Test Bank Community Health Nursing: A Canadian Perspective 5th Edition by Stamler

TEST BANK COMMUNITY HEALTH NURSING: A CANADIAN PERSPECTIVE 5th Edition, By Stamler, Yiu

TEST BANK

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 communicable disease, infant mortality, and childhood morbidity? 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. 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) 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)

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)

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)

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)

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 b. 2000 c. 1987 d. 1976 Correct Answer: c (page 11)

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

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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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. How has the Canada Health Act (1984) been successful in ensuring all Canadians have

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.

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. 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

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

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.

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.

- 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 (BNA Act) 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

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).

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

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)

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 b. Global health

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

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. During World War I within the Royal Canadian Army c. During World 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

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

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 and health protection

Health maintenance, restoration, and palliation

Professional relationships

Capacity building

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).

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 Health Agency 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)

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)

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

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

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

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

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-lifecare 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

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

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).

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)

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?

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 the World 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

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)

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

Correct answer: c (page 92) 21. What term best describes the most common ethical orientation in public health nursing practice that embraces the World 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

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).

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)

Chapter 7: Theoretical Foundations of Community Health 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)

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

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)

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

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

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

b. Grand theories c. Middle range theories d. Broad theories Correct Answer: a (page 124) 18. Susan is a public health nurse who engages in home visits with new mothers who are at risk of poor parenting practices. Susan works with her clients to build trusting relationships. To increase the effectiveness of home visiting and to establish a connected relationship, which theory guides Susan to understand mothers’ perspectives as they build trust together? a. Relational inquiry theory of working with young families b. Critical caring theory to working with unsusceptible families c. Theory of maternal engagement with public health nurses and family visitors d. Self-care deficit theory of nursing to identify health needs Correct Answer: c (page 125) 19. Stephanie is using the supportive care model for end of life care of a client in home care. Which Canadian Community Health Nursing Standard of Practice does this model align with? a. Health promotion b. Health maintenance, restoration, and palliation c. Prevention and health protection d. Professional accountability Correct Answer: b (page 126) 20. Community health nurses use theories to inform their practice. Which of the following statements is true about the use of theories: a. Community health nurses must use only community health nursing theories

b. Community health nurses only use nursing theories c. Community health nurses often use theories from other disciplines d. Community health nurses only use theories from medical science Correct Answer: c (page 125) 21. Which of the following theories uses a process through which an innovation spreads via certain communication channels over time among members of a social system? a. Relational inquiry b. Theory of human becoming c. Strengths based theory d. Theory of diffusion of innovation Correct Answer: d (page 125) 22. In his community health nursing practice, Jesse facilitates the establishment of a “good food box” system in an impoverished neighbourhood. In this system, families are charged a small fee and receive seasonal fruits and vegetables once a week. Families normally hear about this via work of mouth and are invited to participate. What theory does Jesse use to guide his practice? a. Intervention wheel b. Theory of diffusion of innovation c. Health promotion d. Supportive care theory Correct Answer: b (page 125) 23. Maria is a community health nurse working in a culturally diverse neighbourhood. She engages community members to learn and understand more about local belief systems. She

hopes to use this new knowledge to help her community build capacity and decrease inequities in health status. Which middle range theory would best serve Maria? a. Strengths based theory b. Relational inquiry c. Theory of human becoming d. Critical caring theory Correct Answer: d (page 123) 24. Why is Orem’s Self-Care Deficit Nursing Theory applicable to community health nursing practice? a. Because the underlying self-care philosophy has been embraced by community health nursing b. Because in the end we all need to take care of ourselves c. Because all nursing theories are applicable to specialty practice areas d. Because it is important to know about acute care nursing issues Correct Answer: a (page 123) 25. Jasdeep is a community health nurse working with a group of young mothers who are feeding their children a diet high in carbohydrates. Jasdeep identifies an opportunity for health promotion teaching. Which community health nursing conceptual model would help guide Jasdeep’s nursing practice? a. Intervention wheel b. Roy’s adaptation model c. Community health promotion model d. Relational inquiry

Correct Answer: c (page 115) Short Answer Questions 26. Compare and contrast three broad theoretical perspectives relevant to community health nursing. Correct Answer: See Table 7.2 on page 111 27. Discuss the importance of the Intervention Wheel Correct Answer: -

It is an evidence-based and validated public health nursing conceptual model

It demonstrates how public health nursing improves population health through interventions with individuals, families, and communities

It identifies 17 core public health nursing interventions that are common to the work of public health nurses

It is population based; all work is carried out in the service of improving population health

It is transferable to other areas of community health nursing practice (pages 119-120)

28. Describe the Canadian Community as Partner Model Correct Answer: -

The model assists users in moving iteratively through the phases of assessment, analysis, diagnosis, planning, intervention, and evaluation

Assessment is guided by the assessment wheel that has 8 subsystems

The subsystems are consistent with the broad determinants of health

The interventions can be aligned with the three levels of prevention (pages 117 – 118)

29. Compare and contrast two grand nursing theories

Correct Answer: See Table 7.4 on page 121 30. Discuss the similarities and differences of three substantive theories. Correct Answer: See Table 7.6 on page 126

Chapter 8: Health Promotion Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1. “The process of enabling people to increase control over and improve their health” is a definition of what concept? a. Health promotion b. Social change c. Social justice d. Empowerment Correct Answer: a (page 136) 2. A nurse participating in an active, involved process where the people, groups, and communities in the area are moving toward increased individual and community control, political efficacy, improved quality of community life, and social justice. What is the nurse working toward? a. A lifestyle approach b. Biomedical stability c. Community empowerment d. Developing a healthy city Correct Answer: c (page 137) 3. What publication is widely recognized as marking the transition from medical and behavioural health determinants to a new socio-environmental health promotion approach?

a. The Declaration of Alma Ata b. An article by Labonte c. The Ottawa Charter d. Innocenti Declaration Correct Answer: c (page 139) 4. What does the Population Health Promotion Model most closely reflect? a. Socio-environmental perspective b. Natural law perspective c. Social change perspective d. Biomedical perspective Correct Answer: a (page 144) 5. Which model was developed to explain why individuals do or do not take action to prevent disease? a. Disease Prevention Model b. Health Belief Model c. Population Health Promotion Model d. Health Equity Model Correct Answer: b (page 155) 6. A conference in what Canadian city is widely recognized as having given birth to the worldwide health promotion movement? a. Toronto b. Vancouver

c. Montreal d. Ottawa Correct Answer: d (page 140) 7. A nurse is involved in political action to reduce homelessness by increasing the availability of affordable housing. Which primary health care principles is the nurse utilizing? a. Social justice and equity b. Accessibility and public participation c. Legislative changes and social activism d. Community organization and political activism Correct Answer: b (page 138) 8. A nurse is working on a project aimed at addressing the effects of poverty on a community’s health. Which primary health care value is being enacted in this scenario? a. Social justice b. Intersectoral collaboration c. Health promotion d. Economics Correct Answer: a (page 138) 9. Which primary health care (PHC) project best addresses inequities within society? a. An intersectoral plan that focuses on lobbying for improvements in minimum wage b. A community venture that focuses on street safely and neighbourhood patrols c. An interdisciplinary approach on educating the public about recreation and fitness

d. Establishment of a local primary care clinic that employs both physicians and nurse practitioners Correct Answer: a (page 138) 10. A nurse works in a large urban hospital using telehealth to provide cardiac consultations to clients in rural settings. What principle of Primary Health Care (PHC) is evident in this scenario? a. Public participation b. Equity c. Accessibility d. Social justice Correct Answer: c (page 138) 11. The World Health Organization describes Primary Health Care as the route to better health for all, with five key elements to achieve that goal. Which of the following is part of the five key elements? a. Intersectoral collaboration and health promotion b. Increasing stakeholder participation and reducing social exclusion c. Using appropriate technology and increasing social disparity d. Organizing health services around provider needs to increase accessibility Correct Answer: b (page 137) 12. One of the principles of Primary Health Care is appropriate technology. Appropriate technology means: a. Models of healthcare do not need to be tested before implementation b. Appropriate models of care are based on countries’ political persuasion

c. Alternatives to low-cost and high-technology needs to be developed d. Appropriate models of care are available based on a society’s economic development Correct Answer: d (page 138) 13. Which document received international attention, helping to stimulate the World Health Organization to convene a meeting of member countries to address the disparities in health status between developed and underdeveloped countries? a. The Lalonde Report b. The Declaration of Alma Ata c. The Romanow Report d. The Principles of Primary Health Care Document Correct Answer: a (page 139) 14. Which country is known to be a leader in health promotion? a. The United States of America b. Canada c. Switzerland d. Croatia Correct Answer: b (page 139) 15. Which global conference resulted in the Bangkok Charter for Health Promotion in a Globalized World? a. Mexico in 2000 b. Sweden in 1991 c. Thailand in 2005

d. Indonesia in 1997 Correct Answer: c (page 142) 16. There are variations in the literature about the terms used to describe the social determinants of health. Which term below best describes income and social status? a. Housing b. Poverty c. Education d. Gender Correct Answer: b (page 145) 17. One difference between the Toronto Charter on the Social Determinants of Health and the determinants of health as presented in the Population Health Promotion Model is: a. The Toronto Charter includes building healthy public policy b. The Population Health Promotion Model does not include health services c. The Toronto Charter includes Aboriginal status d. The Population Health Promotion Model includes social exclusion Correct Answer: c (page 147) 18. Non-communicable diseases such as heart disease, stroke, diabetes, and many cancers are directly linked to physical inactivity. Which of the following initiatives can be used to increase population levels of physical activity? a. Lobbying the government to increase the living wage by $5.00 b. Implementing healthy lunch programs in all public schools c. Ensuring that seniors at home are not at risk for falls d. Public education using mass media to change social norms on physical activity

Correct Answer: d (page 148) 19. What is the definition of risk communication? a. The measure of health of populations b. Using social media to change people’s thoughts about health c. Transmission of information about an existing health risk d. A philosophy and approach to health care where health is protected Correct Answer: c (page 149) 20. What is used to measure the health of populations as well as the progress made toward creating healthier citizens? a. Population health indicators b. Prevention interventions c. Social marketing campaigns d. Health promotion Correct Answer: a (page 149) 21. What approach to healthcare delivery is implemented with a goal to protect the health of, and reduce negative consequences for, individuals who engage in high risk activities that are associated with poor health outcomes? a. Upstream approach b. Harm Reduction c. Health Promotion d. Risk communication Correct Answer: b (page 149)

22. Which of the following nursing interventions is an example of an upstream approach? a. A nurse who runs a needle exchange program b. A nurse who facilitates a support group for teens who have survived sexual abuse c. A nurse lobbying the local school board to use recycled tires to soften children’s landing on playgrounds d. A nurse who provides health promotion strategies for community members who have heart health issues Correct Answer: c (page 152) 23. Which social marketing term is used to describe an intervention that considers what will motivate people to engage in the intervention and offers them something beneficial in return? a. Behaviour change intervention b. Market segment intervention c. Target intervention d. Exchange intervention e. A nurse who facilitates a support group for teens who have survived sexual abuse Correct Answer: d (page 157) 24. Thomas, a community health nurse, is talking with city bus drivers who feel a lack of control over their unrealistic bus schedules. They were able to identify that harmful working conditions were causing multiple health problems. They dialogue together about what could be done. Thomas is using which approach to promoting health of the bus drivers? a. Strengths-based appreciative approach b. Behaviour change approach c. Problem solving approach

d. Population health approach Correct Answer: a (page 161) 25. Ingrid, a community health nurse, is working with a local news agency to draft a segment about the increase rate of measles in a community. Ingrid, is engaging in which activity? a. Social marketing b. Tertiary prevention c. Harm reduction d. Risk communication Correct Answer: d (page 149) Short Answer Questions 26. Discuss population health promotion. Correct Answer: -

Is a process of taking action on the interrelated conditions (i.e. the social determinants of health) that affect a population’s health, to create healthy change

Focuses on maintaining or improcing the health of populations and reducing disparities in health status between people

Population health concepts are integrated with the principles that guide action on health promotion (page 143)

27. List the Principles of Primary Health Care. Give a community health nursing practice example related to each. Correct Answer:

Accessibility: community health nurses using telehealth to provide services to clients in rural and remote areas.

Public participatio: involving youth in the development and administration of a youth afterschool program

Health promotion: working with elementary school children on how to build healthy lunches

Appropriate technology: Developing a puppet show with a kindergarten classroom to illustrage handwashing rather than a pamphlet as these children don’t read yet.

Intersectorial collaboration: involving education, social work, small businesses, communitiy agencies, religious organizations to help build a seniors’ resource centre (page 138)

28. List the elements of primary health care to the Canadian Context. Give a current Canadian community health nursing practice example for each. Correct Answer: -

Health education and disease prevention: prenatal education has been shown to improve birth outcomes

Promotion of food supply and proper nutrition: school nurses working to demonstrate healthy eating using the food guide

Adequate supply of safe water and sanitation: Nurses working with the government to upgrade Canada’s water treatment plants and sanitation systems

Maternal child health including family planning: Public Health Nurses who engage in home visiting to promote the health postpartum mothers and newborns after birth

Immunization against major infectious diseases: Immunization campaigns in school-aged children

Prevention and control of locally endemic diseases: nurses who deliver influenza immunizations

Appropriate treatment of common diseases and injuries using the PHC principle of appropriate technology: Education campaigns about when it is appropriate to use the emergency departments at hospitals

Provision of essential drugs: Community health nurses who participate in direct observed treatment of tuberculosis in outpatient clinics (page 138-139)

29. Draw the Population Health Promotion Model Correct Answer: Figure 8.2 (page 145) 30. List and describe Andreasen’s benchmarks of a successful social marketing intervention Correct Answer: See Table 8.1 (page 157)

Chapter 9: Race, Culture, and Health Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1. What is a characteristic of culture? a. Constant over time b. Consistent across an ethnic group c. Separate from language and traditions d. Largely unconscious Correct Answer: d (page 172) 2. Which term refers to the variety and differences of attributes among, between, and within groups? a. Ethnicity b. Diversity c. Multiculturalism d. Race Correct Answer: b (page 172) 3. Which Canadian Community Health Nursing Standard of Practice holds relevant expectations for the community health nurse providing cultural care? a. Access and equity b. Health promotion c. Capacity building d. Health protection Correct Answer: a (page 170)

4. Which of the following statements is true about how culture is currently conceptualized? a. It leads to tolerance, respect, and changes in discriminatory behaviours b. It emphasizes the similarities of experiences and simplifies differences c. It is a dynamic, power laden process created by people in relation to one another d. It accentuates the culture of origin and discounts changes that occur through migration Correct Answer: c (page 171) 5. Which term is used to describe the belief that one’s own culture is the best of most desirable? a. Racism b. Transnationalism c. Ecological d. Ethnocentrism Correct Answer: d (page 171) 6. In what year did the federal multiculturalism policy recognize and acknowledge cultural pluralism as an essential and valued contribution to Canadian Culture? a. 1891 b. 1971 c. 1941 d. 1991 Correct Answer: b (page 172) 7. Which term refers to those who are eligible for permanent residency? a. Refugees b. Immigrants c. Transnationalists d. Temporary workers

