. Increased funding for physical infrastructure
b. Re-institutionalization of mental health patients
c. Improved capacity to follow-up with patients with communicable diseases
d. Reduced nursing positions
Correct Answer: d (page 10)
23. In which year was the Community Health Nurses Association of Canada established? a. 1995
Correct Answer: c (page 11)
b. 2000
c. 1987
d. 1976
9. 24.Which document continues to be recognized as a visionary document with recommendations for shifting
resources and policy in the direction of primary health care, home healthcare, and health promotion,
which nurses as key players in the system?
a. The Alma-Ata Declaration
b. The Ottawa Charter for Health Promotion
c. The Medical Care Act
d. The Romanow Commission’s report
Correct Answer: d (page 11)
25. General public health nursing practice emerged from which type of nursing
a. School nursing
b. Visiting nursing
c. Outpost nursing
d. Home-visiting nursing
Correct Answer: a (page 12) Short
Answer Questions
26. Contrast the three sectors of nursing that existed in Canada in the 20th century.
Correct Answer: Hospital nurses, private-duty nurses, and public health nurses (including visiting nurses).
Differences in practice settings/locations, pay/funding, educational preparation, focus of care, types of clientele
(page 4).
27.Discuss the role that women’s volunteerism and leadership in communities played in the
development of community health nursing.
Correct Answer: They worked on community development, the made the development of healthcare services a
priority; they lobbied local officials, served tea at child welfare clinics, sewed layettes for destitute families,
provided transportation, made referrals, raised funds, and enabled CHNs to fulfill their professional obligations to
the fullest extent possible (page 4).
28. Discuss why local physicians sometimes did not support local public health programs
10. Correct Answer: Because they feared that the PHNs would provide primary care and thus compete with them for
both patients and income (page 5).
29.Discuss how increased government responsibility for the healthcare of Canadians had an impact on
public health nursing.
Correct Answer: Programs were expanded between 1940 and 1970; shift in focus from child health, immunization,
and communicable disease control to a focus on decreasing morbidity and mortality from chronic diseases and
injuries; increased demands on time for the early postpartum discharge home visiting program (page 9).
30.The early practice of community health nursing was generalist in nature, consisting of a comprehensive
range of services, including home healthcare and health promotion. Why did community health nursing
become specialized over time?
Correct Answer: specialization occurred as a response to social, economic, and political forces, including the
expanding knowledge of society (page 12).
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Nursing Test Banks, Exams and Solution Manuals
11. Chapter 2: Financing, Policy, and Politics of Healthcare Delivery
Community Health Nursing A Canadian Perspective 5th Edition Stamler
Multiple Choice Questions
1. Where was Canada’s first universal health insurance program implemented?
a. Manitoba in 1957
b. Canada in 1967
c. Prince Edward Island in 1867
d. Saskatchewan in 1947
Correct Answer: d (page 18)
2. What was the purpose of the Canada Health Act (1984)?
a. Provide the provinces with more legal authority
b. Ban extra billing and user fees
c. Establish a national drug plan
d. Increase access to care based on ability to pay
Correct Answer: b (page 18)
3. What Act has as its cornerstones publicly administered, comprehensive, universal, portable, and
accessible?
a. Hospital Insurances and Diagnostic Services Act
b. Constitution Act
c. Canada Health Act
d. American Medicare Act
Correct Answer: c (page 18)
4. What is one of the primary objectives of Canadian health care policy according to the Canada Health Act
(1984)?
a. Facilitate reasonable access to hospital care
b. Protect the health care system from privatization
c. Restore stable health care funding to the provinces
d. Protect, promote, and restore the physical and mental well-being of the residents of Canada
Correct Answer: d (page 19)
5. Howhas the Canada Health Act (1984) been successful in ensuring all Canadians have
12. access to the health care they need?
a. Creating specific mechanisms to ensure accountability and transparency
b. Establishing criteria and conditions for insured health care services that must be met before
federal transfer of funds are made
c. Penalizing provinces that do not comply with the public health aspects of the act
d. Determining the extent to which each province and territory has satisfied the conditions and
criteria of the Act
Correct Answer: b (page 18)
6. Which model dominated public and political thinking about health during the time that the Canadian
Medicare System was created in 1957?
a. Healthy lifestyle model
b. Socio-environmental model
c. Biomedical model
d. Health promotion model
Correct Answer: c (page 19)
7. Which document was considered revolutionary by the global community and led to a
reconceptualization of health promotion?
a. The Lalonde Report
b. The Declaration of Alma Ata
c. The Ottawa Charter
d. The Social Determinants of Health
Correct Answer: a (page 20)
8. Who said, “The practice of healthcare has evolved. And despite efforts to keep pace, medicare
has not.”
a. Monique Begin, former Minister of Health
b. Ralph Klein, former Premier of Alberta
c. Justin Trudeau, Prime Minister of Canada
d. Ray Romanow, Commissioner on the Future of Health Care
Correct Answer: d (page 19)
9. How does Canada rank in the world with respect to healthcare?
a. Canada has the lowest infant mortality rate in the world
b. Canada’s universal coverage is more costly and less effective than the privatized U.S.
13. health care system
c. Canada’s life expectancy at birth ranks among the highest in the world
d. Canada spends less than one-half as much per capita on healthcare than Japan
Correct Answer: c (page 19)
10. What are the four determinants of health identified in the Lalonde Report (1974)?
a. Socio-environmental, biomedical, disease prevention, and health promotion
b. Gender, culture, working conditions, and education
c. Biological, emotional, spiritual, and psychological
d. Environment, lifestyle, human biology, and healthcare system
Correct Answer: d (page 20)
11. What provided the basis for the Ottawa Charter?
a. Epp Report
b. Alma Ata Declaration
c. Canada Health Act
d. British North America Act
Correct Answer: a (page 20)
12. What is involved in a system that focuses on primary care?
a. People accessing health care services at the first point of contact
b. Health education, proper nutrition, and disease prevention
c. Health protection, health promotion, and disease prevention
d. Accessible, affordable, and acceptable health care
Correct Answer: a (page 22)
13. In which province do Family Health Teams deliver primary health care?
a. Quebec
b. Nova Scotia
c. Ontario
d. British Columbia
Correct Answer: c (page 22)
14. 14. Who funds public health in Canada?