Correct Answer: b (page 173) 8. Which of the following statements is true about immigrants to Canada? a. Prior to 1971, more than 75% of immigrants were from Europe b. After 1990, more than 80% of immigrants were from Africa c. Prior to 1943, more than 50% of immigrants were from South America d. After 1967, more than 90% of immigrants were from the Middle East Correct Answer: a (page 173) 9. According to Statistics Canada (2013), what proportion of Canada’s total population is foreign born? a. 45% b. 30% c. 20% d. 15% Correct Answer: c (page 173) 10. The majority of permanent residents across Canada come from which part of the world? a. Asia and Pacific b. United States c. Africa and Middle East d. South and Central America Correct Answer: a (page 174) 11. Most of the skilled and temporary workers entering Canada are from which part of the world? a. United States and Africa b. United States and Middle East c. United States and Asia

d. United States and Europe Correct Answer: d (page 174) 12. Giselle is a community health nurse working with temporary residents in Vancouver. Giselle recognizes that her clients would benefit from English classes. Giselle mobilizes local community members who are willing to teach English to offer free classes one evening a week. Why is Giselle exploring this community health nursing intervention? a. Because the temporary residents are busy during the day b. Because temporary residents are not eligible for government sponsored language classes c. Because the temporary residents are embarrassed about their language skills d. Because temporary residents have significant other commitments Correct Answer: b (page 175) 13. Which of the following statements is true about newcomer health? a. Newcomers to Canada experience significant health challenges b. Newcomers to Canada rate their health more highly than people born in Canadian c. Newcomers to Canada are at risk for developing various communicable diseases d. Newcomers to Canada rate their health lower than people born in Canada Correct Answer: b (page 175) 14. Recent women immigrants have a lower probability of having their previous work experience recognized when compared to men. Jason is a community health nurse who is working to promote equity on this issue. Jason is demonstrating which community health nursing value? a. Social justice b. Cultural competence c. Multiculturalism d. Transnationalism

Correct Answer: a (page 170, 175) 15. Yasmin is working with recent immigrants from Syria. She works with her clients to access community resources that will assist in developing a social support network. Why is this an important community health nursing intervention? a. Because learning to be social will alleviate any post-traumatic stress b. Because interpreters are scarce and this will help with language skills c. Because social support can facilitate establishing economic stability d. Because it’s important for people from the same place to stick together Correct Answer: c (page 175) 16. Mr. and Mrs. Espinosa have immigrated to Canada from the Philippines. A community health nurse is visiting the Espinosa family following the birth of their first child. What is an appropriate comment for the nurse to make? a. “I have some coupons for disposable diapers. Would you like them?” b. “I will give you this book on baby care that you will find very helpful.” c. “I understand that women from the Philippines like to be waited on following childbirth.” d. “What would happen if you were in the Philippines after you had your first baby?” Correct Answer: d (page 171-172) 17. Rosa is a community health nurse. She is open and flexible with others, accepts differences, and is willing to learn. What term describes Rosa’s nursing practice? a. Ethnocentrism b. Cultural competence c. Multiculturalism d. Ethnic stereotyping Correct Answer: b (page 177) 18. Current conceptualizations of cultural competence include which of the following statements?

a. It is a lifelong process of approaching relationships with openness and humility b. Making sure nurses understand details about various cultural practices c. Being able to identify which culture your clients belong to d. Showing that you understand cultural practices that impact health status Correct Answer: a (page 177) 19. Which of the following are included in the five constructs that inform the process of cultural competence: a. Cultural sensitivity, self-reflection, and cultural skill b. Cultural skill, cultural safety, and cultural sensitivity c. Cultural knowledge, cultural desire, and cultural encounters d. Cultural desire, cultural safety, and cultural awareness Correct Answer: c (page 177) 20. Which term is used to describe any action with diminishes, demeans, or disempowers the cultural identity and well-being of an individual? a. Cultural competence b. Group diversity c. Unsafe cultural practice d. Cultural care Correct Answer: c (page 178) 21. Which of the following is a strength of using a cultural safety approach: a. Disable practitioners to consider difficult concepts b. Improve healthcare access for populations c. Challenge equal power relations d. Acknowledge that only people of color are bearers of culture Correct Answer: b (page 178)

22. The concept of cultural safety has been criticized for which of the following? a. It is inadequately understood and utilized in practice b. People use this too often and it skews other data that needs to be considered c. It promotes racism, discrimination, and prejudice among health care providers d. It acknowledges that cultural safety is determined by those receiving care Correct Answer: a (page 178) 23. Gigi is a community health nurse who is completing a cultural assessment on a Chinese community she is working with. What is Gigi’s intension for completing a cultural assessment? a. To de-emphasize the relational process between the nurse and the community b. To give people in the community a way to voice their concerns about health c. To break down barriers so that racism, discrimination, and prejudice are abolished from society d. To discover meanings and experiences of health and illness through a cultural lens Correct Answer: d (page 178) 24. Juan is working with an Aboriginal community in a rural and remote location. Juan works to draw more attention through explicitly addressing inequities that have arisen from the political and historical events. Juan is likely working from which nursing practice? a. Cultural sensitivity b. Cultural safety c. Cultural competence d. Cultural knowledge Correct Answer: b (page 178)

25. Sarah is working with a community to increase the immunization rates for influenza. At which level of prevention is Sarah working at if she is advocating for changes to policies and service delivery? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Quaternary prevention Correct Answer: d (page 179) Short Answer Questions 26. Describe the concept of cultural safety. Correct Answer: -

It has much in common with cultural competence and makes explicit the issues of power

It is effective nursing practice with a client from another culture

The client determines if the practice was effective or not

It focuses on the capacity of clients to shape and contribute to their health experiences (page 177)

27. List and discuss 5 key themes for building and maintaining cultural competence. Correct Answer: See Table 9.1 on page 177 28. List and define the three dimensions of cultural competence Correct Answer: -

Awareness: having some knowledge of similarities and differences combined with self-reflection

Attitudes: sensitivity, openness, being non-judgmental, and respecting differences

Behaviours” require creativity while providing care through a cultural lens (page 177)

29. Discuss the limitations of the current literature available on cultural competence. Correct Answer: -

The lack of research evidence exploring if patient outcomes are improved with increased healthcare provider knowledge and awareness of culture

It is important to also recognize and integrate the role of institutional resources and structures which support culturally competent practices (page 177)

30. List five questions that a community health nurse would use to complete a community cultural assessment. Correct Answer: See Table 9.2 on page 178

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Chapter 10: Evidence-Informed Decision Making in Community Research Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1.

Which is the best description of evidence-based nursing practice? a. Incorporation of research findings into policies and procedures that directly affect patient care at the bedside b. Intuitive nursing practice based on evidence gained through extensive clinical practice c. Conscientious and judicious use of best evidence in making decisions about the care of individuals patients d. Integration of clinical expertise with the best available external clinical evidence

Correct Answer: c (page 185) 2. A nurse is attempting to conduct a search of the literature related to the use of condoms by men who have sex with men. What activity will allow the nurse to conduct the most efficient search? a. Generating a list of search terms b. Accessing a health sciences librarian c. Reading abstracts at the university library d. Looking at articles already found on the subject

Correct Answer: b (page 187) 3.

What is the Cochrane Library? a. A collection of websites and journals of pre-appraised research including EvidenceBased Nursing and Evidence-Based Medicine b. A searchable online database of abstracts and websites related to evidence-based practice based in Australia c. An online site for high quality systematic reviews relevant to public health in Canada d. A collection of reports and protocols from systematic reviews produced by an international collaboration, as well as summaries of reviews and abstracts of randomized controlled trails

Correct Answer: d (page 187) 4.

A group of nurses have questions about the effectiveness of assessing post-surgical clients over the telephone versus assessing post-surgical clients at home. What type of research article would be most useful for the nurses to review? a. Qualitative ethnography b. Cohort studies c. Randomized controlled trails d. Participatory action research

Correct Answer: c (page 187) 5. Which statement most accurately describes a randomized controlled study design? a. The researcher examines the individual histories of a group of people manifesting a particular disease to find out what common factors they share and what differences can be discerned b. Questions and interventions that evolve through partnerships between researchers and participants c. This is the best design for answering questions about the effectiveness or harms of a certain intervention d. Questions exploring perceptions, feeling, and experiences are best answered by this study design Correct Answer: c (page 187)

A nurse reads in a journal article, "Participants were randomized into an intervention group. The intervention group was to receive an epidural in labour. All the birth outcomes of the intervention group were analyzed in that group, regardless of whether the participants received an epidural or not." What concept is illustrated in this statement? a. A double blinded study b. Researcher bias c. Intention-to-treat analysis d. Allocation concealment

Correct Answer: c (page 189)

What is relative risk? a. Proportion of the participants experiencing an outcome in the intervention group divided by the proportion experiencing the outcome in the control group b. Proportional reduction in the rates of poor outcomes between the experimental and control participants c. Range of values with a specified probability of including the true effect, which can never be known absolutely d. Number of study participants who would have died anyway without the intervention

Correct Answer: a (page 191) 8.

A student nurse has been asked to write a clinical question that includes the three essential elements of a structured question. Which question meets these criteria? a. What is the evidence for school-based activity programs? b. What are the health-promoting behaviours of well seniors? c. Is glucosamine effective in reducing pain and increasing functional ability in people with osteoarthritis? d. Does a structured breastfeeding support program affect duration, exclusivity, or gastrointestinal infections in the infants?

Correct Answer: c (page 186) 9.

What is most likely to be included in a meta-analysis? a. A narrative review of several articles using pre-set criteria b. A summary of research evidence that relates to a general question c. A quantitative combination of results of several studies d. Statistics from various studies presented separately in a table

Correct Answer: c (page 191) 10. What is included in a systematic review of community health nursing research studies? a. Only randomized trials b. Non-randomized cohort studies c. A strictly statistical synthesis d. Only studies that use the biomedical model Correct Answer: b (page 192) 11. AA nurse reads in a study on a diabetes prevention program that the odds ratio was <1. What does this mean? a. Study was biased b. Participants were not affected by the program c. Prevention program was beneficial d. Control group was the same as the intervention group Correct Answer: c (page 193) 12. A nurse wants to do qualitative research to describe the culture of youth who live away from their parents. What research methodology should the nurse choose? a. Grounded theory b. Phenomenology c. Ethnography d. Prospective cohort study Correct Answer: c (page 194) 13. A nurse is reviewing a qualitative study on homelessness and dental health. Which question about validity is appropriate in this scenario? a. Was follow-up sufficiently long and complete?

b. Is the research question clear and adequately substantiated? c. How were the participants randomized into groups? d. Was allocation concealment used? Correct Answer: b (page 194) 14. What is the best course of action for nurses to follow when there is no research evidence to support practice? a. Utilize expert opinion as the standard for decision-making b. Implement several different practices and see what works well c. Develop individual best practice guidelines d. Change practice according to somewhat related research evidence Correct Answer: a (page 195) 15. A health department has decided to change recommended immunization techniques. There is substantial evidence to support changing the current practices of nurses and physicians who administer influenza vaccinations to children. Which dissemination method is most likely to work? a. Completing a large one-time-only information mail-out b. Creating multifaceted interventions targeting different barriers c. Sending out a directive from the Medical Officer of Health d. Emailing all immunization providers Correct Answer: b (page 197) 16. What is the next step after implementing an evidenced-based practice and policy change related to head lice screening? a. Replicate the original research study within a one-year timeframe

b. Establish an evaluation period to see if the change is working c. Conduct comprehensive chart reviews on every aspect of nursing practice d. Wait and see what the results of the change turn out to be Correct Answer: b (page 197) 17. What type of health research are community health nurses most likely to be involved in? a. Randomized clinical trials b. Client outcome studies c. Program evaluation using process outcomes d. Principle investigators of a qualitative study Correct Answer: c (page 199) 18. A nurse is reading an article by Heater, Becker, and Olson (1988), who conducted a metaanalysis to determine the contribution of research-based nursing practice to client outcomes. What conclusion did the authors reach about clients who received research -based nursing care versus those who received routine nursing care? a. No appreciable difference between the two groups b. Made sizeable gains in behavioural knowledge and physiological and psychosocial outcomes c. Increased their behavioural knowledge but did not make gains in physiological and psychosocial outcomes d. Increased insignificantly in knowledge, attitudes, and behaviour related to healthy lifestyle choices Correct Answer: b (page 186) 19. What is the lag time between when technical information is generated and the time it is used in actual practice? a. 15 to 18 years b. 8 to 15 years

c. 1 to 2 years d. 5 to 10 years Correct Answer: b (page 186) 20. Angela and Kerry are nurses working in partnership with a university research unit on a community project focusing on women experiencing homelessness. They are using actionoriented research. What type of research are they most likely to be engaging in? a. Grounded theory b. Randomized clinical trials c. Participatory action d. Phenomenology Correct Answer: c (page 194) 21. AA nursing student is learning to critically appraise studies on treatment or prevention. What question best addresses whether the results of the study are valid? a. Is the description of the findings thorough? b. Were all the clinical significant outcomes considered? c. Were the groups similar at the start of the trial? d. Is the design appropriate for the research question? Correct Answer: c (page 189) 22. A group of nurses have formulated a research question on how to best support new mothers with breastfeeding. What is the next step in the process to develop evidence-based nursing practice? a. Implement evidence-based practice decision b. Appraise the research evidence c. Evaluate the outcomes of evidence-based nursing practice d. Complete a systematic search of research evidence Correct Answer: d (page 186)

23.

How is number needed to treat (NNT) calculated? a. One divided by the absolute risk reduction b. Incidence rate of disease in exposed population over the incidence of disease in unexposed population c. Event rate in control group minus event rate in experimental group d. Number of people with given disease in given population at one point in time divided by the total in given population at same point in time

Correct Answer: a (page 191) 24. What website is the preferred source of pre-appraised research for community health nurses? a. Evidence-Based Nursing b. BMJ Clinical Evidence c. Health-Evidence d. National Guideline Clearinghouse Correct Answer: c (page 187) 25. What is meant by wide confidence intervals? a. There is less accuracy in the estimated effect of the intervention. b. The intervention has an effect on the outcome and is statistically significant. c. This indicates the reliability of an estimate. d. Precision increases with larger samples. Correct Answer: a (page 191) 26. Write one clinical question related to community health nursing practice and identify the three parts in the clinical question. What is the purpose of clinical questions? Correct Answer: For elementary school children (situation), does a health fair promoting healthy habits such as handwashing and teeth brushing (intervention) promote the adoption of healthy behaviours at home (outcome)? Three parts: - situation (patient, client, population, or problem)

- intervention (action under consideration for health promotion, disease prevention, or treatment effect) - outcome (result of interest from client or clinical perspective) Purpose of clinical questions: To allow one to consider all the possible synonymous search terms for the conduct of an efficient search of existing research and resources. (page 186) 27. What are the three major questions used to critically appraise primary studies of treatment or prevention? Give two secondary questions related to each major question. Correct Answer: a) Are the results valid? - Was randomization to treatment groups used? - Was follow-up sufficiently long and complete? b) What were the results? - How large was the effect? - Is it clinically important? c) Will the results help me in improving the health of clients? - Is the treatment feasible in our setting? - Were all the clinically important outcomes (harms vs. benefits) considered? 28. In a large urban health department, a decision has been made related to the type of support nurses provide to the male partners of pregnant teens. After the decision has been made, describe eight things that need to happen in order to implement the change successfully.

Correct Answer: - need to gather organization support for the change in practice - need to develop a comprehensive plan on how to inform nurses of the change in practice - need to use multifaceted strategies targeting barriers to change - need to conduct a diagnostic analysis (environmental scan) in relation to the characteristics of the * change being introduced, * clients/practitioners, * the organization, and * the environment - need to identify factors that are likely to help to make the change - need to identify factors that are likely to hinder the change - need to identify important stakeholders and customize meetings with tailored messages - need to identify champions - need to identify areas for further research - need to plan for an evaluation period (page 196) 29.

What is the Effective Public Health Practice Project?

Correct Answer: A project in Ontario in which potential review questions are sought from the policy, management, and frontline clinicians perspectives. The review groups include the methodological experts along with the community practitioners who were chosen for their content expertise and their understanding of the context and relevance to community health. They assist in identifying and refining the priority questions; rating articles for relevance to the questions; reviewing drafts; and helping to write clinical, management, and policy implications. (page 197) 30.

Describe two advantages and two disadvantages of using a systematic review

Correct Answer: Advantages - help answer questions without having to access large numbers of research reports - overcome obstacles of lack of time - sometimes overcome obstacles of lack of skill to conduct critical appraisal Disadvantages - sometimes there are still too many systematic reviews - how do you narrow them down? - systematic reviews are not all equally well done - systematic reviews on the same question can sometimes still yield different results

Chapter 11: Epidemiology Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1. What term refers to "the study of the occurrence and distribution of health-related states or events in specified populations"? a. Nosology b. Epidemiology c. Susceptibility d. Biologic plausibility Correct Answer: b (page 202) 2. Who is believed to be the first person to notice and record the relationship between the environment and health a. Labonte b. Nightingale c. Epp d. Hippocrates Correct Answer: d (page 203) 3. A nurse is working with the school-aged population during the prepathogenesis period. What primary prevention activity would promote the health of this population? a. Case finding children who may have been exposed to a teacher with hepatitis A b. Teaching handwashing and respiratory hygiene c. Providing antimicrobials for newly diagnosed contacts d. Advocating for testing of sexually transmitted infections (STIs) at a schoolbased clinic

Correct Answer: b (page 205) 4. A nurse is working with a student nurse and explains that 12% of deaths were from colorectal cancer in 2010. What word is used to describe this type of statistical information? a. Crude mortality b. Relative risk c. Prevalence d. Proportional mortality Correct Answer: d (page 210) 5. What statistic is used to answer the question, "How likely is it that I will die from this disease?" a. Case-fatality rate b. Specific mortality rate c. Relative risk d. Incidence Correct Answer: a (page 210) 6. A public health nurse (PHN) is explaining to a nursing student how to use health statistics to understand population health. The PHN is comparing the incidence of childhood asthma in a population exposed to a certain air pollutant with the incidence in a population not exposed to that pollutant to determine relative risk. The PHN asks the student to select the statistic, which supports that the risk for asthma is greater in the exposed population. What is the correct answer? a. <1.0 b. 0.05 c. 1.0 d. >1.0

Correct Answer: d (page 211) 7. A public health nurse (PHN) is explaining to a nursing student how to use health statistics to understand population health. The PHN asks the nursing student to develop some questions for a survey about smoking behaviour. Which question would be best at eliciting information on period prevalence? a. “Do you currently smoke?” b. “Have you smoked within the last six months?” c. “Have you ever smoked?” d. “At what age did you start smoking?” Correct Answer: b (page 211) 8. A public health nurse (PHN) is explaining to a nursing student how to use health statistics to understand population health. The nursing student wants to administer a survey about smoking behaviours to students in various grade levels within the school district to identify the best grade to initiate health education. A follow-up survey will be administered to assess the effectiveness of the educational program. What type of research design would be best at providing the epidemiological information needed in this scenario? a. Cross-sectional study b. Cohort design c. Randomized control trial d. Case-control methodology Correct Answer: a (page 212)

9. A public health nurse (PHN) is explaining to a nursing student how to use health statistics to understand population health. The PHN asks the nursing student how participant privacy will be managed in the study. What strategy presented by the student would be best at meeting this ethical concern? a. Data will be used in a confidential manner b. The survey will be anonymous c. The participants will sign a consent form d. Ethics approval will be sought Correct Answer: b (page 214) 10. A nurse in a large urban centre is working to provide prophylactic agents to exposed vulnerable hosts. What action is the best example of this goal? a. Providing varicella-zoster immune globin (VZIG) to appropriate children after a classmate is diagnosed with chickenpox b. Administering human papilloma virus (HPV) vaccine to girls in grade 6 c. Routinely immunizing 1-year-old children for measles, mumps, and rubella d. Tuberculosis (TB) testing exposed students at a high school after a student is diagnosed with TB Correct Answer: a (page 205) 11. The public health nurses (PHNs) are busy responding to seasonal influenza in a community of approximately 75 000 people. An assisted living facility has an increased number of influenza cases among the residents. A nurse is doing an inservice with the nursing staff at the facility about the transmission of the influenza virus. Which is an example of direct transmission? a. Inhaling a droplet from a sneeze b. Shaking a contaminated hand

c. Drinking tainted water d. Touching a contaminated doorknob Correct Answer: b (page 205) 12. The public health nurses (PHNs) are busy responding to seasonal influenza in a community of approximately 75 000 people. An assisted living facility has an increased number of influenza cases among the residents.The PHNs are trying to protect the residents from the flu. What is an example of a primary prevention initiative? a. Increasing assessments of the ill to identify complications early b. Screening individuals for signs of influenza c. Instructing individuals to sneeze into one's arm d. Administering Tamiflu to ill residents Correct Answer: c (page 205) 13. The public health nurses (PHNs) are busy responding to seasonal influenza in a community of approximately 75 000 people. An assisted living facility has an increased number of influenza cases among the residents. Family members of the residents have been following FluWatch on the Public Health Agency of Canada web page. What type of reporting is FluWatch? a. Statistics Canada information b. Surveillance data c. Health Reports d. Reportable disease Correct Answer: b (page 206)

14. What statement best describes a cohort study? a. It focuses on a group of people exposed to a particular health problem or potential stressor over time b. The researcher manipulates some of the variables in order to ascertain the effect of the manipulation c. The individuals in the group with the disease are matched with individuals who are similar in some characteristics (e.g., age, gender) but who have not manifested the disease in question d. Selected variables within a specific population are studied to look for evidence of association and causality Correct Answer: a (page 213) 15. What is an example of tertiary prevention of a communicable disease? a. Observing clients taking tuberculosis medication b. Demonstrating vaccine efficacy rates c. Encouraging frequent handwashing during flu season d. Immunizing students during a meningitis outbreak Correct Answer: a (page 205) 16. What agency in Canada is currenlty responsible for gathering surveillance data on reportable diseases? a. Health Canada b. Statistics Canada c. Canadian Institutes of Health Information (CIHI) d. Public Health Agency of Canada (PHAC)

Correct Answer: d (page 211) 17. A nurse is concerned about a recent outbreak of measles in a group of migrant workers. How would the nurse explain the concept of incidence to a new staff member? a. The rate at which new cases occur in a population during a specified period b. A measurement of disease frequency c. Occurs frequently and with predicted regularity d. The proportion of a population that is affected by the disease at a specific time Correct Answer: a (page 209) 18. Which epidemiological model best allows a nurse to visualize the relationships between various determinants of health? a. Causation criteria b. Epidemiological triangle c. Web of causation d. Venn diagram Correct Answer: c (page 208) 19. What is the purpose of epidemiology? a. The study of the occurrence and distribution of health-related states in specified populations b. To provide statistics to direct health care funding to the appropriate cause c. To predict and control challenges to population health d. An area of medicine that deals with the study of the causes of disease in populations

Correct Answer: c (page 202) 20. A nurse wants to know the current rate of human papilloma virus (HPV) infection in women aged 25 years as indicated by abnormal Pap smears. Which type of research design would be best to answer this question? a. Manipulation methodology b. Cross-sectional c. Prospective cohort d. Randomized controlled Correct Answer: b (page 212) 21. What type of research design was used in the Framingham Heart Study? a. Case series b. Cohort c. Cross-sectional d. Case-control Correct Answer: b (page 203) 22. What term is used to answer the question “how bad is it?” and to describe the effect of a given disease? a. Survival rate b. Incidence rate c. Prevalence rate d. Mortality rate Correct Answer: a (page 210)

23. Which of the statements below is true of the epidemiologic model a. The classic epidemiologic model contains four elements: The agent, host, environment, and vector b. The vector is the contagious or non-contagious force that can begin or prolong a health problem c. The host is the human being in which the disease occurs d. The agent is a factor that moves between the host and environment Correct Answer: c (page 203) 24. Which of the following is included in the most commonly cited criteria for causation? a. Specificity b. Sensitivity c. Qualitative replication d. Strength of screening Correct Answer: a (page 207) 25. Which of the following terms is used to compare the number of deaths from a specific cause within the entire population? a. Specific mortality rate b. Infant death date c. Crude mortality rate d. Relative death rate Correct Answer: c (page 209)

Short Answer Questions 26. Identify four criteria that researchers and practitioners use to assess a causal relationship between a stimulus and the occurrence of a disease. Correct Answer: -

temporal relationship: A person does not get the disease until after exposure to the cause.

strength of association: Exposure to a specific stressor or cause is most likely to bring on the disease.

dose-response: Persons who are most exposed to the contaminated food (e.g., ate the most) are the most ill.

specificity: The cause is linked to a specific disease (e.g., Mycobacterium tuberculosis does not result in chickenpox).

consistency: Everyone who eats contaminated food gets the illness. If other food in another time and place is contaminated with the same bacteria, the same illness occurs.

biologic plausibility: Consistent with the biologic/medical knowledge that is known (new discoveries may precede biologic plausibility).

experimental replication: Several studies done by different scientists in different places produce the same or similar results. (page 207)

27. A public health nurse has been contacted because 12 students living in a college dormitory are ill with bacterial meningitis. The cases have been confirmed to be caused by Neisseria meningitidis. Using the Venn diagram, describe the environmental characteristics in this scenario and the mode of transmission of this organism. Correct Answer: Venn diagram—Environmental Characteristics Physical—weather (e.g., meningitis typically occurs in late winter or early spring)Biological— microorganism (e.g., Neisseria meningitidis) Social—housing (e.g., young people living in close quarters) Mode of transmission: spread by droplet from mouth and nose usually through coughing, sneezing, or kissing (page 204) 28. Describe three areas that Florence Nightingale addressed during the Crimean War that advanced the science of epidemiology. Give an example for each area that illustrates the relationship with current community health nursing practice. Correct Answer: -

increased the recording of death statistics. CHN e.g., HHN provide information for the completion of the death certificates.

used the death statistics to explain and publicize the reality of the horrid situation. CHN e.g., CHNs have been very vocal in publicizing the effects and causes of homelessness.

used polar diagrams to demonstrate that what was killing the soldiers was contagious diseases. CHN e.g., CHNs can use Venn diagrams to illustrate the multiple host/agent/environmental factors influencing heart disease.

implemented sanitation practices that proved to authorities that her ideas were correct. CHN e.g., CHNs educate people about how HIV is transmitted and correct myths about how it is not transmitted. (page 203)

29. Calculate the odds ratio of developing colorectal cancer related to a low-fibre diet from the following example. Write a statement that would explain your results to a client. Study group = 300 Risk factor = low-fibre diet Disease = colorectal cancer Persons with low-fibre diet and colorectal cancer = 100 Persons with high-fibre diet and colorectal cancer = 20 Total persons with colorectal cancer = 120 Person with low-fibre diet and no colorectal cancer = 20 Persons with high-fibre diet and no colorectal cancer = 160 Total persons without colorectal cancer = 180 Correct Answer: OR = a/c divided by b/d = ad divided by bc = 100 x 160 divided by 20 x 20 = 40 In this study, people who ate low-fibre diets were 40 times more likely to develop colorectal cancer. (page 213) 30. Choose any infectious disease, such as tuberculosis, sexually transmitted infection, influenza, leprosy, etc. Apply your chosen disease to the natural history of disease process and describe two interventions that could be done by CHNs in each of the five levels of preventive measures. Correct Answer: Sexually transmitted infections Health promotion -

health education on human sexuality development

social marketing campaign to promote healthy sexual choices, such as condom use, abstinence, and limited sexual partners

specific protection

accessibility to free condoms and sexual health counselling Early diagnosis and prompt treatment

STI testing at easily accessible free clinics

treatment of STIs and case follow-up to treat contacts Disability limitation

testing of cure after STI treatment for high-risk persons

counselling for people with nontreatable STIs such as herpes Rehabilitation

HIV/AIDS support agencies

HIV/AIDS hospices (page 205)

Chapter 12: Communicable Diseases Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1.

What was the most likely causes of death in the 1900s? a. Influenza b. Heart disease c. Bubonic plague d. Diarrhea

Correct Answer: a (page 218) 2.

What change had the most influence on the decline in communicable diseases? a. Improvements in nutrition, sanitation, and living conditions b. Free medical care and low-cost prescriptions c. Dissemination of germ theories and access to hospitals d. Development of vaccines and blood tests

Correct Answer: a (page 218) 3.

What is a nurse today likely to encounter while working with clients with tuberculosis (TB)? a. Increased compliance with chemoprophylaxis b. Healthy young adults with the disease c. Multi-drug-resistant strains d. Easily cured infection with antibiotics

Correct Answer: c (page 218)

A nurse is concerned about a recent outbreak of measles in a group of migrant workers. How would the nurse explain the concept of an outbreak to a new staff member? a. The disease spreads and affects a large number of the population worldwide b. Exposure to a specific stressor or cause is most likely to bring on the disease c. It is a steady presence of a disease in a defined geographical area d. New cases of a disease are more than the normal occurrence during a given time period

Correct Answer: d (page 220) 5.

A nurse is planning a primary prevention measure for the school-aged population against a communicable disease. What strategy best fits this goal? a. Case finding children who may have been exposed to a teacher with hepatitis A b. Counselling families about ways to treat head lice c. Working toward achieving high immunization rates for hepatitis B d. Administering tuberculosis (TB) medications to children with the disease

Correct Answer: c (page 220) 6.

What is the key to controlling the number of people that become infected with an organism? a. Preventing the transmission of communicable diseases b. Timely screening for communicable diseases c. Effectively treating communicable diseases d. Recognizing the signs and symptoms of communicable diseases

Correct Answer: a (page 220) 7.

When must community health nurses complete notifiable disease reports?

a. For a fixed list of communicable diseases determined by the WHO b. For all communicable diseases in their community c. For communicable diseases mandated by the federal level d. For specific communicable diseases that must be reported to local health officials Correct Answer: d (page 236) 8.

What agency in Canada is responsible for collating all the notifiable communicable disease reports? a. Centers for Disease Control (CDC) b. Public Health Agency of Canada (PHAC) c. Health Canada d. World Health Organization (WHO), Canadian branch

Correct Answer: b (page 236) 9.

After 2003, SARS was added to the list of diseases that people can be quarantined for in Canada. What does it mean to be quarantined? a. Restriction of a well person who has been exposed to an infectious agent b. The time that a person is able to spread the disease over a two-week period c. Separation of an infectious person for a period of time to reduce the transmission of disease d. A specific time period that the communicable disease can be transmitted

Correct Answer: a (page 241)

10. AA nurse is screening clients at a local health centre for severe acute respiratory syndrome (SARS) after a recent outbreak in Vancouver. Which client response would constitute an immediate quarantine and notification of the local public health department? a. Has travelled within the last 10 days to Ontario and has nausea and vomiting b. Has been in contact with a health care worker from Vancouver and has a chronic cough c. Has been in contact with a person with SARS in the last 10 days and did not wear protection d. Has not travelled to an area of SARS in the last 10 days but has a temperature of 37.5°C Correct Answer: c (page 241) 11. Which diseases would require a nurse in Canada to complete a notifiable disease report? a. Chickenpox, pediculosis, scarlet fever, smallpox b. AIDS, measles, pertussis, tuberculosis c. Chlamydia, hepatitis B, rhinovirus, smallpox d. Botulism, hantavirus, mumps, roseola Correct Answer: b (page 237)

12. At a public health travel clinic, Jasper states that he will be going to work in a developing country. Which waterborne communicable diseases does Jasper need to be vaccinated against? a. Yellow fever and malaria b. Rabies and rubella c. Hepatitis A and B d. Cholera and typhoid Correct Answer: d (page 223) 13. How long have communicable diseases been identified as a part of human life? a. From the early 13th century b. Since the mid-1800s c. As long as people have lived in cities d. As long as history has been recorded Correct Answer: d (page 217) 14. What was the first recorded worldwide threat from a communicable disease? a. Bubonic plague b. Scarlet fever c. Influenza epidemic of 1918 d. Smallpox Correct Answer: a (page 218) 15. Which is an example of passive surveillance? a. A family doctor reporting a positive case of West Nile virus to a local health authority b. Sentinel systems to identify disease occurrence in the community when individuals present with suggestive symptoms c. The Influenza-Like Illness (ILI) screening tool used in emergency rooms d. Absenteeism data related to influenza from all schools in the community Correct Answer: a (page 238)