a. Provinces and municipalities
b. Municipalities
c. Federal government
d. Provincial and federal government
Correct Answer: a (page 23)
15. Which of the following is a challenge of public health in Canada?
a. There is decreased complexity and increased funding
b. While funding is decreasing, it is still adequate
c. Public health infrastructure was constructed
d. There is disparity in human resources among provinces
Correct Answer: d (page 23)
16. Which services have been steadily growing in Canada over the past 35 years?
a. Public health
b. Acute care
c. Home care
d. Long term care
Correct Answer: c (page 24)
17.Mr. Jones lives in Ontario and requires home care nursing and support services. Who would deliver these
services?
a. Social services branch of the department of health
b. Local public health units
c. Agency contracted by the Local Health Integration Network
d. Local health authority
Correct Answer: c (page 25)
18.Role clarity has been identified as an issue for community health nurses. What is a component
of role clarity?
a. Understanding the role of other health care professionals
b. Sharing a common language to describe the role
c. Leadership development
d. Access to specialized expertise
15. Correct Answer: b (page 25)
19.What would help community health nurses to be valued more by other health care
professionals?
a. To be able to describe their role with confidence
b. Quality supervision and management
c. Access to ongoing education and training
d. Stronger leadership in the area
Correct Answer: a (page 25)
20.Which of the following is identified as attributes of nurse leaders that contribute to
effectiveness:
a. Avoiding risk taking
b. Organizational ability
c. Social awareness
d. Comfort with routines
Correct Answer: c (page 28)
21.Within a context of community health nursing practice, which organizational supports positively
influence practice?
a. A work environment that disestablishes leadership
b. A work environment that devalues unique contribution of staff
c. A work environment that has unstable funding
d. A work environment that has access to resources
Correct Answer: d (page 29)
22. Transformational leadership practices include which of the following?
a. Building relationships and trust
b. Creating disempowering work environments
c. Creating a culture that supports knowledge stasis
d. Avoiding taking any risks
Correct Answer: a (page 28)
23.Professionals working in health service organizations with strong leadership demonstrate which of
the following?
a. Lower levels of organizational effectiveness
16. b. Decreased organizational commitment
c. Increased ability to lead a stagnant workforce
d. Greater sense of affiliation with organizational goals
Correct Answer: d (page 28)
24.Which of the following personal resources are necessary for developing and sustaining leadership?
a. Personal identity
b. Leadership expertise
c. Community attributes
d. Family supports
Correct Answer: b (page 28)
25. What is one way to strengthen collaborative leadership at the national level?
a. Promoting community health solutions across sectors
b. Creating an empowering work environment
c. Cultivating personal supports
d. Willingness to be risk averse
Correct Answer: a (page 29)
Short Answer Questions
26.Contrast the terms primary care and primary health care and give an example of each related to
community health nursing practice
Correct Answer:
Primary Care: a person's first point of contact with the health care system. Primary care services are dominated by
medicine and have focused mainly on acute care and treatment of disease. The largest group of primary care
providers in Canada is physicians. Other primary care providers are nurse practitioners, dentists, chiropractors,
pharmacists, dieticians, midwives, optometrists and to some extent PHNs. Most Canadians access primary care
though a family or general practitioner who is reimbursed on a fee-for-service basis. Only a few Canadians receive
primary care services through a CHC, walk-in clinics, or emergency rooms.
Example related to CHN practice: A family who a PHN visits in the postpartum period may also see the primary
care provider, most likely a GP, around the same time, increasing the need for interprofessional communication.
17. Primary Health Care: a philosophy or approach to care that involves the principles set forth at Alma Ata in 1978:
health care that is accessible, affordable, and acceptable; uses appropriate technology; promotes health; and
recognizes intersectoral and interdisciplinary approaches.
Examples related to CHN practice: a multidisciplinary community health council with several CHNs as members
collaborates with a community to develop a network of safe bike and walking trails through residential and
industrial neighbourhoods (page 22).
27.Summarize two federal initiatives in the development of health promotion and give one rationale
for each that illustrates their importance on an international level.
Correct Answer:
- Lalonde Report (1974): acknowledged the limitations of the funded medical/treatment system. Presented a
vision for health promotion. Identified four determinants of health, with an emphasis on lifestyle and the
environment. Led to a global reconceptualization of health promotion.
- Epp Report (1986): expanded the definition of health promotion, incorporated some of the tenets of primary
health care, and emphasized social/environmental/political dimensions of health. Formed the basis for the Ottawa
Charter of Health Promotion.
18. - Ottawa Charter of Health Promotion (1986): International document identifying the prerequisites for health,
strategies for promoting health, and outcomes of the strategies. Acknowledges that caring for one's self and others
is conducive to health. Identifies caring, holism, and ecology as essential concepts in health promotion.
- Population Health Template and Population Health Promotion Model (2001 and 1996): resources developed
to put population health and health promotion into action. Used nationally and internationally in program
planning, community development, and resource allocation (page 20)
28.Describe the importance of three historical milestones in the development of the Canadian health care
system
Correct Answer:
1867-1867—Constitution Act (BNAAct) assigned responsibility for hospitals to provinces. Did not explicitly
assign responsibility for health policy to either federal or provincial government.
1919—national health insurance on the Liberal Party platform 1947— Saskatchewan gets
Medicare under Tommy Douglas
1957—national Hospital Insurance and Diagnostic Services Act (HIDS) provides financial incentives to the
provinces to build hospitals through 50/50 grants if provinces meet five key principles 1962— Saskatchewan gets
universal, publicly funded medical insurance
1966—federal Medicare including physicians' services; if provinces meet same principles as HIDS, feds pay 50%
of costs
1971—all provinces participate
1977—Established Programs Financing Act changes federal share of health costs to a per capita block grant
1996—Canada Health and Social Transfer (CHST) payments include federal transfer payments for health,
postsecondary education, and welfare (page 18-19)
29. Discuss three Canadian values that are reflected in the current Medicare system.
Correct Answer:
- Social justice: All members of society, including the most vulnerable, are entitled to free health care in Canada.
- Equity: All Canadians are viewed equally and without discrimination in terms of universal health care
19. coverage.
- Community: All members of society contribute through taxation to provide everyone in the
community with access to health care regardless of ability to pay (page 18).
30.Name three of the five principles of the Canada Health Act (1984) and give an example for each.
Correct Answer:
- Publicly administered: Health care funds are administered by a local elected regional health authority
under the direction of the provincial health department.
- Portable: A person from Saskatchewan can receive insured health care in Ontario.
- Accessible: Families across Alberta have access to pediatric health care in their own communities or in
communities within their health region without additional user fees.
- Universal: All residents of British Columbia are covered by B.C. health care.
- Comprehensive: In-hospital health care, such as medically necessary surgery, is covered in the province of
Newfoundland (page 18).
20. Chapter 3: Nursing Roles, Functions, and Practice Settings
Community Health Nursing A Canadian Perspective 5th Edition Stamler
Multiple Choice Questions
1. Which of the following statements is true about the Blueprint for Action for Community Health Nursing
in Canada (CHNC, 2011)?
a. It incorporates the voices of government officials about public health
b. It is a point of reference for ongoing dialogue about community health nursing practice
c. It is a landmark document about primary health care in Canada
d. It provides a framework for intersectoral collaboration
Correct Answer: b (page 38)
2. Which of the following documents outlines six areas of action, one of them being supporting nursing
leadership development?
a. The Ottawa Charter
b. The Declaration of Alma Ata
c. The Blueprint for Action for Community Health Nursing in Canada
d. The Lalonde Report
Correct Answer: c (page 38)
3. The Canadian Nurses Association predicts that by 2020:
a. 25% of nurses will be working outside of the acute care setting
b. 45% of nurses will be working outside of the acute care setting
c. 60% of nurses will be working outside of the acute care setting
d. 70% of nurses will be working outside of the acute care setting
Correct Answer: c (page 38)
4. What level of prevention is evident in screening school children for vision and hearing?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Quaternary prevention
Correct Answer: a (page 38)
5. What activity is an example of a community health nurse working at the individual level?
a. Providing immunization in a travel clinic
21. b. Providing school health education services
c. Developing a web-based community resource guide
d. Engaging in consultation about healthy public policy
Correct Answer: a (page 38)
6. A community health nurse has successfully lobbied the government to invest in a rehabilitation facility for
people with traumatic brain injuries. What type of health promotion strategy does this represent?
a. Secondary prevention
b. Tertiary prevention
c. Primary prevention
d. Quaternary prevention
Correct Answer: b (page 38)
7. Which of the following is foundational to health equity and central to community health nursing practice?
a. Health promotion
b. Social determinants of health
c. Social justice
d. Health education
Correct Answer: c (page 38)
8. The mission of the Community Health Nurses of Canada (CHNC) is to:
a. Advance practice and to improve the health of Canadians
b. Build capacity among community health nurses
c. Advocate for healthy public policy
d. Provide services to vulnerable populations
Correct Answer: a (page 38)
9. Clinical practice, research, administration, and education are known as:
a. Priorities for community health nursing
b. Standards of practice for community health nursing
c. Blueprint for action for community health nursing
d. Domains of practice for community health nursing
Correct Answer: d (page 40)
22. 10.The purpose of is to define the scope and depth of nursing practice in the
community and establish expectations for acceptable, safe, and ethical nursing care:
a. Blueprint for action for community health nursing
b. Domains of practice for community health nursing
c. Standards of practice for community health nursing
d. Priorities for community health nursing
Correct Answer: c (page 40)
11. Which two types of community health nurses are the largest groups?
a. Public health nursing and home health nursing
b. Home health nursing and outpost nursing
c. Public health nursing and military nursing
d. Home health nursing and street nursing
Correct Answer: a (page 40)
12. What is the goal of public health nursing?
a. To develop health education messages for school children
b. To increase the health of the public by preventing disease
c. To provide immunizations to community members
d. To conduct home visits to newborns in the postpartum period
Correct Answer: b (page 40)
13.The aim is to provide accessible, responsive, and timely care which allows people to stay in their homes
with safety and dignity. This statement is representative of which type of nursing?
a. Outpost nursing
b. Public health nursing
c. Home health nursing
d. Street nursing
Correct Answer: c (page 41)
14.What type of health care is described in the statement: “healthcare that is scientifically sound, socially
acceptable, universally accessible to individuals and families and at a cost that the community and country
can afford”
a. Disease and injury prevention
24. c. Population health promotion
d. Primary health care
Correct Answer: d (page 42)
15.What type of community health nurse focuses on health promotion, maintenance and
restoration, and injury and disease prevention in the workplace?
a. Nurse entrepreneur
b. Occupational health nurse
c. Forensic nurse
d. Primary health care nurse practitioner
Correct Answer: b (page 44)
16.The 5 A’s of behavior change (assess, advise, agree, assist, and arrange) are used by which type of
community health nurse?
a. Telehealth nurse
b. Primary health care nurse practitioner
c. Public health nurse
d. Chronic disease management nurse
Correct Answer: d (page 48)
17. Which of the following statements best represents the work of outreach/street nurses?
a. They determine the health care needs of clients over the phone
b. They use harm reduction strategies specific to vulnerable population groups
c. They work within the community often in remote and rural areas
d. They work closely with the health care team to monitor and manage diseases with clients
Correct Answer: b (page 48)
18. What is the primary focus of a forensic nurse’s work?
a. Works with clients who have been the victims of crimes
b. Consulting for ethics review boards
c. Working at a summer camp for troubled youth
d. Providing health care services within psychiatric institutions
Correct Answer: a (page 45)
19.What action is required if a community health nurse wants to become a primary health care
25. nurse practitioner (PHCNP)
a. Gather additional skills to be able to assist physicians
b. Take additional nursing education with a focus on advanced clinical nursing practice
c. Write the national nurse practitioner examination
d. Work in the United States as this position is not available in Canada
Correct Answer: b (page 49)
20. What is an example of a health promotion activity that a public health nurse would provide?
a. Giving stress reduction seminars to employees at a large corporation
b. Symptom management support for a family in a palliative care situation
c. Monitoring home oxygen therapy for a client awaiting a lung transplant
d. Providing meningitis prophylaxis to high school students in an outbreak situation
Correct Answer: d (page 43)
21. Which of the following statements pertains to Parish Nursing?
a. Parish nursing began in Europe and moved to the united states in the mid-1890s
b. Parish nursing integrates faith and health into nursing practice
c. Parish nursing arrived in Canada in the early 1900s
d. Parish nursing is not expected to facilitate spiritual care
Correct Answer: b (page 52)
22. The first recorded instance of military nursing in Canada was:
a. At the Northwest Rebellion in 1885 with the Metis uprising against the Canadian
government
b. DuringWorld War I within the Royal Canadian Army
c. DuringWorld War II within the navy, army, and air force
d. The South African War in 1900
Correct Answer: a (page 53)
23.Which term best describes the following statement: Everyone, regardless of socially determined
circumstances, has an equal opportunity to attain their full health potential without being disadvantaged
a. Community justice
b. Social action
c. Political advocacy
d. Health equity
26. Correct Answer: d (page 54)
24. Which of the following is part of the standards of practice for community health nurses?
a. Engaging in capacity building of communities
b. Participating in political advocacy
c. Working towards community justice
d. Initiating social action activities
Correct Answer: a (page 40)
25.What type of community health nurse focuses on primary care, chronic disease prevention and
management, substance abuse prevention and management, personal practices and coping skills, low
income supports, and access to housing?