16. Which population is at a higher risk for methicillin-resistant staphylococcus aureus (MRSA)? a. Inmates b. Elderly admitted to hospital c. School-aged children d. Passengers on a cruise ship Correct Answer: b (page 226) 17. William, 5 years of age, is at a well-child clinic. The nurse has determined that William is up to date on his childhood immunizations and that he received the measles, mumps, and rubella (MMR) vaccine at 18 months of age. What vaccines will William receive today from the nurse? a. Varicella (Var), haemophilus influenza type b, and hepatitis B (HB) b. Diptheria, tetanus, pertussis, and polio (DTaP-IPV) c. Diptheria, tetanus, polio, and haemophilus influenza type b (Hib) d. Hepatitis B, varicella, and meningococcal (Men-C) Correct Answer: b (page 221) 18. What is the purpose of the integrated Public Health Information System (iPHIS)? a. Reporting system that allows jurisdictions within a province to communicate disease patterns b. A system developed by the Centers for Disease Control (CDC) to link Canada and the United States c. Electronic system to communicate outbreaks of respiratory or enteric illnesses interprovincially d. An internationally linked computer system for communicating outbreaks globally Correct Answer: a (page 239) 19. What does it mean if invasive meningococcal disease (IMD) is endemic? a. There is a steady presence of the disease in a defined geographic area or population group b. The new cases of the disease exceed the normal occurrence during a

given period of time c. The occurrence of the disease is higher than what would be expected normally d. The disease spreads and affects a large number of populations worldwide Correct Answer: a (page 220) 20. Which of the following classification of communicable diseases represents the public health programs classification? a. Bacterial, cardiovascular, human b. Air borne, parasitic, diarrheal c. Respiratory, zoonotic, water borne d. Vaccine preventable, perinatal, viral Correct Answer: c (page 219) 21. What is an example of a nursing activity that will provide passive immunity to the client? a. Provide a seasonal influenza vaccine b. Administer hepatitis B immune globulin (HBIG) c. Give the mumps, measles, and rubella (MMR) immunization d. Facilitate the administration of a one-time chemoprophylaxis agent to a vulnerable host Correct Answer: b (page 241) 22. The public health department has been alerted to a potential outbreak of hepatitis A after eight people who attended a wedding in Mexico have tested positive for the hepatitis A IgM. The public health nurse is now involved in contact tracing. The nurse is interviewing the infected individuals regarding contacts they were exposed to during the incubation of the disease. What is the most likely mode of transmission of the pathogen in this scenario? a. Drinking water contaminated with the bacteria b. Ingestion of non-cooked food contaminated by infectious food handlers c. Direct contact with respiratory droplets from nose or throat of the infected person

d. The bite of an infected mosquito Correct Answer: b (page 223) 23. The public health department has been alerted to a potential outbreak of hepatitis A after eight people who attended a wedding in Mexico have tested positive for salmonellosis. What is the incubation period for ssalmonellosis? a. 15 to 50 days b. 6 to 9 hours c. 12 to 36 hours d. 60 to 90 days Correct Answer: c (page 229) 24. Which term is used to describe the collection of data utilizing screening tools, interviews, and sentinel systems to identify disease occurrence in the community when individuals present with suggestive symptoms? a. Active surveillance b. Contact tracing c. Notifiable disease list d. Passive screening Correct Answer: a (page 237) 25. A public health nurse has identified a client who has had contact with an infectious individual who has been diagnosed with active tuberculosis. What term is used to describe the amount of time the client has spent with the infectious individual? a. Incubation period b. Degree of exposure c. Mode of transmission d. Control measure Correct Answer: b (page 239)

Short Answer Questions

26. A Community Health Nurse is engaged in contact tracing. What four main points would he need to consider when identifying contacts? Correct Answer: -

The mode of transmission

The incubation period

The infectious period of the particular disease (page 238)

27.

Discuss the importance of herd immunity

Correct Answer: -

herd immunity is one major public health advantage of a vaccination program. Both the vaccinated and unvaccinated are protected from disease through herd immunity. If one is vaccinated, one typically does not contact the disease and hence cannot spread it to someone who is unvaccinated (page 220)

28. Judy is a nurse responsible for managing an outbreak of hepatitis A in a day camp. Outline the steps she would take to manage the outbreak, using an example for each step. Correct Answer: 1. Verify the diagnosis: check the lab report and confirm the diagnosis of hepatitis A 2. Confirm the existence of an outbreak: plot the existence of hepatitis A on an epidemiologic curve and compare to normal incidence rates 3. Identify affected persons and characteristics: complete case histories on the affected children 4. Define and investigate the population at risk: identify those children and workers exposed in the two weeks before the onset of symptoms and one week after the appearance of jaundice 5. Generate a hypothesis: investigate the cause of the outbreak by trying to determine

the index case 6. Contain the outbreak: coordinate control measures such as closing the day care, immunizing exposed children and staff (page 24) 29.

Discuss the two reasons to test or screen for a communicable disease

Correct Answer: -

The first reason is in response to the disease being identified in the community

Testing and screening after broad immunization campaigns (page 241)

30. What is Direct Observed Therapy (DOT) and why is this method used in the community setting? Correct Answer: -

DOT is an example of a tertiary prevention measure used to ensure clients with TB take their prescribed medication

The nurse observes the clients taking the medication on a pre-set schedule

This is to prevent the risk of non-compliance and thereby reduce the possibility of drug-resistant TB, which could place the community at risk (page 242)

Chapter 13: Community Nursing Process Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1.

What is the best definition of a community? a. A random group of people b. Members of an extended family living within the province c. All the seniors living within the same province d. Students at a college

Correct Answer: d (page 247) 2.

What is included in community dynamics? a. Decision-making b. Community history c. Geographical boundaries d. Community centres

Correct Answer: a (page 247) 3.

What is included in a healthy community process? a. Involvement by selected sectors of the community b. Participation from formal leaders c. Access to health care d. Support from the mayor and council

Correct Answer: d (page 248) 4.

How does a nurse assess lines of resistance in a community? a. Facilitating the community's buffer zone b. Analyzing the community's tension-producing stimuli c. Collecting information about the community's strengths d. Observing the community's normal state of health

Correct Answer: c (page 248) 5.

A nurse is conducting a windshield survey. What activity is part of the windshield survey? a. Distributing a comprehensive needs assessment survey throughout the

community b. Driving through the community's main street on her way home c. Asking residents what they think of their neighbourhood d. Using the five senses to get a picture of the overall community environment Correct Answer: d (page 250) 6.

What is the best way for a nurse to conduct an assessment of an aggregate community? a. Meet residents at a seniors' complex b. Survey adults who ride the transit system to work c. Observe children at a local playground d. Interview members of the high school debate team

Correct Answer: b (page 251) 7.

A nurse works in a community with political boundaries. What is most likely to define the community's boundaries? a. The river that runs through the town b. The mountains east of the town c. The shape of the valley d. The catchment area for the local schools

Correct Answer: d (page 247) 8.

A nurse is collecting qualitative data as part of a community assessment. What is the nurse most likely to be doing? a. Conducting a public meeting b. Reviewing data in a birth registry c. Distributing a multiple-choice questionnaire d. Generating files of statistical data

Correct Answer: a (page 255) 9.

What is a disadvantage of a community forum? a. Produces one-way dialogue on issues

Everyone who attends has to participate c. A few people may dominate the discussion

d. Relatively inexpensive to plan Correct Answer: c (page 255) 10. AA group of nurses feel overwhelmed as they conduct their community assessment. What would be important in helping them continue with their work? a. Spend more time collecting data from new sources b. Determine what their outcomes are going to be c. Use several more methods to collect data d.

Focus on the purpose of the assessment Correct Answer: d (page 255) 11. AA group of nurses are using a population health approach in a community project. What is an example of this approach? a. Trying to reduce inequalities in health between population groups b. Improving health access for mothers who live east of town c. Working to treat illness in selected groups d. Addressing only factors that affect the health of preschool children Correct Answer: a (page 256) 12. Where is the best place for a nurse to look for Canadian population health indicators? a. Nursing journals b. Canadian Institute of Health website c. Statistics Canada d. Books in the university library Correct Answer: b (page 256) 13. Mr. Yeung, 44 years old, is concerned with his psychosocial risk factors for heart disease. What would the nurse want to address with Mr. Yeung? a. Smoking patterns b. Family history c. Age and gender d. Cultural beliefs about nutrition Correct Answer: d (page 256)

14.

What will a nurse do when analyzing community data? a. Collect information on a survey b. Assess the effectiveness of the data collection c. Use inferences to categorize data

Compare summarized data with related sources Correct Answer: d (page 257) 15. AA nurse is writing a community health nursing diagnosis. What statement is the nurse most likely to use? a. Potential for improvement within the family unit b. Individual knowledge deficit about nutrition c. High school students' risky behaviours d. As evidenced by self-reporting information from the parents Correct Answer: c (page 258) 16. AA nurse asks participants to discuss what they perceive to be the most important health problem in their community. What community participatory tool has the nurse used? a. Web of causation b. Community mapping c. Community needs matrix d. Present-future drawing Correct Answer: c (page 259) 17. Which of the following represents a step in community program evaluation? a. Engage stakeholders throughout the process b. Plan the evaluation once the program is implemented c. Provide the rationale for the assessment d. Identify governance and politics Correct Answer: a (page261) 18. AA nurse is asked about the goal of community health nursing. What would be the best response? a. To protect people from harm and prevent them from re-entering the acute health care system

b. To promote, preserve, and protect the health of individuals, families, aggregates, and populations c. To work with population groups to support them to make healthy lifestyle choices d. To provide cost-effective nursing services within the context of people's homes Correct Answer: b (page 246) 19. What is the core of a community? a. The people b. The community health nurse c. The hospital d. The geographical centre Correct Answer: a (page 249) 20. Which of the following is true about the community health promotion model? a. It applies individual health promotion strategies to achieve commuity actions b. It incorporates strategies from Newmans model to guide community planning c. It uses a biologic approach to promote the health of the population d. The nursing process and primary health care are an integral part of the model Correct Answer: d (page 249) 21. AA nurse is conducting a community assessment of a large northern city. What should the nurse assess in the physical environment? a. High unemployment rates b. Limited access to transportation c. Mercury poisoning of the fish d. Decreased literacy rates Correct Answer: c (page 252)

22. AA community health nurse has been sent to a small rural community. The incidence of sexually transmitted infections (STIs) in the adolescent population is four times greater than in the surrounding communities. How might the nurse collect quantitative data on the community? a. Talk to the community leaders b. Review public health records c. Drive around the community d. Hold a focus group meeting Correct Answer: b (page 255) 23. AA community health nurse has been sent to a small rural community. The incidence of sexually transmitted infections (STIs) in the adolescent population is four times greater than in the surrounding communities. What is the best way for the nurse to engage key stakeholders in identifying the cause of the increased rate of STIs? a. Hold small focus group meetings in the high school b. Hold a community forum open to all taxpayers c. Meet with the formal leaders in the community d. Send a survey to the parent of adolescents Correct Answer: a (page 255) 24. AA community health nurse has been sent to a small rural community. The incidence of sexually transmitted infections (STIs) in the adolescent population is four times greater than in the surrounding communities. A nurse does a risk assessment of the community. What will this identify? a. The incidence of STIs in the community b. Location of condom machines c. Behaviours that place the adolescents at risk d. The organism causing the increase in STIs Correct Answer: c (page 256)

25. AA community health nurse has been sent to a small rural community. The incidence of sexually transmitted infections (STIs) in the adolescent population is four times greater than in the surrounding communities. A nurse wants to plan strategies to reduce the incidence of STIs. What approach would increase community participation? a. Ask the stakeholders what is the priority need b. Ask the community formal leaders to provide input c. Develop a curriculum for teachers on STI prevention d. Teach the adolescents about safe sex Correct Answer: a (page 260) Short Answer Questions 26. Describe the four components of a community nursing diagnosis and give an example of a community nursing diagnosis. Correct Answer: -

Specific aggregate or target group

Actual or potential unhealthy or healthy responsive/situation that a nure can change Etiology or cause for the unhealthy or healt response/situation Charaterics (i.e. signs and symptoms) or evidence that describe the response or situation

See table 13.2 for examples (page 258)

27. Describe two approaches to community participation in planning. Give an example where each approach could be used by a CHN. Correct Answer:

community needs matrix tool-e.g., to prioritize health concerns with school children

community mapping-e.g., to plan for where in a community a pilot project to address low-birthweight babies should start

present-future drawing-e.g., to address barriers and strengths to help a community plan to move beyond the cycle of poverty (page 259)

28. List seven areas that need to be addressed during a community-wide assessment. Give a sample data course for each area. Correct Answer: -

purpose: data source-agency or group that engaged CHN in process

target group: data source-agency or group that engaged CHN in process

community history and perception: data source-local library

population: data source-health department statistics

physical environment: data source-city departments information

socioeconomic condition: data source-employment rates

education: data source-literacy rates

culture characteristics: data source-new immigrant service groups

religion: data source-listing of churches/faith groups

recreation: data source-community newsletters

health and social services: data source-ratios of health workers to population

transportation: data source-windshield survey

community dynamics: data source-town council structure (page 261 – 263)

29. Describe five community functions and give an example for each from community health nursing practice. Correct Answer: -

space and infrastructure-e.g., schools. employment and income-e.g., economic growth

security, protection, and law enforcement-e.g., community policing

participation, socialization, and networking-e.g., community recreation centres

linkages with other systems-e.g., connections with other communities through a community association (page 247)

30. What is the difference between vertical communication, horizontal communication and diagonal communication? Correct Answer: -

Vertical communication links communities to larger communities or to those with higher decision-making power

Horizontal communication connects the community to work collaboratively with its own members, environment, and other service systems

Diagonal communication reinforces the cohesiveness and communication of all system components, both horizontally and vertically, and helps to reduce the silo effects that occur when communication is done only vertically or horizontally (page 247)

Chapter 14: Community Health Planning, Monitoring and Evaluation Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1.

A nurse is involved in planning a health promotion program in a community. What occurs after the program is designed and implemented? a. Conducting a situational analysis b. Monitoring the program c. Identifying the issues of concern d. Selecting the best alternatives

Correct Answer: b (page 268) 2.

Which comment is true about program planning? a. The process is linear b. Steps can be repeated c. The first step is to identify a problem d. Evaluation is the final step

Correct Answer: b (page 268) 3.

A community group is using the program logic model to plan a new community wide system of bike and walking trails. What is true about the program logic model? a. Shows how to document different facets of a program after evaluation b. Provides a diagram of what the program is supposed to do, with whom, and why c. Helpful when started from the top as it does not require specific target groups d. Yields a diagram that provides rigid guidelines on the expected impacts of the program

Correct Answer: b (page 268) 4.

A nurse is using the program logic model to develop a program to reduce adolescent sexually transmitted infections (STIs). What is an example of an activity in the CAT (Component, Activity, Target) stage?

a. Focus on 15- to 18-year-old females b. Placing condom machines in washrooms c. Determining risk behaviours d. Reducing STIs Correct Answer: b (page 269) 5.

A group of nurses are using a program logic model to plan a new multicultural liaison program. What would be the most appropriate short-term outcome for the program? a. Increasing awareness in the community of multicultural resources b. Building the knowledge of health care workers on how to work with multicultural groups c. Building the knowledge of health care workers on how to access the liaison program d. Increasing appropriate use of the health care system for multicultural groups

Correct Answer: c (page 269) 6.

What does program evaluation primarily look at? a. Methods to initiate change b. What works and what else needs to be done

How best to meet the community's needs d. What can be achieved through standards of practice Correct Answer: b (page 269) 7.

What will ensure that program monitoring and evaluation are more likely to be successful? a. Uses a predetermined approach that focuses on a final report b. Is designed to be participatory from the beginning c. Utilizes conventional approaches d. Has external measures of success using quantitative processes

Correct Answer: b (page 267) 8.

A nurse uses a SWOT analysis as part of the planning process. What information will this provide the nurse?

a. Sources of information b. Timetable c. Opportunities d. Working plan Correct Answer: c (page 270) 9.

A nurse is using qualitative research strategies as part of the planning process. What question will be answered using this research approach? a. Who b. Why c. When d. How much less likely

Correct Answer: b (page 271) 10. Callie is a new nurse who wants to analyze quantitative data about her community. What will be her first step? a. Conduct a focus group b. Develop a survey c. Examine existing health status reports d. Estimate program cost Correct Answer: c (page 271) 11. AA nurse is identifying priority interventions as part of community planning. Whatis a subjective criterion the nurse might use? a. Size of the problem b. Cost of the program c. Consequences of the problem d. Political will to address the problem Correct Answer: d (page 271) 12. David is planning, monitoring, and evaluating a community program on farm safety. He uses a tool to depict the timing and sequence of activities to ensure success of the program. What tool is David using? a. Program evaluation tool kit b. Gantt chart

c. Program logic model d. SWOT Correct Answer: b (page 273) 13. Helga, a nurse manager, is involved in developing long-term strategic plans for her organization. What tool is she likely to be using? a. Key informant interviews b. SWOT analysis c. Community assessment d. Program logic model Correct Answer: d (page 268) 14. What is an ongoing dynamic process that supports further refinement of program activities and helps to identify gaps or flaws in the original program design? a. Evaluation b. Planning c. Assessment d. Implementation Correct Answer: a (page 269) 15. Why is it important for a nurse to engage with community partners while working on a community family violence prevention program? a. Reduces program planning and implementation costs b. Reflects the priorities of the public health department c. Ensures the success of the program d. Helps to build community commitment to the program Correct Answer: d (page 272) 16. What is included in the multiple intervention program framework? a. Implement strategies suggested in the literature b. Describe ecological determinants of the problem c. Select the most economical strategy d. Optimize interventions Correct Answer: d (page 278)

17. AA nurse is evaluating a bike safety program for school-age children. What would be an example of a spin-off? a. Parents wearing helmets when biking b. More children wearing helmets when biking c. Reduction in head injuries in school-age children d. Change in attitudes of children regarding use of helmets Correct Answer: a (page 280) 18. What type of reporting format is used to assemble quantitative data findings from research studies with a common objective? a. Questionnaires b. Surveys c. Systematic reviews d. Epidemiological studies Correct Answer: c (page 271) 19. AA nurse is planning a wellness centre and wants to ensure that her planning process is transparent. What does the nurse need to do? a. Ensure that all voices are heard in the process and reflected in the final outcomes b. Make sure identified needs and wants are operationalized into the proposed interventions c. Ensure that the process for selecting priorities is made apparent to those not directly involved in the process d. See that all suggestions and inputs are incorporated into the planning process Correct Answer: c (page 272)

20. AA community group, including nurses, is concerned about the number of alcoholrelated deaths among high school students following graduation parties. How will the group do their program planning? a. Address each phase of their framework before moving on to the next phase b. Complete a planning framework after justifying the need for the program c. Present their plan to funding agencies and then develop their framework d. Participate in a complex process that helps to build consensus about priorities Correct Answer: d (page 272) 21. AA community group, including nurses, is concerned about the number of alcoholrelated deaths among high school students following graduation parties. A nurse is reviewing the qualitative data as part of the assessment of the problem. What will the nurse include in this review? a. Interviews with senior students b. Systemic reviews c. School survey d. Police reports Correct Answer: a (page 271) 22. AA community group, including nurses, is concerned about the number of alcoholrelated deaths among high school students following graduation parties. How might the nurse package the qualitative data? a. Matrices b. Meta-analysis c. Gantt chart d. Integrative review Correct Answer: a (page 271)

23. AA community group, including nurses, is concerned about the number of alcoholrelated deaths among high school students following graduation parties. The community group uses the program logic model. What is an appropriate long- term outcome of the program? a. Using a designated driver b. Decrease in drinking in high school students c. Awareness of the relationship between alcohol and death d. Decrease in deaths Correct Answer: d (page 269) 24. AA community group, including nurses, is concerned about the number of alcoholrelated deaths among high school students following graduation parties. The group is selecting the priorities for the program. What will guide the group in this process? a. Obtaining agreement from managers on the process to ensure their support b. Ensuring the priorities address all the identified needs c. Holding a community meeting to set priorities d. Communicating a list of priorities to the community Correct Answer: a (page 272) 25. AA community group, including nurses, is concerned about the number of alcoholrelated deaths among high school students following graduation parties. The group evaluates the program. What would be an example of sustainability of the program? a. Students demonstrating knowledge about the effects of alcohol b. Continuing funding for education c. Promotion of a dry graduation by the student council d. Decrease in alcohol-related deaths Correct Answer: c (page 280)

Short Answer Questions: 26. A nurse is planning a needle exchange program for homeless youth in an urban inner city. Describe five aspects of a program logic model. Provide two examples for each aspect related to the above program description. Correct Answer: -

components are the themes of program activities, e.g., harm reduction

activities are the specific intervention strategies used for each component, e.g., needle exchange outreach nursing services

target groups are the intended recipients of the program, e.g., homeless youth

short-term outcomes are the short-term changes or benefits from delivering the program demonstrated by participants in the program, e.g., increase in the number of youth who exchanged needles

long-term outcomes are the long-term changes or benefits from delivering the program demonstrated by participants in the program and reflecting the program goals, e.g., decrease in the number of blood-borne infections among street youth in a given area serviced by the needle exchange program (page 269)

27. Describe why the Multiple Intervention Program (MIP) framework was developed initially in the late 1980s. Correct Answer:

In Ontario in the late 1980s, there was a shift away from public health programs that predominantly involved home visits and clinically oriented services in schools and workplaces. As evidence on socio-ecological determinants increased, and as considerations of how best to distribute scarce resources in public health were debated, programs increasingly began to focus on interventions targeting multiple layers of the system. CHNs were asked to expand their interventions to include communities, organizations, and policy levels. With the input of PHNs and managers in Ottawa, a program framework was developed. (page 274)

28. Describe why the Multiple Intervention Program (MIP) framework was updated in the late 1990s. Correct Answer: The MIP framework was updated because of observation and reflections of practitioners and from research. Managers identified the challenges of trying to plan and evaluate multiple intervention programs. Research findings were shedding light on a related set of issues, as some multiple intervention projects were successful and some were not. (page 274) 29. Outline the five main elements of the Multiple Intervention Program (MIP) framework and give a community health nursing practice example for each element. Correct Answer: -

Identification of community health issues. CHN e.g., completing a community assessment to prioritize needs

description of socio-ecological determinants. CHN e.g., outlining strengths and capacities at different system levels

intervention options. CHN e.g., considering strategies that have demonstrated success and are theoretically sound

optimizing intervention strategies. CHN e.g., attending to the sequence and combination of strategies

monitoring and evaluating impacts, spin-offs, and sustainability. CHN e.g., identifying unintended effects of the program (page 274 – 280)

30. Define reach, dose, and intensity as they relate to interventions being considered within program planning. Provide a community health nursing practice example for each. Correct Answer: -

The reach of an intervention concerns what proportion and which particular segments of an intended target population receive the interventions. CHN e.g., a PSA intended for all seniors will only reach those with a TV/radio.

The dose is the amount of intervention required to have an effect. CHN e.g., multiple exposures to a PSA are required to change awareness.

The intensity of the intervention refers to its quality and whether it is tailored to the population subgroup receiving the information. CHN e.g., a media campaign for seniors on the importance of walking has low relevance for seniors with impaired mobility. (page 278)

Chapter 15: Information Technology Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1.

Clarissa, an e-health specialist, is planning an update to a health unit's website. She is checking the content for readability. What is readability? a. A technique to help net-evaders feel comfortable with using the Internet b. A public relations campaign that is formally planned but is disguised as popular "grassroots" behaviour c. A dedicated electronic communication method for health professionals d. A measure of how easily and comfortably text can be read

Correct Answer: d (page 293) 2.

What percentage of Canadians used the Internet to search for medical and health information in 2009? a. 70% b. 32% c. 49% d. 86%

Correct Answer: a (page 287) 3.

Which group is most likely to use the Internet as a source of health information? a. Young men b. High school graduates c. Lower-income individuals d. Women

Correct Answer: d (page 288)

What is the digital divide? a. Those acute care hospitals with access to digital monitoring equipment b. Access by all health professionals to secure electronic medical records for all people in a particular region c. The division of population groups who have and do not have access and/or the capability to use information technology d. The ability of health professionals to transmit electronic information and data through a secure interface

Correct Answer: c (page 289) 5.

Jackson is a nurse who is planning a smoking awareness campaign for students, teachers, and parents at a junior high school. He wants to develop a web page and use social networks in this campaign. The school population is diverse and includes students with disabilities. While designing the website Jackson must adhere to accessibility standards for people with disabilities. What is the minimally acceptable standard? a. The Canadian Nursing Informatics Association (CNIA) guidelines b. Community Health Nurses Association of Canada (CHNAC) standards of practice c. Web Content Accessibility Guidelines (WCAG) d. World Wide Web Consortium (W3C) Priority Level One standard

Correct Answer: c (page 290)

Jackson is a nurse who is planning a smoking awareness campaign for students, teachers, and parents at a junior high school. He wants to develop a web page and use social networks in this campaign. The school population is diverse and includes students with disabilities. Jackson is meeting with the teachers and parents to discuss the significant potential the website has to enhance the students' health decision-making. What strategy would be useful in addressing the "access quality divide" for the students? a. Set a dedicated time period during school hours for accessing the website b. Have privacy screens between the computers to facilitate student comfort c. Apply a block to areas of the website d. Include chat rooms

Correct Answer: d (page 290) 7.

Jackson is a nurse who is planning a smoking awareness campaign for students, teachers, and parents at a junior high school. He wants to develop a web page and use social networks in this campaign. The school population is diverse and includes students with disabilities. Jackson knows the students will surf the net, so he is developing guiding questions to help the students assess the quality of the Internet site. Which question would be most useful in determining the quality of health information? a. Is the sponsorship of the website clearly apparent? b. Does the homepage explain the mission, purpose and objectives, sources of funding, and governance of the organization? c. Is your identity protected on the website? d. Is the health information provided by a qualified organization that is committed to the public's health?

Correct Answer: d (page 291)

Jackson is a nurse who is planning a smoking awareness campaign for students, teachers, and parents at a junior high school. He wants to develop a web page and use social networks in this campaign. The school population is diverse and includes students with disabilities. Mrs. Mitchell, a parent of one of the students, is visually impaired. Mrs. Mitchell asks Jackson if there are any tools available to assist her in using the Internet. How should Jackson respond? a. "I understand that Braille displays are available through the Canadian Adaptech Network Project website." b. "Once you become blind, you will not be able to use the Internet. Let me provide you with some information on CD." c. "What type of information are you looking for on the Internet? Maybe your son can find out the information that you need." d. "The settings on your own computer can be adjusted to accommodate for hearing, vision, and mobility issues."

Correct Answer: d (page 291) 9.

Jackson is a nurse who is planning a smoking awareness campaign for students, teachers, and parents at a junior high school. He wants to develop a web page and use social networks in this campaign. The school population is diverse and includes students with disabilities. Jackson discusses with the teachers and parents the importance making the website interactive to engage the students. What strategy would be most effective in meeting this goal? a. Have pop-up advertisements that appeal to youth b. Create colourful and flashy designs appealing to youth c. Incorporate quizzes and games on the web page d. Integrate music and video clips into the web page

Correct Answer: c (page 293)

10. What is the target reading level for websites intended for laypersons? a. High school graduate b. Does not matter c. Grade 6 d. Grade 9 Correct Answer: c (page 293) 11. What is the significance of www.wrapin.org in terms of health information on the Internet? a. It is a service where a consumer may submit a URL to determine if the site is accredited or trustworthy b. It sets the standards of information credibility on the Internet c. It shortens long URLs to tiny URLs to aid in dissemination of information d. It sends out warnings about untrustworthy Internet sites Correct Answer: a (page 292) 12. AA nurse has created a web page for teachers on comprehensive school health. The nurse is going to use the Simple Measure of Gobbledygook (SMOG) Readability Test to assess the website. What information will this tool provide? a. Translation of the website text into other languages b. Whether the text is easy to read for persons with a visual impairment c. Information on word and sentence length d. A method to ensure a 9-year-old can understand the site Correct Answer: c (page 293)

13. What term refers to "development of a single intervention approach for a defined population sub-group that takes into account characteristics shared by the subgroup's members"? a. Tailoring b. Linking c. Marketing d. Targeting Correct Answer: d (page 295) 14. What website design element would be appropriate for immigrant women? a. One paragraph per web page b. Enlarged text c. Bright colours d. Slide show illustrations Correct Answer: d (page 295) 15. Which statement is the best example of writing in plain language? a. Avoid missing any doses of your prescribed medication b. Eat 5 to 10 fruits and vegetables every day c. A topical analgesic will work to reduce your child's pain and anxiety before his procedure d. Talk to your health care professionals about any concerns that you or your family may have about your treatment plan Correct Answer: b (page 295)

16. Jane is an e-health nurse specialist working for the federal government to create tailored health messages aimed at young women around body image. What feature will this website include? a. Messages that pull the user to more information b. Links to fact sheets and downloadable booklets c. Links to videos and images d. Messages that push the user to self-compare with others Correct Answer: d (page 296) 17. AA community health centre has received a grant to start an online support group. Which group would be most likely to be interested in such a service? a. Seniors over 65 years b. New immigrant men c. New mothers d. Adolescent men Correct Answer: c (page 298) 18. Who controls and owns an electronic health record? a. Primary health care clinic b. The doctor's office c. The client d. Health care organization Correct Answer: c (page 299)

19. What does the term information and communication technologies (ICT) represent? a. A fancy term to mean websites b. A designation given to websites that meet the World Wide Web accreditation standards c. Health-related information found on government-supported websites d. Computer-based technology systems that support a number of functions related to processing and transmitting information Correct Answer: d (page 286) 20. Jana, a healthy 25-year-old, works in a service industry. She uses the Internet on her work breaks to search for information about health issues relevant to her. What is she most likely to do? a. Start with a PubMed search for a specific topic b. Discuss her online findings with her physician c. Spend about 30 minutes on a search d. Order medications online Correct Answer: b (page 288) 21. Mr. Soronski brings an article he found on the Internet to his next well-senior appointment at the health centre. What is the best response by the nurse? a. "This is not valid information because it doesn't have the accreditation seal on it." b. "Don't trust anything you read online." c. "Let's look through this together to see how useful this information might be for your situation." d. "Didn't the information I gave you last time help?" Correct Answer: c (page 292) 22. What is included as a recommended nursing action with respect to health information on the internet.

a. Develop face to face skills with health information retrieval b. Consider gender and cultural preferences when developing materials c. Consider provider-provider online communication options d. Teach clients how to devalue the quality of information they find Correct Answer: b (page 291) 23. Which of the following is part of the Health on the Net code of conduct for medical and health websites? a. Accountability b. Health promotion c. Transparency d. Disease prevention Correct Answer: c (page 292) 24. Which of the following criteria is used for assessing health information websites for accuracy and completeness of content? a. Content b. Credibility c. Links d. Design Correct Answer: a (page 293) 25. When developing an online health promotion resource, Stacey uses short words and short sentences. In addition, she chooses to use simpler language over difficult words. Which strategy is Stacey using? a. The disclosure strategy b. The complementarity strategy c. The plain language strategy d. The attribution strategy Correct Answer: c (page 293)

Short Answer Questions 26. Outline four out of eight recommended nursing actions with respect to health information on the Internet. Provide a community health nursing practice example for each action. Correct Answer: -

develop skills in online health information retrieval and evaluation to identify and recommend the best online sites for health information. CHN e.g., take a course in nurse informatics

assess clients' Internet access, computer competencies, health literacy, online activity, etc. CHN e.g., include questions about Internet usage in client assessments

identify local community resources. CHN e.g., check out the free Internet sites in the community

invite clients to discuss the health information they find online. CHN e.g., ask clients what types of information they find/use online

consider client-provider online communication options. CHN e.g., set up a secure email address for clients to email CHNs with questions

learn about Internet security and client privacy issues. CHN e.g., read up on employers'/organizations' privacy and security policies/procedures

consider gender and culture preferences. CHN e.g., assess client groups for openness and acceptance of ICT

teach clients how to evaluate health information from the Internet. CHN e.g., develop a simple teaching sheet to post on the health department website as well as have available in clinical practice (page 291)

27. Rosie is a community health nurse (CHN) manager working to develop information for other CHNs to use with clients to examine health information obtained from the Internet. She is using the HON code to guide her work. Define four of the eight principles of the code and provide an example of what a CHN should look for on an Internet site for each principle. Correct Answer: 1. Authority. CHN e.g., look for a clear statement on a site of who is providing the information 2. Complementarity. CHN e.g., look for a clear statement on a site that the information is meant to supplement but not replace health advice from a professional 3. Confidentiality. CHN e.g., look for a clear statement outlining the confidentiality of data collected 4. Attribution. CHN e.g., look for clear references and related links plus a last updated date 5. Justifiability. CHN e.g., look for claims supported by evidence 6. Transparency of authorship. CHN e.g., look for who owns/designs/updates the site with clear contact information 7. Transparency of sponsorship. CHN e.g., look for who supports/sponsors the website 8. Honesty in advertising and editorship policy. CHN e.g., look for clear statements about advertising including a policy about same (page 292)

28. Rosie is a CHN manager working to develop information for other CHNs to use with clients to examine health information obtained from the Internet. She is using the HITI criteria to guide her work. Define four of the seven criteria and provide an example of a question for each criterion that a CHN should ask when looking at an Internet site. Correct Answer: 1. Credibility. CHN e.g., who is the sponsor? 2. Content. CHN e.g., is there a disclaimer statement? 3. Disclosures. CHN e.g., what is the purpose of the site? 4. Links. CHN e.g., how easy are the links to use? 5. Design. CHN e.g., how accessible is the site for someone with a hearing impairment? 6. Interactivity. CHN e.g., what types of feedback mechanisms are there? 7. Caveats. CHN e.g., does the site market any products? See Table 15.4 for definitions and more details. (page 293) 29. Rewrite the following statement at a grade 9 and a grade 6 reading level. It is recommended that you breastfeed your baby with an appropriate latch and audible swallowing until she indicates satisfaction and releases from the breast spontaneously. Aim to feed your baby at least 8 to 12 times in each 24-hour period for at least the first 6 weeks postpartum. Monitor the baby's output after each feeding and record all bowel movements and urinations.