a. Occupational health nurse
b. Rural/outpost nurse
c. Telehealth nurse
d. Parish nurse
Correct Answer: b (page 51)
Short Answer Questions
26.Contrast three of the practice settings of community health nurses in terms of role focus and unique
characteristics of nursing practice. Give an example for each practice setting of where the community
health nurse might work.
Correct Answer:
Public Health Nurse:
Role focus-mandated by legislation to promote and protect the health of populations. Focus is on health
enhancement, health protection, and disease prevention
Unique characteristics-primarily works with a healthy population, minimal contact with unwell
people, may have entire community as client
Work setting-public health unit
Home Health Nurse:
Role focus-client as individual or family; provides direct clinical care and case management
Unique characteristics-works alone, practises highly autonomously and independently, adaptable to client-
controlled environment
27. Work setting-client home or school
Parish Nurse:
Role focus-client as individual or group; focuses on education, counseling, and referrals
Unique characteristics-integrates faith-based approach to care. U.S.-based credential available
Work setting-a United Church
Occupational Health Nurse:
Role focus-client as individual or group; provides direct care, including primary, secondary, and tertiary preventive
services
Unique characteristics-addresses health, safety, and well-being for employees. May earn specialty credential from
CNA COHN(C)
Work setting-a meat-packing plant (pages 43 – 46)
27.Discuss the role of two professional nursing associations as they relate to community health nurses
Correct Answer:
- Community Health Nursing Association of Canada (CHNAC) developed the Canadian Community Health
Nursing Standards of Practice (2003).
- Canadian Nurses Association (CNA) is a national voluntary association that exists to link nurses who work in the
same practice area. Will work with CHNAC to create a national certification for CHNs. All provincial associations
except Quebec belong to the CNA.
- Provincial regulatory body and professional associations regulate the profession of nursing in each province.
Protect the public through maintaining a nursing registry. Professionally advocate for nurses and the public to have
a strong publicly funded universal health care system. Promote excellence in nursing practice (page 38).
28. List the seven Canadian Community Health Nursing Standards of Practice
Correct Answer:
- Health promotion
- Prevention andhealth protection
- Health maintenance, restoration, and palliation
- Professional relationships
- Capacity building
28. - Access and equity
- Professional responsibility and accountability (page 40)
29. Draw the Canadian Community Health Nursing Professional Practice Model
Correct Answer: see figure 3.1 (page 39)
30.Several factors, both enablers and barriers, are influencing community health nursing education.
List 2 enablers and 2 barriers.
Correct Answer:
- Enablers: strong community-academic partnerships, supportive curriculum structures and processes.
- Barriers: devaluing community health nursing education, insufficient time in theory classes and clinical
placements (page 55).
29. Chapter 4: Public Health Nursing
Community Health Nursing A Canadian Perspective 5th Edition Stamler
Multiple Choice Questions
1. “The organized efforts of society to keep people healthy and prevent injury, illness, and
premature death” is the definition of which term?
a. Public health nursing
b. Public health
c. Social determinants of health
d. Vaccination campaigns
Correct Answer: b (page 60)
2. What is the mission of the Public Health Agency of Canada?
a. To apply international research and development to Canada’s public health programs
b. To strengthen intergovernmental collaboration on public health
c. To facilitate national approaches to public health policy and planning
d. To promote and protect the health of Canadians though leadership, partnership,
innovation, and action in public health
Correct Answer: d (page 60)
3. What was the significance of the Public HealthAgency Act (2006)?
a. It confirmed the agency as a legal entity and appointed a chief public health officer
b. It served as a central point for sharing Canada’s expertise in health promotion
c. It helped to increase the lifespan of all Canadians through various initiatives
d. It helped to secure funding for chronic diseases and illness and injury prevention
Correct Answer: a (page 60)
4. What type of community health nurse applies public health science, the principles of primary health care,
nursing science, and the social sciences to promote, protect, and preserve the health of populations?
a. Outpost nurse
b. Forensic nurse
c. Public health nurse
d. Occupational health nurse
Correct Answer: c (page 61)
30. 5. The first public health activities in Canada occurred in 1831 with the arrival of immigrants to Upper
Canada who had contracted which disease?
a. Tuberculosis
b. Spanish influenza
c. Cholera
d. The black plague
Correct Answer: c (page 61)
6. One of the first types of public health legislation in Canada provided detailed regulations for which of
the following?
a. Personal and environmental cleanliness
b. Water and sanitation pipeline initiatives
c. Mandatory vaccination of school children
d. Water fluoridation initiatives
Correct Answer: a (page 62)
7. When were the responsibilities for health and social welfare matters delegated to the provinces?
a. After World War I
b. After World War II
c. After the British North American Act
d. After Canadian confederation
Correct Answer: d (page 62)