Correct Answer: Grade 9 We recommend that you nurse your baby until she lets go on her own. Watch to see if she is showing you that she is satisfied. As well, make sure she is latched well and you can hear audible swallowing. Feed your baby at least 8 to 12 times every 24 hours for the first 6 weeks after birth. Keep track of your baby's bowel movements and urinations on your tracking sheet. Grade 6 Aim to nurse your baby 8 to 12 times every 24 hours. She needs to feed often for the first 6 weeks. Check the latch during a feeding. Listen for the baby swallowing. She will let go on her own when she is done. Write down when she poops and pees on your sheet. (page 294) 30. Outline three benefits and three drawbacks of online counselling. Provide examples of two practice areas that has been successful in using online counselling. Correct Answer: - Benefits: helpful for people who live in remote areas, value anonymity, or have access problems (transportation, scheduling); may have more disclosure; may allow better integration of therapy into day-to-day life - Drawbacks: loss of nonverbal communication, potential miscommunication, need for client and provider to be comfortable with technology, privacy/security issues - Practice areas: weight loss with type 2 diabetes, mental health interventions, smoking cessation, alcohol use (page 296-297)

Chapter16: Maternal, Newborn and Child Health Community Health Nursing A Canadian Perspective 5th Edition Stamler

Page Multiple Choice Questions 1.

What single factor, in Canada, is associated with poorer outcomes for mothers and children? a. Access to prenatal education b. Access to medical care c. Geography d. Poverty

Correct Answer: d (page 307) 2.

What best describes the concept of maternal health care in Canada? a. Family planning through to postnatal care b. Pregnancy, birth, and postpartum care c. Preconception counselling d. Prenatal education to prevent birth defects

Correct Answer: a (page 311) 3.

What is an example of a reproductive right? a. Freedom from socio-economic disadvantages b. Access to appropriate health care c. Right to use reproductive technologies d. Deciding on the number of children

Correct Answer: d (page 312)

What statement is correct about the maternal mortality rate in Canada from 19972011? a. The rate was highest from 2001-2003 b. The rate was lowest from 2005-2007 c. Rates have increased over the past three decades d. Rates have doubled over the past four decades

Correct Answer: a (page 311) 5.

What is an example of the medicalization of childbirth? a. Delivering in hospital assisted by a midwife b. Having an episiotomy c. Squatting to deliver d. Delivering at home assisted by a midwife

Correct Answer: b (page 314) 6.

A woman has electronic fetal monitoring during her labour. What term would best describe this practice? a. Maternal health care b. Liberal individualism c. Reproductive right d. Medicalization

Correct Answer: d (page 314) 7.

What is the leading cause of maternal mortality in Canada? a. Postpartum hemorrhage b. Obstetric embolism c. Diseases of the circulatory system d. Antepartum hemorrhage

Correct Answer: c (page 311) 8.

Which statement is correct regarding breastfeeding in Canada?

a. The rates of breastfeeding initiation are lower in eastern Canada b. The rates of breastfeeding initiation are lower in western Canada c. Breastfeeding at 6 months of age is was higher in 2011 than 2003 d. Breastfeeding at 4 months of age was lower in 2011 than 2003 Correct Answer: c (page 315) 9.

An Inuit woman leaves her community to deliver her baby in an urban centre. How might this impact access to care for others in the community? a. Ensures access to the latest technology b. Decreases access to community-based midwives c. Increases risks of maternal complications d. Reduces risk of maternal complications

Correct Answer: b (page 314) 10. What is the most common reason cited for why Canadian mothers discontinue breastfeeding? a. The infant was ready for solids b. The mother needed to return to work c. Breastfeeding was inconvenient d. The mother did not have enough breast milk Correct Answer: b (page 316)

11. Which of the following statements is true about women who smoke during pregnancy? a. Women who smoke during pregnancy are more likely to be younger b. Women who smoke during pregnancy are more likely to be from higher socioeconomic status c. Women who smoke during pregancy are more likely to have a post secondary education d. Women who smoke during pregnancy are more likely to be married Correct Answer: a (page 317) 12. Which of the following statements is true regarding teenage mothers? a. Teenage mothers are less likely to experience postpartum depression as adult mothers are b. Teenage mothers are more likely to experience postpartum depression as adult mothers are c. Teenage girls are less likely to binge drink during pregnancy d. Tennage girls are more likely to come for higher socioeconomic status Correct Answer: b (page 318) 13. Which of the following is an example of an indicator that is used to measure child well-being in Canada? a. Maternal mortality rate b. Breastfeeding rates c. Child death rate d. Relative risk Correct Answer: c (page 320)

14.

What Canadian agency is responsible for tracking the health of children? a. No Canadian agency is responsible for this b. The Public Health Agency of Canada c. The Canadian Association of Midwives d. The Centre for Child Health

Correct Answer: a (page 319) 15.

Which territory in Canada has the highest infant mortality rate? a. Northern Manitoba b. Northwest Territory c. Yukon Terrority d. Nunavut Territory

Correct Answer: d (page 231) 16. What is the main reason children present in emergency departments across Canada? a. Injuries b. Behaviour problems c. Neglect and abuse d. Risk of overeating Correct Answer: a (page 324) 17. Which of the following is part of the International Code of Marketing of Meast-Milk Substitutes what was developed by the World Health Organization in 1981? a. Different types of artificial nipples may be advertised to the public b. Different types of formula may be advertised to the public c. Health care facilities may not promote artificial feeding d. Healthcare facilities may distribute artificial nipples Correct Answer: c (page 322)

18. Which of the following is associated with physical activity during the preschool years? a. Decreased motor skill development b. Improved psychosocial health c. Increased levels of adiposity d. Lower measures of cognitive development Correct Answer: b (page 324) 19. A nurse visits the Calloway family. Mrs. Calloway states that she is having difficulty feeding her three children. What is the best action for the nurse to take? a. Provide Mrs. Calloway with money to purchase food b. Teach Mrs. Calloway how to make nutritious meals with the food she has c. Ask Mrs. Calloway if the children are in a school lunch program d. Discuss resources in the community the family can access Correct Answer: d (page 324) 20. Which of the following is included as one of the seven principles for healthy term infants’ nutrition from 0 – 6 months? a. Breastfeeding is contraindicated in many instances b. First complementary foods should be iron-rich c. Formula feeding is the best method of feeding infants d. Supplemental vitamin D is recommended for formula fed infants Correct Answer: b (page 323) 21. Aiden, 1 year old, is noted to be a picky eater. What teaching should the community health nurse include while speaking to Aiden’s parents? a. Aiden should be offerred what ever he will accept to eat b. Aiden should be offerred nutrient dense foods along with breastfeeding c. Aiden should be offerred nutrient dense foods and unpasteurized cow’s milk d. Aiden should be offerred unpastuerized goat’s milk with every meal Correct Answer: b (page 232) 22. AA new mother and her 6 month old baby arrive at the community health

centre for immunizations. The nurse completes a nutrition assessment. Which of the following signs indicate that the infant is ready for other foods? a. The ability to stand up without assistance b. The ability to roll from their back to their stomach c. The ability to speak a few words d. The ability to sit up a lean forward Correct Answer: d (page 323) 23. AA nurse works in a small northern Aboriginal community. Four of the women are pregnant and due to deliver in three to four months. The women tell the nurse that they are upset about having to relocate to a community 600 kilometres away for the last month of the pregnancy. What would be an appropriate comment by the nurse? a. "The four of you will be together and can support each other" b. "I have arranged for a doctor to do the deliveries in this community" c. "It will be safer to deliver in a large hospital" d. "Let's discuss this practice and look at options that may work for you" Correct Answer: a (page 314) 24. A nurse works in a small northern Aboriginal community. Four of the teenagers are pregnant and due to deliver in three to four months. What is a complication these girls are most likely to experience in the weeks following delivery? a. Shock b. Hemorrhage c. Depression d. Deep vein thrombosis Correct Answer: c (page 318) 25. AA nurse works in a small northern Aboriginal community. The nurse wants to improve the nutrition of preschool children in the community. What would be the nurse's first step? a. Develop a program for the children b. Teach the parents about nutrition c. Conduct a literature review

d. Assess the families social determinants of health Correct Answer: d (page 324) Short Answer Questions 26. What is the impact of poverty on maternal-infant health in Canada? Correct Answer: -

associated with poorer health outcomes for mothers and babies

places mother at greater risk for depression

higher infant mortality rates in Aboriginal population due to higher level of poverty

inequity in health care (page 310 – 320)

27.

List and discuss 4 facts about maternal health around the world

Correct Answer: See Table 16.1 28. What is the difference between maternal mortality rate and maternal mortality ratio? Correct Answer: -

The maternal mortality ratio is the number of maternal deaths during a given period per 100 000 live births during the same period

The maternal mortality rate is the number of maternal deaths in a given period per 100 000 women of reproductive age during the same time period (page 309)

29.

List and discuss 4 reproductive rights

Correct Answer: -

Reproductive health as a component of overall health, throughout the life cycle, for both men and women

Reproductive decision making, including voluntary choice in marriage, family formation and determination of the number, timing, and spacing of one’s children and the right to have access to the information and means needed to exercise voluntary choice

Equality and equity for men and women, to enable individuals to make free and informed choices in all spheres of live, free from discrimination based on gender

Sexual and reproductive security, including freedom from sexual violence and

coercion, and the right to privacy (page 312)

30. You are a community health nurse completing a postpartum home visit with a family. You notice that the father is a smoker. What illness prevention information related to smoking should you convey to the family? Correct Answer: -

Encourage a smoke-free home environment in order to avoid exposure to second-hand smoke

Offer the father smoking cessation interventions

Ask the father to not smoke in the house or in the car

Do not allow anyone else to smoke near the infant (page 317)

Chapter 17: School Health Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1.

What statement is true about school-aged children and youth? a. Drop-out rates are slowly increasing b. In Canada 10 million children and youth attend school each day c. Schools contribute to poor health behaviours in children and youth d. Schools play a key role in youth development

Correct Answer: d (page 329) 2.

Nurses in schools provide health promotion and health protection programs and services to individuals, families, groups, and aggregates within the school community. What model are they working within? a. Clinical services b. Treatment based c. Biomedical d. Primary health care

Correct Answer: d (page 330) 3.

Johanna, 10 years old, is confident, competent, reasonable, and composed. What task is she likely to complete? a. Developing core values b. Relying on her parents and teachers to make decisions c. Establishing intimate relationships d. Seeking opportunities to master new skills

Correct Answer: d (page 330)

What percentage of Canadian children under age 18 live in poverty? a. 19% b. 29% c. 49% d. 39%

Correct Answer: a (page 330) 5.

What percentage of indiginous youth live in poverty? a. 25% b. 50% c. 75% d. 60%

Correct Answer: b (page 330) 6.

Karl is a new nurse working in several inner-city schools. What will he learn through his community assessment? a. 20% of Caucasian (white) children live in poverty b. Children who are new immigrants to Canada are less likely to live in poverty c. Children with disabilities are more likely to live in poverty d. Aboriginal children who live off reserve are less likely to live in poverty

Correct Answer: c (page 330) 7.

Which group of children has the highest mortality rate from motor vehicle collissions? a. Youth between the ages of 10 and 19 years b. Adolescent females c. Children under 3 years d. Pre-adolescent males

Correct Answer: a (page 331)

Angelique, 12 years old, lives in a suburban area. What type of non-fatal injury is she most likely to suffer in the next year? a. Suicide attempt b. Sports injury c. Serious head injury d. Injury from pertussis

Correct Answer: b (page 331) 9.

Which statement is true about physical activity and weight in children? a. One in 3 Canadian children is overweight b. It's a problem of equal concern in girls and boys c. Of Grade 6 to 10 students, 25% are physically inactive d. Over 70% of children on reserve are overweight

Correct Answer: a (page 331) 10. What statement is true about the mental health of children in Canada? a. About 25% of children live with some form of mental illness b. Suicide rates continue to slowly increase for early adolescent and adolescent youth c. Grade 10 girls report feeling low more frequently than boys d. Hospitalization for eating disorders in girls under age 15 increased by 10% from 1987 to 1999 Correct Answer: c (page 332)

11. In a group of 300 youth attending grades 7-12, how many could the school nurse expect to use alcohol? a. 135 b. 235 c. 100 d. 70 Correct Answer: a (page 331) 12. Which group of 15- to 19-year-old youths is most likely to complete their suicide attempt? a. Youth of Aboriginal origin b. Youth who identify as transgender c. Male youth of Asian origin d. Youth of immigrant families Correct Answer: a (page 332) 13. Randy, a school nurse, is doing an environmental scan of youth and risk-taking behaviours. Which statement would he include in this scan as being accurate? a. 31% of youth aged 15 to 19 years report smoking b. 50% of youth aged 12 to 17 years have tried marijuana c. 20% of youth aged 15 to 17 years report having intercourse without using a condom d. 75% of youth aged 15 to 17 years reported drinking alcohol Correct Answer: c (page 331)

14. A group of school nurses are working with the high school student council to create a school health committee to identify health issues. What component of the Health Promoting Schools approach are the nurses using? a. Teaching and learning b. Healthy school policy c. Partnership and services d. Supportive environment Correct Answer: d (page 333) 15. Which of the following statements is true about the commprehensive school health approach? a. It describes a sociopolitical approach to disease prevention in schools b. It involves mobilizing a talking group of parents and students c. It recognizes that an educational approach alone doesn’t change behaviours d. It’s not important for school policies to reinforce educational messages Correct Answer: c (page 332) 16. AA group of nurses work with an approach that includes the components of teaching and learning, healthy environment, supportive social environment, and supportive services. What approach are they using? a. Comprehensive School Health b. Canadian Public Health Association c. Joint Consortium on School Health d. Canadian Association for School Health Correct Answer: a (page 332)

17. From which perspective would a school nurse in 1965 have practised? a. Socio-ecological framework b. Comprehensive school health approach c. Population health approach d. Biomedical model Correct Answer: d (page 334) 18. Thomas is a nurse working with several local high schools using a comprehensive school health approach. He is most likely applying what process within a school community? a. Critical thinking process b. Ethical decision-making process c. Partnership and services process d. Community health nursing process Correct Answer: d (page 335) 19. Jennifer is a school nurse working in Nova Scotia. What model is she likely working with? a. Youth Health Centre Model b. Healthy School Profile c. Global School Health d. School-based Health Clinic Model Correct Answer: a (page 337)

20. Nurses in a community want to facilitate the Comprehensive School Health program in the community. What should the nurses do first? a. Develop a health curriculum for the teachers to use b. Provide a community inservice on the benefits of the program c. Form a partnership with the school board and the public health unit d. Determine the school community's level of readiness Correct Answer: d (page 332) 21. What is an example of a public health nurse promoting health with small groups or classrooms? a. Providing or recommending curriculim materials to teachers b. Ensuring equitable access to health and social services for the school population c. Collecting statistics to identify trends and prevailing issues d. Assessment, supportive counselling, and referring students to services Correct Answer: a (page 336) 22. Joseph, 16 years old, lives with his parents on a reserve. What task is Joseph completing? a. Controlling his own behaviour b. Establishing co-operative relationships with peers c. Looking at situations from multiple perspectives d. Feeling unsure about his future plans for work or school Correct Answer: b (page 330)

23. Joseph, 16 years old, lives with his parents on a reserve. The school nurse wants to promote a healthy eating program in the school. What factor will aid in making it successful? a. Inviting youth in the school to become involved b. Scheduling one nutrition break per day c. Promoting the use of organic food d. Limiting student access to neighbourhood convenience stores Correct Answer: a (page 336) 24. The school nurse working on an Aboriginal reserve identifies that youth are in a high-risk group for suicide. What action should the nurse take in relation to teaching and learning? a. Incorporate student performances in health promotion events b. Provide educational opportunities for parents about positive mental health c. Ensure government participation with respect to funding initiatives d. Provide formal recognition of staff contributions in health initiatives Correct Answer: b (page 340) 25. The school nurse working on an Aboriginal reserve identifies that youth are in a high-risk group for suicide. What action should the nurse take in relation to healthy school policies? a. Provide posters that promote positive health messages b. Share health status reports to assist staff in addressing issues c. Ensure protocols are in place to refer students to partner agencies d. Provide educational opportunities for young siblings to promote health

Correct Answer: c (page 341) 26. Discuss three challenges and three successes for nurses in Canada related to school health in the last 15 years. Correct Answer: Challenges: -

significant reductions in financing of health and social services within schools

health services restructuring

changing public health mandates at the provincial/territorial level

reduced or eliminated CHN positions in schools

fragmentation of programs

- invisibility of PHNs Successes: -

articulation of health promotion and illness prevention roles of CHNs in schools

challenging the political forces that shape CHN practice

lobbying for integration of CHS into public health programs and services (page 335)

27. In working with youth who are engaging in risky behaviours, discuss three ways that the nurse could lessen the potential harm and encourage more health enhancing behaviours. Provide a community health nursing practice example for each point. Correct Answer: - Promote positive relationships with families, peers, community members. CHN e.g., peer-to-peer support group -

Build individual capacity and coping skills such as personal competence and a sense of control. CHN e.g., life skills noon -hour talks

Offer linked interventions that address both risky behaviours and positive development. CHN e.g., recreation activities for a smoking cessation group

Create supportive environments and opportunities for connecting with caring committee adults. CHN e.g., adult mentorship program

Engage in age-appropriate decision-making and problem-solving. CHN e.g., planning a safe grad led by youth

Offer meaningful youth participation opportunities. CHN e.g., student reps on the school health committee (page 333-334)

28. Yolanda works as a nurse within a Youth Health Centre. Describe the two types of programs, three services, and four additional activities she is likely to deliver. Correct Answer: Programs: - accessible, confidential, and nonjudgmental programs Services: -

health education, health assessment and intervention, referral, support, and follow-up

Additional: -

support student action teams, provide health curriculum support, offer consultations, coordinate immunizations (page 337)

29. A school health nurse is working with the school community to promote health. What questions does the nurse need to ask when engaging with the school community? Correct Answer: -

How effective is the health, physical education and other curriculum delivery?

Is the school aware of an able to access support services from the board and local community to support the health of students, staff, and families?

Does the school have a democratic and supportive social environment with shared decision making?

Is the physical environment supportive of the health curriculum being taught in the classroom?

Does the school implement and enforce health-supporting policies? (page 338)

30. The comprehensive school health approach involves mobilizing an action group of students, parents, school staff, and community partners to form a planning structure. The group then undertakes the panning process. What is involved in the planning process? Correct Answer: -

Create a shared vision of the school as a “healthy school”

Assess existing strengths and needs

Prioritize an issue

Develop a comprehensive plan addressing 4 areas (social and physical environment, teaching and learning, partnerships and services, & healthy school policy)

Implement the plan

Monitor and evaluate

Celebrate and communicate successes (page 332)

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Chapter 18: Family Health Community Health Nursing A Canadian Perspective 5th Edition Stamler

Page Multiple Choice Questions 1.

What term is defined by “any combination of two or more persons who are bound together over time by ties of mutual consent, birth and/or adoption or placement”? a. Community b. Couple c. Population d. Family

Correct Answer: d (page 347) 2.

What type of family is the most common today? a. Same-sex couples b. Blended family c. Mother, father, and children d. Couples with no children

Correct Answer: d (page 346) 3.

What is a characteristic of families who are launching children? a. Members are adusting to changes in the partner relationship b. The children are referred to as baby boomers c. Children leave home at an earlier age than previously

d. The children are more likely to marry Correct Answer: a (page 348)

What is required for a nurse to practise from a family systems nursing perspective? a. Has a community health nursing certificate b. Has knowledge of family subsystems c. Experienced in public health nursing d. Has extensive knowledge of family dynamics and systems theory

Correct Answer: d (page 350) 5.

What is one structural dimension of families? a. Nurture each other b. Communication c. Has similar values and rules d. Socializes children

Correct Answer: b (page 347) 6.

A health nurse is assessing how a family's structure helps to meet its purpose. What theory is the nurse using? a. Family health theory b. Family developmental theory c. Systems theory d. Structural-functional theory

Correct Answer: d (page 350) 7.

A nurse is using Friedman's Family Assessment Model to collect data about family structure. What is the nurse assessing?

a. Family values and communication patterns b. Associations with the community and role structure c. Coping strategies and recreational activities d. Family history and geographic mobility Correct Answer: a (page 350) 8.

A nurse is using the Calgary Family Intervention Model. What would be the most effective family intervention? a. Learned during the process in which health behaviours are acquired b. Uses the strengths of individual members and the family as a unit c. Determined by the nurse based on a family assessment d. Congruent with the family's beliefs and values

Correct Answer: d (page 351) 9.

A nurse during a family assessment asks the question, "What is the greatest challenge facing your family right now?" What data is the nurse attempting to elicit? a. Clarify the expectations of the family b. Identify past difficulties and coping mechanisms c. Identify stress, roles, values, and beliefs d. Assess family strengths and resources

Correct Answer: c (page 355) 10. AA nurse is using the McGill Model in working with a family who has two children with epilepsy. What can the nurse expect of the family during the implementation phase?

a. Comfortable in the supportive environment the nurse has created b. Passive as they recognize the nurse is the expert c. Active learners in collaboration with the nurse d. Partners in deciding with the nurse which areas need to explored in depth Correct Answer: c (page 352) 11. What is the best strategy to make a family feel comfortable during the initial visit? a. Introduce oneself and explain the purpose of the meeting b. Set the interview at a time that works best for the family c. Engage converstaion to put the family at ease d. Begin by asking questions that are less personal Correct Answer: c (page 354) 12. AA nurse has spent one hour interviewing the Petrovic family. What is the best way to terminate the interview? a. Ask the family if they agree that it is time to terminate b. Share the assessment of the situation with the family c. Tell the family that another appointment is needed d. Commend the family for their participation Correct Answer: a (356) 13. What is the primary role of the case manager in community health nursing? a. Monitor the caseload for the nurses in the health unit b. Assess and develop a care plan for the family c. Assess clients and assign them to a nurse d. Provide quality, cost-effective outcomes for clients Correct Answer:

14. An instructor is discussing the definition of a family with students. What example of a family given by a student indicates that more discussion is needed? a. A senior living with her beloved cat b. Two women living together c. A common-law couple d. A bachelor living alone Correct Answer: a (page 347) 15. Mr. and Mrs. Johal live with their three children. Also living in the home are Mr. Johal's mother and brother and Mrs. Johal's youngest brother. What type of family is this? a. Traditional family b. Extended family c. Nuclear family d. Blended family Correct Answer: b (page 347) 16. AA nurse is providing culturally sensitive care to a family from Albania. What Canadian Community Health Nursing standard is the nurse attempting to meet? a. Building relationships b. Promoting health c. Building capacity d. Facilitating access and equity Correct Answer: d (page 357) 17. Nicholas and Jacques are a gay couple who were recently married. They consider themselves to be a family. What is the status of their marriage in Canada?

a. Legal under the Civil Marriage Act b. Recognized as a common-law couple c. Illegal but would be recognized in the United States d. Legal as long as they do not have children Correct Answer: a (page 346) 18. Which family life cycle developmental stage is connected to the correct developmental task for North American middle-class families? a. Stage: aging parents Task: committing to and establishing a new family b. Stage: childbearing families Task: adjusting to parenthood and new family members c. Stage: forming partnerships and/or marriage Task: adjusting to needs of young adults leaving and/or re-entering family d. Stage: launching children Task: meeting age-appropriate developmental needs of children Correct Answer: b (page 348) 19. The Schimdt family's 13-year-old son recently became a paraplegic. The family uses a social networking site to keep friends and relatives informed. They openly talk about renovations to the house to allow their son wheelchair access. How would the nurse most accurately describe this family? a. Family in crisis b. Resilient family c. Family in denial d. Stigmatized family Correct Answer: b (page 350) 20. What is an example of viewing the family as context to the client? a. Helping a family following the death of child

b. Visiting a new mother and her baby at home c. Giving care to a family following a motor vehicle accident d. Visiting a new diabetic at home Correct Answer: d (page 348) 21. What is a demographic change of the Canadian family? a. There has been an increase in married couples with children b. Couples with children exceed those without children c. Married couples are a majority d. Common-law families are the fastest growing Correct Answer: d (page 346) 22. Which statement is correct about family assessment models? a. The Developmental Model of Health and Nursing emphasizes health as a process and the client as an empowering partner b. Family systems theory focuses on the interaction within and between family members c. The Calgary Family Assessment Model fully describes the multifaceted nature of family relationships d. The McGill Model has health as the sole focus of working with a family Correct Answer: b (page 350) 23. Trevor and Scott live in their own home with their biological young children. Both their son and daughter do well in elementary school and are involved in extracurricular activities through their school and church. What type of family are the Smiths? a. Abnormal family b. Nuclear family c. Blended family

d. Stigmatized family Correct Answer: b (347) 24. Oliver and Mary Smith live in their own home with their biological young children. Considering the family developmental theory, what task is the Smith family working on? a. Adjusting to changes in the partner relationship b. Adjustments to parenthood and new family members c. Commitment to and establishing a new family d. Maintenance of supportive relationships with children Correct Answer: b (page 348) 25. Which of the following statements is true about family nursing? a. Family nursing reserachers must advance family nursing research and foster knowledge utilization of findings b. The Canadian Nurses Association disseminates a collection of family research studies c. Family physicians must play a key role in allocating resouces for family nursing development d. No progress has been made in family nursing over the past three decades Correct Answer: a (page 357)

26. A nurse and the LeBlanc family are meeting to start a family assessment process. The LeBlancs' son, 10 years old, has just been diagnosed with severe allergies. Describe three important features of the nurse's comprehensive family assessment. What are two purposes of the assessment process? What are two advantages to the assessment occurring in the LeBlancs' family home? Correct Answer: Important features: -

Detailed

Inclusive

Uses open-ended questions

Aimilar to a comprehensive cultural assessment

Ongoing -

Added to and developed over time

Nurse facilitates process rather than conducts

Purpose: -

starts to build relationship with the family

part of the nursing process

foundation for planning, interventions, and evaluation

Advantages of home: -

Family is likely to be more comfortable

Other family members may be present

Multiple visits promoting trust and relationship building

Data are gathered in the family's own context (page 350)

27. A nurse is facilitating an assessment of a Sudanese family who has come recently to Canada to work in a large meat-packing plant. The family has been referred to the nurse by the occupational health nurse from the plant as the mother is expecting her fourth child. The family is very unfamiliar with the Canadian health care system. Select four areas from the Friedman Family Assessment Model. Develop an appropriate question for the nurse to ask during the assessment from each of the selected areas. Correct Answer: -

identifying data e.g., Whom do you consider to be part of your family?

developmental stage and history e.g., How did your family come to be in Canada?

environmental data e.g., How would you describe your home?

family structure e.g., In your family, how do you organize various roles and responsibilities?

family functions e.g., What can you tell me about your beliefs about health?

family coping e.g., How do you cope with stress and change? (pages 350-351)

28. Discuss three criticisms of case management as it relates to service delivery in community health nursing in Canada. What would improve case management in the future? Correct Answer: Criticisms: -

focus on cost containment

high-quality care vs. managing finances

prioritizing outcomes based on cost

need to get the most benefit from the least cost

needs of the client are balanced with the need to control costs improvements

- nationally funded home care program (Page 357) 29. Describe five ways to look at the family in family nursing. Give a community health nursing practice example related to each. Correct Answer: -

family as context. CHN e.g., Mr. Smith with high blood pressure is the client. His family is his context.

family is sum of its parts. CHN e.g., nursing care is provided to all members of the Jones family who are home from hospital after being treated for first- and second-degree burns in a house fire.

family subsystem is client. CHN e.g., focus is on the mother/baby dyad during a postpartum home visit.

family as client. CHN e.g., focus is on both Mrs. Green and her adult children simultaneously as they cope with her advancing Alzheimer's disease.

family as component of society. CHN e.g., family health is promoted through increases in social benefit payments (page 348)

30. List 5 questions that can be used as part of a family interview Correct Answer: See Table 18.3 (page 355)

Chapter 19: Gender and Community Health Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1.

The life expectancy of Canadians is changing. What is the current trend in life expectancy? a. The rate for men is increasing faster than for women b. Life expectancy for men has surpassed that of women c. Life expectancy for women is decreasing d. The rate increase is identical for men and women

Correct Answer: a (page 362) 2.

Which of the following statements is true? a. Sex refers to the psychosomatic characteristics that define men and women b. Gender refers to the socially constructed roles, behaviours and attributes tha a given society consideres appropriate for men and women c. Sex refers to the behaviours and activities that all societies consider appropriate for men and women d. Gender includes sex specific diseases like prostate cancer and ovarian cancer

Correct Answer: b (page 364) 3.

What is included in the definition of sex? a. Psychology b. Anatomy c. Behaviours d. Activities

Correct Answer: b (page 363)

What is the impact of sex on the health of men and women? a. Less tendency for women to experience depression b. No impact on disease progression for cardiovascular disease c. Similar response to drugs for both men and women d. Differences in incidence and natural history of many diseases

Correct Answer: d (page 363) 5.

What is the correct term for how we are treated by people around us? a. Gender role b. Gender relations c. Gender identity d. Institutionalized gender

Correct Answer: b (page 365) 6.

Why is prostate cancer termed a couples' disease? a. Impacts gender relations b. Greater incidence in married men c. Causes vaginal cancer d. Vaginal secretions can lead to prostate cancer

Correct Answer: a (page 366)

Michelle dresses her daughter in frilly dresses. What would be the correct term for this behaviour? a. Gender relations b. Gender identity c. Institutionalized gender d. Gender role

Correct Answer: d (page 365) 8.