8. In what year and in what province was the first Public Health Act passed?
a. In Ontario in 1884
b. In Saskatchewan in 1910
c. In British Columbia in 1896
d. In Manitoba in 1927
Correct Answer: a (page 62)
31. Chapter 5: Home Health Nursing in Canada
Community Health Nursing A Canadian Perspective 5th Edition Stamler
Multiple Choice Questions
1. The Canada Health Act (1984) sets the requirements that must be met by all provinces and territories in
or to ensure:
a. Reasonable access to medically necessary hospital and doctors’ services anywhere in Canada
b. Reasonable access to all services related to healthcare anywhere in Canada
c. Reasonable access to medically necessary hospital, doctors’ and nurses’ services anywhere in
Canada
d. Reasonable access to medically necessary hospital nurses’ services anywhere in Canada
Correct Answer: a (page 74)
2. According to the Canada Health Act (1984), home care is recognized as:
a. An essential service that is insured under the Canada Health Act
b. An extended health service that is not insured under the Canada Health Act
c. An essential service but the principles of the Canada Health Act do not apply
d. An extended health service but the principles of the Canada Health Act do apply
Correct Answer: b (page 74)
3. Which of the following statements best reflects the definition of home health nursing:
a. Home health nursing focuses on the provision of care to only chronically ill patients of all ages
b. Home health nurses work in isolation from other health care providers
c. Home health nursing is delivered in the client’s home, school, workplace or other setting that
requires nurses to travel from place to place to care for individuals
d. Home health nursing focuses on health promotion initiatives only
Correct Answer: c (page 77)
4. According to the Ontario Home Care Association (2011), the unique contribution of home health
nurses is their ability to:
a. Combine knowledge from primary health care, nursing science, and social science to focus on
prevention of health deterioration and health restoration
32. b. Combine knowledge from secondary health care and social science to focus on health
maintenance and end of life care
c. Combine knowledge from medical science and nursing science to work on the
pathophysiology of illness in the home environment
d. Combine knowledge from secondary health care to work with well populations in the
community
Correct Answer: a (page 77)
5. In 2010, what percentage of registered nurses were home health nurses?
a. Less than 1%
b. More than 20%
c. More than 30%
d. Less than 5%
Correct Answer: d (page 77)
6. Which of the following is true of the features of home health nursing?
a. Home health nurses work on their terms with clients and families
b. Home health nurses do not need to know about cultural diversity as they work with the same
clients over time
c. Home health nurses experience both rewards and challenges
d. Home health nurses identify their own needs for the client
Correct Answer: c (page 78)
7. What is the primary area of focus for home health nurses?
a. Disease and injury prevention
b. Policy development
c. Program planning for health and wellness
d. Treatment of diseases or conditions
Correct Answer: d (page 79)
8. The Competencies for Home Health Nursing place a strong emphasis on the highly independent and
autonomous, flexible, and adaptive nature of home health nursing in the context of:
a. Being a guest in the home
b. Being the expert in the home
c. Being the most qualified health professional in the home
33. d. Being licensed to practice in the home
Correct Answer: a (page 80)
9. An important role of the home health nurse is to assess the family’s coping. It continues to be an
expectation that
a. Only Registered Nurses and Licensed Practical Nurses will provide care in the home
b. Friends who can help may not do so as they are under qualified
c. Family and friends will provide care to supplement the care provided by home health nurses
d. Family hire additional care providers as home health nurses have minimal time
Correct Answer: c (page 80)
10.Which document introduced concepts such as protected job leaves, caregiver allowance and tax credits as
provinces and territories shift to home-based care?
a. The Canada Health Act
b. The Romanow Report
c. The Declaration of Alma Ata
d. The Kirby Report
Correct Answer: d (page 80)
11. In 2008, how many people across Canada purchased home care privately?
a. 3.5 million
b. 5.5 million
c. 0.5 million
d. 8.5 million
Correct Answer: c (page 81)
12. The diversity of home visiting interventions carried out by home health nurses can:
a. Decrease functional status and mortality rates
b. Increase depression and functional status
c. Favourably affect health and functional status
d. Decreased functional status and quality of life
Correct Answer: c (page 81)
13. What proportion of home care clients have wound care needs?
a. One third to one half
34. b. One quarter to one third
c. Three quarters
d. Half to three quarters
Correct Answer: b (page 80)
14.Wound care can range from basic to very complex care and is related primarily to six diagnoses.
Which of the following is one of these six diagnoses?
a. Arterial leg ulcers
b. Medial wounds
c. Pilonidal sinuses
d. Diabetic arm ulcers
Correct Answer: c (page 80)
15.The home health nurse works with many clients who are dealing with end-of-life issues. In these cases,
the role of the home health nurse is to:
a. Provide palliative care
b. Liaise with the funeral home
c. Psychological support for members of the health care team
d. Medication pain management for family members
Correct Answer: a (page 80)
16.What must home health nurses do in order to achieve positive health outcomes of their clients?
a. Limit the number of student nurses in home health settings
b. Work collaboratively with other members of the health team
c. Include family members only when medically necessary
d. Communicate only with other members of the health team
Correct Answer: b (page 78)
17. Where does funding for home health nursing come from?
a. The national health budget
b. Private companies
c. It differs by province
d. Only through the provincial health budget
35. Correct Answer: c (page 79)
18. What does the home health nurse’s workload depend on?
a. The clients with the same condition who require the same nursing care
b. The number of clients in the same neighbourhood
c. The type of clients who request the nurse
d. The clients condition and the nursing care required
Correct Answer: d (page 80)
19.Priya is a home health nurse working with a palliative patient. In order to demonstrate
professional responsibility and accountability, Priya should do which of the following?
a. Speak with the client about their end-of-life care wishes
b. Speak with only the doctor about what type of end-of-life care should be implemented
c. Speak with individual family members about their personal wishes for their own end-life- care
Correct Answer: a (page 80)
20. Why is it important to articulate the contributions of nurses in home health?
a. Because the population is decreasing in age
b. Because there are more regulated workers in the home setting
c. Because there are more unregulated workers in the home setting
d. Because there are too many registered nurses in the home setting
Correct Answer: c (page 81)
21.Over the last 10 years, nursing outcomes for home health have been captured through “Health
Outcomes for Better Information and Care.” One of the uses is to better assess the needs of clients.
This is important because:
a. We can identify resources in other countries that we can copy
b. We can identify which types of people our clients need to avoid
c. We can determine different types of unhealthy snack food are okay to eat
d. We can develop ongoing connections with primary health providers
Correct Answer: d (page 81)
22.There is some evidence that home health nurses play a major role in health promotion at the individual
level. This is due to:
a. Providing health assessment, support, and access to resources through regular home
36. visits
b. Providing health interventions and support based on nurse led initiatives
c. Providing access to resources though irregular home visits
d. Providing health assessment and mediocre interventions that not all team members agree on
Correct Answer: a (page 81)
23. Why do nurse leaders require different skill sets?
a. To know which stakeholders to trust and which not to
b. To work only with one stakeholder to decide the course of action
c. To collaborate with various stakeholders on ways to move initiatives forward
d. To decide how to divide up the work on various initiatives
Correct Answer: c (page 83)
24. Which of the following is the most important part of the care delivered in home health?
a. Identifying evidence that only relates to the experience of colleagues
b. Evidence-informed decision making
c. Basing evidence on the client experience
d. Using research evidence only
Correct Answer: b (page 83)
25.What is required in order to maintain high-quality clinical care and a positive work environment in home
health?
a. A suggestion box and complaint phone line
b. Appropriate vehicles to reach various clients
c. Appropriate support and infrastructure
d. Enough time to fit in breaks daily
Correct Answer: c (page 82)
Short Answer Questions
26.Discuss what is important for leaders to do in order to successfully implement evidence-based guidelines in
the home health setting.
Correct Answer:
- Leaders who communicated regularly with staff
- Leaders who attended clinical practice meetings
37. - Leaders who recognized staff efforts to change (page 83)
27. Discuss the future of home health nursing.
Correct Answer:
- The future of home health nursing is bright, and given the predictions, a larger percentage of care will be
delivered in the home in the coming years
- By 2020 two thirds of nurses will be working in the community versus the 30% that currently work in
the community
- Clients expect to be engaged in decision-making related to their care, to receive timely information and
options for care, and to focus on managing chronic diseases and healthy living (page 84)
28. Discuss what home health nurses do.
Correct Answer:
- Section on what do home health nurses do on page 78
29.Compare and contrast the setting of care, primary area of focus, and target population between
the home health nurse, public health nurse, and occupational health nurse
Correct Answer:
- The correct answer can be found in table 5.2 on page 79
30. What is the definition of a service provider organization?
Correct Answer:
- Service provider organizations (SPOs) are usually incorporated entities and can be non-profit
organization, private corporation, municipal government, or Aboriginal organization. SPOs are responsible
for providing nursing care, home support services, personal care, physiotherapy, occupational therapy,
social work, dietetics, speech language therapy, and medical equipment and supplies in the home to
individuals of all ages (page 77).
38. Chapter 6: Advocacy, Ethical, and Legal Considerations
Community Health Nursing A Canadian Perspective 5th Edition Stamler
Multiple Choice Questions
1. Which statement provides the best definition of ethics?
a. Universally held theory on how the world evolved
b. A set of rules that apply only to health care professionals in the practice setting
c. Values, norms, moral principles, virtues, and traditions that guide human conduct
d. A specialized area of philosophy
Correct Answer: c (page 88)
2. Jack, 14 years old, presents at the community health nurses office requesting an initial immunization
series. His parents have never immunized him because they do not believe in immunization. Jack’s
parents did not sign the immunization consent form sent home from school. What does this situation
present for the nurse?
a. Something that never happens in Canada
b. An issue for feminist decision-making
c. An ethical dilemma
d. A course of action that is easily decided and recognized
Correct Answer: c (page 90)
3. What is an example of social control?
a. Smoking cessation program
b. Influenza immunization clinics
c. Request to stay at home when ill with the flu
d. Seatbelt law
Correct Answer: d (page 91)
39. 4. Which scenario represents the principle of reciprocity in ethical decision-making about public health
interventions?
a. All stakeholders are involved with developing policy on how to manage a particular infectious
disease
b. An individual is committed under the Mental Health Act to protect and prevent harm to others
c. A person who is exposed to a communicable disease is provided instructions on how to quarantine
at home
d. The public health department is providing financial compensation to a person who is
quarantined
Correct Answer: d (page 92)
5. What does the concept of social justice assume?
a. There is a limit to collective action
b. All societies experience broad, systematic oppression and inequities
c. The individual is valued over the collective
d. It is better to benefit the few than the disadvantaged many
Correct Answer: b (page 89)
6. Which situation has undergone medicalization?
a. Menopause
b. Breast cancer
c. Homosexuality
d. Hyperthyroidism
Correct Answer: c (page 91)
7. What statement is congruent with capacity building?
a. Equitable sharing of rights, roles, and responsibilities among institutions and individuals
b. Just or fair treatment of all individuals, including equitable access to meet health needs
c. Democracy and civil rights defining a social state in which all have equal rights
d. Strengthening of individual and institutional core skills, capabilities and knowledge
Correct Answer: d (page 95)
8. What term describes the way that nurses approach their practice and reflect on their ethical commitment
to their clients and colleagues?
40. a. Committed ethics
b. Situational autonomy
c. Empowering a community
d. Everyday ethics
Correct Answer: d (page 90)
9. What nursing action best demonstrates professional responsibility and accountability?
a. Respecting a client’s wishes not to inform her boyfriend that she has gonorrhea
b. Keeping a confidential client’s repeated statements that she wants to kill her husband
c. Documenting home visit notes in a timely and thorough manner
d. Protecting the identity of a child who reveals that she has been abused
Correct Answer: c (page 97)
10.Which Canadian Community Health Nursing Standard of Practice is being used when advocating
for appropriate resource allocation?
a. Facilitating access and equity
b. Practice setting safety
c. Empowering communities
d. Maintaining professional boundaries
Correct Answer: a (page 96)
11. Which statement reflects theWorld Health Organization’s (2013) definition of empowerment?
a. A professional process in which communities are allowed to become self-directed
b. A static process that provides people with power
c. A nurse-driven process whereby people are given what they need
d. A process where people and communities move toward increased control
Correct Answer: d (page 95)
12. Who should develop an advanced directive?
a. A physician working in the palliative care setting
b. A person who is terminally ill and needs one to clearly spell out how his or her estate will be divided
c. An individual who wants to stipulate what medical treatments he or she will accept or reject
d. A nurse working with a client who is incapable of making choices
41. Correct Answer: c (page 95)
13.Melanie is a nurse doing home visits. What must she recognize as she builds relationships with her
clients?
a. Sharing her attitudes, beliefs, and values regarding health
b. The client’s attitudes, beliefs, and values regarding health
c. Using the power in the relationship to meet her personal needs
d. Maintaining a distant and clinical boundary
Correct Answer: b (page 95)
14. What must be considered when nurses assist clients to make informed choices?
a. The benefits of the intervention but not the risks
b. Legally binding paperwork
c. The exchange of information and respect for the individual’s autonomy
d. The benefits of the risks, negligence, and autonomy
Correct Answer: c (page 93)
15.Kennedy is a community health nurse that has been working with a lesbian, gay, transsexual, and bisexual
(LGTB) youth group in a large urban centre. Kennedy is lobbying his co-workers to change the nursing
intake form to have more gender-neutral language, such as “Do you live with a partner?” What standard of
practice is the nurse trying to uphold?
a. Professional responsibility and accountability
b. Facilitating access and equity
c. Building individual/community capacity
d. Promoting health
Correct Answer: c (page 96)
16.Anne-Marie, a recent nursing graduate, is really enjoying developing relationships with her clients. Anne-
Marie tells her mentor that she works hard to meet the needs of her clients and has been using the strategy
of meeting one client for coffee in the afternoons. How should the mentor respond to Anne-Marie?
a. “Tell me more about how this strategy is helping to meet your needs?”
b. “It sounds like the nurse-client relationship has moved into a personal relationship.”
c. “I use a more distant and clinical approach with my client relationships.”
d. “This is a great nursing strategy that you should share with the rest of the nurses.”
Correct Answer: b (page 95)
42. 17.Why is it important for community health nurse to be aware of social justice and everyday ethical and
legal concerns?
a. Because it will assist nurses in gaining the capacity to reflect critically on the multiplicity of ethical
and legal dimensions inherent in community health nursing
b. Because they can assist their clients in preparing for legal cases for medical malpractice
c. Because ultimately nursing will be intertwined with the legal system
d. Because it will assist nurses in building resistance to reflect critically on the multiplicity of ethical
and legal dimensions inherent in community health nursing
Correct Answer: a (page 89)
18. Which of the following statements about social justice is true?
a. Social justice strives to apply justice to medical groups
b. Social justice is the foundational moral justification for public health as a social institution
c. Social justice work does not require consideration of the socio-environmental context
d. Social justice work involves the perspectives of only medicine and nursing
Correct Answer: b (page 89)
19.Given the current emphasis on obesity in Canadian society, a large body size in women has come to
symbolize self-indulgence and moral failure, which in turn may lead women to question their sense of
self and right to good healthcare. This is an example of an ethical implication of which community
health nurse standard of practice?
a. Health maintenance, restoration, and palliation
b. Capacity building
c. Professional responsibility and accountability
d. Prevention and health protection
Correct Answer: d (page 91)
20.Which ethical principle for public health interventions stipulates that the full force of governmental
authority and power should not be used unless less-coercive methods are unavailable or have failed?
a. Harm principle
b. Reciprocity
c. Least restrictive or coercive means
d. Transparency
43. Correct Answer: c (page 92)
21.What term best describes the most common ethical orientation in public health nursing practice
that embraces theWorld Health Organization’s perspective on empowerment?
a. Advocacy
b. Capacity building
c. Transparency
d. Reciprocity
Correct Answer: a (page 95)
22. Which of the following options below correctly describes the cycle of oppression?
a. Stereotype, oppression, biased information, prejudice, discrimination
b. Oppression, stereotype, biased information, prejudice, discrimination
c. Prejudice, biased information, oppression, discrimination, stereotype
d. Biased information, stereotype, prejudice, discrimination, oppression
Correct Answer: d (page 96)
23.Which community health nursing standard of practice is demonstrated when a nurse adheres to regulatory
standards, federal and provincial or territorial professional standards, laws, codes of ethics, and institutional
policies?
a. Capacity building
b. Professional responsibility and accountability
c. Professional relationships
d. Health maintenance, restoration, and palliation
Correct Answer: b (page 97)
24.There are four key elements that must be proved to make a finding of negligence. Which of the following is
one of the four elements?
a. That the standard of care was breached
b. That the nurse took money from that client
c. That the nurse and the client did not have a professional relationship
d. That there was no harm caused
Correct Answer: a (page 97)
25. Which of the following is part of the ten defining attributes of social justice
a. Equality
44. b. Disabling environments
c. Empowerment
d. Ethical practice
Correct Answer: d (page 90)
Short Answer Questions
26.Discus three issues faced by community health nurses who provide care in community settings,
and provide a practice example for each issue
Correct Answer:
- Many community settings were not designed for the purposes of caregiving (e.g., apartment buildings
without elevators to carry equipment).
- CHNs must adapt their practice to a variety of community venues (e.g., immunizing children in a church gym
versus a clinic environment).
- There may be risks to CHNs due to violence, tobacco smoke, pets, ergonomic issues, and physical
conditions (e.g., aggressive farm dogs that are not used to visitors).
- Travelling in both urban and rural settings can be an issue for CHNs as a result of inclement weather,
driving conditions, becoming stranded, collisions, and communication (e.g., breaking down in a isolated
rural area between home visits).
- Providing care in the home can have social and ethical implications (e.g., the assumption that clients all
have a telephone and can phone for assistance) (page 92-93).
27.Compare and contrast health promotion with prevention and health protection. Provide an example
from community health nursing practice.
Correct Answer:
Health promotion is a mediating strategy between people and their environments, a positive, dynamic,
empowering, and unifying concept that is based in the socio-environmental approach to health. The nurse may be
involved in facilitating community action, assisting in the development of skills, and increasing client knowledge
and control over the determinants of health (e.g., facilitating a community to develop a drop-in recreation centre
for adolescents) (page 91).
Prevention and health protection involves a variety of strategies that seek to minimize the occurrence of
diseases and their consequences. The nurse may be involved in education, direct services, disease surveillance,
immunization, risk reduction, outbreak management, and social marketing (e.g., working at a sexually
transmitted infection clinic) (page 91).
45. 28.Discuss the potential moral harm that community health nurses need to be aware of when planning
activities as part of a health promotion program.
Correct Answer:
- influencing individuals to conform to social norms
- becoming unwitting agents of social control
- becoming unwitting agents of medicalization
- creating adversarial relationships between groups of clients-those who activity enhance their health and
those who do not
- viewing clients who do not enhance their health as morally weak and inferior
- compromising respect for the inherent worth of clients regardless of behaviour and situation
29. List the four key elements that must be proven to make a finding of negligence.
Correct Answer:
- That there was a relationship between the person bringing the claim and the person being sued
- That the defendant breached standard of care
- That the plaintiff suffered harm
- That he harm suffered was caused by the defendant’s breach of the standard of care (page 97)
30. List and discuss the four ethical principles for public health interventions.
Correct Answer:
- Harm principle: the only purpose for which power can be rightfully exercised over nay member of a
civilized community, against his will, is to prevent harm to others
- Least restrictive or coercive means: the full force of governmental authority and power should not be used
unless less-coercive methods are unavailable or have failed
- Reciprocity: if a public action is warranted, social entities are obligated to assist individuals in meeting
their ethical responsibilities; compensation must be given
- Transparency: all relevant stakeholders should participate in decision-making in an accountable and
equitable fashion that is free of political interference or coercion. (page 92)
46. Chapter 7: Theoretical Foundations of CommunityHealth Nursing
Community Health Nursing A Canadian Perspective 5th Edition Stamler
Multiple Choice Questions
1. What term is use to describe an organized, coherent, and systematic articulation of a set of statements
related to significant questions in a discipline?
a. A framework
b. A model
c. A theory
d. A philosophy
Correct Answer: c (page 102)
2. Carper (1978) identified four fundamental patterns of knowing in nursing. Which of the
following is a correct representation of Carper’s patterns of knowing?
a. Aesthetic knowing, personal knowing, ethical knowing, and empirical knowing
b. Scientific knowing, interpersonal knowing, ethical knowing, and empirical knowing
c. Empirical knowing, moral knowing, legal knowing, and interpersonal knowing
d. Scientific knowing, surface knowing, legal knowing, and ethical knowing
Correct Answer: a (page 102)
3. What term is used to describe the capacity of a community health nurse to recognize social and political
problems of injustice or inequity, to realize that things could be different, and to piece together complex
elements of experience and context to change a situation?
a. Empirical knowing
b. Aesthetic knowing
c. Emancipatory knowing
d. Ethical knowing
Correct Answer: c (page 103)
47. 4. Sunil, a community health nurse, has brought a team of community stakeholders together. On a white
board, Sunil identifies various issues in the community. They discuss and organize the issues according to
the determinants of health. The team identifies potential community-level interventions for the issues. By
engaging in this process, the team of stakeholders is developing a:
a. A theory
b. A conceptual framework
c. A philosophy
d. A metaparadigm
Correct Answer: b (page 103)
5. Over the past three decades, many nurses have expressed a concern about the lack of theory development
in community health nursing. Why is this such a significant concern?
a. Because nursing theories were originally developed to focus on population health
b. Because it is difficult to adapt theories that were developed to focus on individual illness to the
community settings where health promotion is the focus
c. Because nursing theories often depict community problems as isolated events rather than as
representative of a pattern of illnesses seen at the family level
d. Because primary care nursing needs to focus more on social justice, health equity, and advocacy
Correct Answer: b (page 106)
6. What type of knowledge represents the most abstract level of knowledge, identifies the phenomenon of
central concern to a discipline, and describes concepts and the relationships among them?
a. Conceptual frameworks
b. Grand theories
c. Metaparadigms
d. Philosophies
48. Correct Answer: c (page 108)
7. An important philosophical value in community health nursing is to promote the common good. This
means that:
a. Decisions are made based on shared human interests
b. Interests of the individual needs to be a priority
c. The few people who have specialized knowledge should make decisions for all
d. The person who is most at risk needs to be in control
Correct Answer: a (page 109)
8. Which of the following theories pushes community health nurses to consider the web-like influences
at play in any situation and the interrelationships among multiple agents in the system?
a. Critical social theory
b. Feminist theory
c. Complexity science theory
d. Intersectionality theory
Correct Answer: c (page 112)
49. 9. Sameera, a community health nurse, is working in a low-income neighbourhood. In order to assess the
health status of the neighbourhood, she gathers information about the interplay among the community
and the social, institutional, and cultural context of people-environment relations. What theory is Sameera
using to guide her community health nursing practice?
a. Community as partner theory
b. Multiple interventions theory
c. Community assessment theory
d. Social ecological theory
Correct Answer: d (page 113)
10.Emily is a community health nurse that needs to address the underlying power differentials and social
inequities at a meat packing plant that hires a large portion of immigrant people. Which type of theory
should Emily consider using to guide her practice?
a. Critical social theory
b. Integrative theory
c. Immigrant health promotion theory
d. Intersectionality theory
Correct Answer: a (page 113)
11.George is working with the Bearskin Lake First Nation in Northern Ontario. He considers the historical
influences have shaped the present context of the health of the community. What theoretical
perspective is guiding George’s community health nursing practice?
a. Reservist theory
b. Postcolonial theory
c. Feminist theory
d. Historical theory
50. Correct Answer: b (page 114)
12.Scott is a community health nurse working with the homeless population. He uses a model that has two
dimensions: (1) the client system and (2) the focus of care. Scott realizes that working with this population
will entail health promotion, the prevention of illness, disease, and injury as well as illness care. Which
model will best serve Scott in his nursing practice?
a. The community health prevention model
b. The intervention circle
c. The integrative model for community health nursing
d. The family assessment model
Correct Answer: c (page 120)
13.Takeshi is a community health nurse who is working with children who sustained playground injuries and
their families. In order to build rapport with the families in the community, Takeshi is authentically
present and works together with the families to seek creative solutions to prevent further injuries.
Takeshi shows her clients respect, compassion, and dignity. What adjective best describes Takeshi’s
community health nursing practice?
a. Trusting
b. Understanding
c. Sympathy
d. Caring
Correct Answer: d (page 122)
14.Orem’s (1985) Self-Care Deficit Nursing Theory is best used in which type of community health
nursing practice?
a. Working with families
b. Working with war veterans
51. c. Working with homeless teens
d. Working with politicians
Correct Answer: a (page 123)
15.Kenya is a community health nurse working with homeless teenagers in an inner-city community. As
part of her nursing practice, Kenya helps her clients to identify the positive things in their lives, the
things that are working well, and uses clients’ strengths to help them deal with problems. Which middle
range theory is Kenya using?
a. Critical caring theory
b. Critical social theory
c. Intersectionality theory
d. Strengths based theory
Correct Answer: d (page 123)
16.When community health nurses work with vulnerable families living in poverty, it is especially important to
develop a trusting and respectful relationship with them. It is important to understand how personal,
interpersonal, and contextual elements shape people’s experiences. What middle range theory listed below is
best suited for such situations?
a. Critical caring theory
b. Relational inquiry
c. Strengths based theory
d. Theory of human becoming
Correct Answer: b (page 124)
17.Which type of theories are the least complex, contain fewer concepts, and refer to specific, well-defined
phenomena?
a. Substantive theories
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