Which statement is correct about how sex and gender affect health outcomes? a. Women are more likely to seek treatment for HIV than men b. Men and women differ in pharmacodynamics c. Men are at greater risk for HIV infections

Increased thyroid functioning in women predisposes them to depression Correct Answer: b (page 364) 9.

Which is one of the top five causes of death for men and women? a. Diabetes b. Cerebrovascular disease c. Alzheimer's disease d. Influenza and pneumonia

Correct Answer: b (page 369) 10. Ayishah is a married Arab woman. She has been ostracized by her family and friends following an affair with a male co-worker. The co-worker has suffered no consequences as a result of the affair. What is the most correct term for this behaviour?

a. Gender bias b. Gender relations c. Gender inequity d. Institutionalized gender Correct Answer: a (page 368) 11. AA nurse looks at society by considering the needs and realities of both men and women. What term best describes the nurse's actions? a. Gender lens b. Gender identity c. Gender inequity d. Gender bias Correct Answer: a (page 369) 12. When using a gender lens, what question should the nurse ask? a. What is the intended outcome for men and women? b. How are the subgroups of men and women taken into account? c. What legal realities need to be considered? d. How is the problem similar for men and women? Correct Answer: b (page 369) 13. Which country has the highest life expectancy for both men and women? a. Canada b. France c. Japan

d. Italy Correct Answer: c (page 363) 14. What group of women in Canada should receive particular attention from community health nurses? a. Women caring for elderly parents b. New mothers c. Aboriginal women d. Elderly women Correct Answer: c (page 365) 15. What statement is true regarding men's health and illness practices? a. Men rely on women to manage their ill health b. Men have more life threatening health conditions c. Men see their family physician if severely ill d. Men's Health Network collects research on men's health Correct Answer: b (page 369) 16. What is a caution nurses must exercise when using a gender lens in community care? a. Reinforcing stereotypes b. Overusing gender in programs c. Questioning the relevance in some programs d. Focusing on meeting the needs of women Correct Answer: a (page 370) 17. Which of the following factors need to be considered when examining policies sand programs through a gender-based analysis process? a. Access, inclusion, and equity

b. Assessment, benefits, and access c. Incidence, access, and social justice d. Prevalence, social justice, and benefits Correct Answer: a (page 368) 18. What is an example of a gender-appropriate public health intervention? a. Pregnancy prevention programs targeting young women b. Binge drinking program that targets seniors in nursing homes c. Anti-smoking campaign that targets pregnant women d. Ads that educate the men and women about the signs of cardiovascular disease Correct Answer: d (page 381) 19. Gender bias is the root of gender inequities. Gender bias results from which of the following three problems? a. Sex specificity, overgeneralization, and double standards b. Undergeneralization, gender and sex insensitivity, and tripple standards c. Overgeneralization, gender and sex insensitivity, and double standards d. Sex incidence, sex specificity, and tripple standards Correct Answer: c (page 368) 20. AA nurse works in a university health clinic. The nurse is aware that male and female students react differently to health issues. Which statement is true? a. Women commonly experience poorer health outcomes than men b. Men commonly experience poorer health outcomes than women c. Men generally live longer than women d. Men have higher levels of psychiatric disorders

Correct Answer: a (page 369) 21. AA nurse works in a university health clinic. The nurse is concerned about the number of students smoking on campus. While developing a policy for this issue, what does the nurse need to do? a. Find evidence to support that smoking is the leading cause of death in women b. Gather information and consider stakeholer perspectives c. Make an individual decision about what is the best policy for smoking d. Make assumptions about why smoking is a problem on campus Correct Answer: b (page 368) 22. AA nurse works in a university health clinic. The nurse wants to develop a program to reduce the accidental deaths on campus. What should the nurse use to develop this program to ensure it is successful? a. Institutionalized gender b. Sex equality c. Gender identity d. Gender lens Correct Answer: d (page 370) 23. A CHN is working with a family to assist them in taking responsibility for establishing, maintaining, or improving their health. This is an example of which level of prevention? a. Primary b. Secondary c. Tertiary d. Quaternary Correct Answer: b (page 372)

24. A CHN notices that different trends exist when men and women are treated for cardiovascular disease. The CHN works with health care professionals to ensure gender equity is maintained in treating patients. This is an example of which level of prevention? a. Primary b. Secondary c. Tertiary d. Quaternary Correct Answer: c (page 372) 25. Which tool needs to be used in order to consider the ways in which policies, programs, services, and interventions can better meet the needs of men, women, and people who identify themselves as transgender? a. Gender lens tool b. Gender policy development tool c. Institutionalized gender tool d. The sex and gender tool Correct Answer: a (page 373)

Short Answer Questions 26. Define and give an example of gender role, gender identity, and gender relations. Correct Answer: -

Gender role: the behavioural norms applied to men and women in societies that influence everyday actions, expectations, and experiences -e.g., in some societies men are expected to be the breadwinner while women raise the children

Gender identity: describes how we see ourselves as men and women and affects our feelings and behaviours -e.g., men are expected to be stoic emotionally, while women can freely express their emotions

Gender relations: refers to how we interact with or are treated by people around us -e.g., a woman being offered a seat on the bus by a man, or a man opening a door for a woman (page 365-366)

27. Define gender lens and discuss the types of questions a community health nurse should ask to ensure a program is appropriate for men and women. Correct Answer: Gender lens: a way to look at the participation, needs, and realities of men and women, boys and girls to ensure programs are equitable Questions the nurse should ask include: -

How is the problem/issue you are addressing different for men and women?

How are the different contexts in the lives of men and women, boys and girls addressed?

How is diversity within subgroups of women and men, girls and boys identified and taken into account?

What intended and unintended outcomes for men and women can be identified?

What other social, political, and economic realities are taken into account? (page 369-370)

28. List and define the four factors that need to be considered when examining policies and programs through a gender-based analysis process. Correct Answer: -

Access: The ability for all people to have equal access to policy, program, and legislative activities

Inclusion: Representation of diverse groups of men and women throughout the policy or program process

Benefits: The intended advantages of any program or policy are equally available to both men and women of diverse cultures, socioeconomic status, and at various levels of identity

Equity: Ensuring that Government of Canada programs and health promotion strategies identify the unique elements, opportunities, and challenges that men, women, and transgendered people face (page 368)

29.

List and define the three problems that five rise to gender bias.

Correct Answer: -

Overgeneralization: when it is assumed that what is good for men is good for women

Gender and sex insensitivity: ignoring gender and sex as important variables

Double standards: assessing the same situation differently on the basis of gender (page 368)

30. When using the gender lens tool, gender differences need to be taken into account. List the factors that consider gender differences. Correct Answer: -

Incidence/prevalence

Diagnosis/investigation

Risk factors

Natural history

Treatment

Response (page 370)

Chapter 20:Lesbian,Gay,Bisexual,Transgender,and Queer Clients Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1.

In a group of 100 people, how many are likely to self-identify as gay or lesbian? a. 1 person b. 20 people c. 2 to 3 people d. 5 to 10 people

Correct Answer: a (page 377) 2.

Ms. Davis, 30 years old, describes herself in masculine terms. What term describes this behaviour? a. Transgender b. Intersexual c. Bisexual d. Lesbian

Correct Answer: a (page 377) 3.

An instructor is teaching her community health students about homophobia. What comment made by a student would indicate that additional teaching is required? a. "So making gay jokes is not acceptable" b. "I worry that a homosexual person will be attracted to me" c. "I guess asking someone about their sexual orientation in a job interview is wrong" d. "I understand why some gay men are beaten"

Correct Answer: b (page 378)

What is the best response by the nurse when a client shares that he is involved in a long-term relationship with another man? a. "Okay, but you really didn't have to tell me" b. "Thank you for sharing that information" c. "Have you had the chance to get married?" d. "Do you want an HIV test done while I am here?"

Correct Answer: b (page 380) 5.

A nurse is concerned about heterosexism and has worked with a colleague to create a new assessment tool. What question would indicate that the nurse needs to discuss heterosexism with the colleague? a. Have you ever had a sexually transmitted infection? b. Are you in a relationship currently? c. What form of birth control do you use? d. Do you or your partner have any children?

Correct Answer: c (page 378) 6.

LGBTQ people experience a variety of health inequities. Which one of the following is one of these health inequitites? a. Lower rates of discrimination b. Higher rates of positive attitudes c. Higher rates of sexual abuse d. Lower rates of cardiovascular disease

Correct Answer: c (page 378) 7.

Mr. Watkins, 51 years old, is gay. He is suffering from the mental health effects of stigma, prejudice, and discrimination. What is this termed? a. Minority stress b. Mid-life crisis c. Sexual orientation stress d. Post-traumatic stress disorder

Correct Answer: a (page 378) 8.

What statement is true about homosexuality prior to 1970? a. Seen as vector for HIV

b. Treated with drug therapy c. Classified as a mental illness d. Ignored as a health problem Correct Answer: c (page 378) 9.

Ruth, 28 years old, has decided to tell her parents she is lesbian. What factor will determine the degree of difficulty in disclosing this information? a. The nature of the relationship she has with her parents b. How long she has admitted to herself that she is a lesbian c. How long she has been in a relationship with another woman d. The support she gets from her partner

Correct Answer: a (page 379) 10. Jody, 17 years old, is a lesbian. When will Jody's risk for suicide be the greatest? a. After her first relationship ends b. After her first encounter with homophobia c. When she tells her best friend d. When she tells her parents Correct Answer: d (page 379) 11. An instructor is teaching her community health students about homophobic attitudes and beliefs that will negatively impact the care of gay, lesbian, bisexual, and transgender clients. Which comment should be addressed by the instructor? a. "So gay men have anal sex" b. "How can I acknowledge when someone discloses their orientation to me?" c. "I will tell my father that gay men are not mentally ill" d. "How can I stop my friends from saying 'fag'?" Correct Answer: a (page 378) 12. AA nurse is working on using more inclusive language in her health assessment with new female clients. What question has more inclusive language? a. "Do you use the birth control pill?" b. "Are you in a relationship?"

c. "What is your marital status?" d. "Does your boyfriend hurt you?" Correct Answer: b (page 381) 13. AA nurse wants to become more gay-affirming with gay/lesbian/bisexual/transgender clients. What is one action the nurse can take? a. Ignore misinformation about gay/lesbian/bisexual/transgender clients b. Obtain education about the gay/lesbian/bisexual/transgender lifestyles c. Create a support group for gay/lesbian/bisexual/transgender clients with local clergy d. Supply a list of psychiatrists who treat gay/lesbian/bisexual/transgender clients Correct Answer: b (page 381) 14. Cynthia is a community health nurse and believes that healthcare should be accessible to all and not based on the particular needs of any one group or population. As a result Cynthia does not asking about sexual orientation when meeting a new client. This is an example of Cynthia being: a. Experienced b. Inclusive c. Neutral d. Homophobic Correct Answer: c (page 380) 15. Honora is a young lesbian woman who is suffering from low self-esteem and selfloathing. This has resulted in a substance abuse problem. What is Honora experiencing? a. Heterophobia b. Heterosexism c. Internalized homophobia d. Homosexuality Correct Answer: c (page 378)

16. What is true about the health inequities of gay and bisexual boys and men? a. Have higher risk of developing cancer b. Have a lower risk of tobacco use c. Have higher body mass index d. Have a higher risk of eating disorders Correct Answer: d (page 379) 17. AA nurse is in a meeting with her colleagues. One of the colleagues mentions that a young client, who many know, is a bisexual. What should the nurse do first? a. Talk to the colleague about confidentiality b. Report the nurse to the professional association c. Ask when the client disclosed this information d. Inquire whether the client's parents have been told Correct Answer: a (page 381) 18. Which group of LGBTQ people are more likely to experience multiple levels of discrimination? a. Caucasian middle-aged women b. Aboriginal young women aged c. All young adults d. Teenaged girls Correct Answer: a (page 381) 19. There are various theories about the nature of sexual orientation. Which of the following theory represents the current scientific evidence? a. Sexual attraction is a psychiatric condition b. There is a genetic basis for sexual attraction c. Sexual attraction is not related to culture d. There is a forensic basis for sexual attraction Correct Answer: b (page 377) 20. Which term is a culturally specific term that is used to describe gender identity, sexual orientation or a combination of both? a. Cisgender b. Bisexual

c. Transgender d. Two Spirit Correct Answer: d (page 377) 21. Sexual health is an important areas of health inequities among LGBTQ people. Which of the following is an example of a sexual health inequity for this population? a. Lower risk of HIV/AIDS b. Lower number of sexual partners c. Higher rates of protected sexual intercourse d. Higher rates of having sex while intoxicated Correct Answer: d (page 379) 22. What is the first step that nurses need to take in order to provide safe and inclusive care for LGBTQ people? a. Take a gender neutral stance in our communication b. Be clear about levels of confidentiality with all clients c. Address assumptions, beliefs, and values about sexual orientation d. Consider using inclusive language in our communication Correct Answer: c (page 380) 23. What is an example of a primary prevention initiative that a community health nurse might engage in to promote the health of LGBTQ people? a. Prevent violence and harassment b. Screening for cardiovascular diseases c. Screening for HIV/AIDS d. Providing strategies for living with arthritis Correct Answer: a (page 382) 24. What term is used to indicate a non-heterosexual orientation? a. Transgender

b. Cisgender c. Queer d. Gender diverse Correct Answer: c (page 377) 25. Sarah is a nurse who works with LGBTQ teenagers at the local high school. What is an example of a secondary prevention interventions that Sarah might be involved in? a. Preventing violence and harassment b. Screening for intimate partner violence c. Providing strategies for managing depression d. Providing treatment for STIs Correct Answer: b (page 382) Short Answer Questions 26. Discuss the meaning of the terms homosexuality, homosexual, gay, lesbian, bisexual, transgenders, and two-spirited. Correct Answer: -

Homosexuality: refers to people whose sexual and emotional attraction is to persons of the same sex

Homosexual: refers to both men and women whose sexual and emotional attraction is to persons of the same sex

Gay: a self-identified homosexual man

Lesbian: a self-identified homosexual woman

Bisexual: a person who is attracted to both men and women

Transgenders: men or women who believe that their physical body and sexual characteristics do not match their self-concept

Two-spirited: people of Aboriginal descent who self-identify as having two spirits (male and female) within themselves (page 376-377)

27. Harpreet is a nursing student working within a community agency that provides services to a large gay/lesbian community. In her orientation she learns about heterosexism and how it affects gay/lesbian/bisexual/transgender people. Discuss the information that Harpreet is likely to have learned. Provide a community health nursing practice example that would counter this view. Correct Answer: Heterosexism is: -

viewing the world through the lens of heterosexuality as the norm and a lack of realization or acknowledgment that alternatives to this exist

assuming that everyone is heterosexual and anything else is not normal

Effects: -

alienates gay/lesbian/bisexual/transgender clients

has far-reaching social and psychological effects

delays entry into the health care system

CHN e.g., asking about relationship or partner status in a client interview versus marital status (page 378)

28. Discuss how a community health nurse might discuss confidentiality with a homosexual teenager Correct Answer: The nurse needs to be clear with the teenager about the following: -

What information about them may be accessible to others

When the nurse might be required to break confidentiality

Disclosure and health-related information will be tailored accordingly (page 381)

29. While it is important to consider our own attitudes, values, beliefs, and practices about sexual orientation and gender identity, discuss why it is important to challenge the same with our colleagues and coworkers. Correct Answer: -

They may potentially cause harm through their words or actions

This will give you a good idea of how easy or difficult it may be to change homophobic or heterosexist attitudes and practices (page 381(

30. Give two examples of a tertiary prevention initiative a nurse might be involved in while working with LGTBQ people. Correct Answer: -

Help HIV-positive LGTBQ people with medication adherence

Locating specific LGBTQ substance abuse treatment programs that attend to societal stigma and unaddressed trauma (page 382)

Chapter 21:Older Adult Health Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1.

What proportion of the world's population will be composed of older people by 2036? a. 1 in 4 b. 1 in 6 c. 1 in 8 d. 1 in 2

Correct Answer: a (page 387) 2.

Which Canadian population will have the highest proportion of seniors in 2036? a. British Columbia b. Newfoundland c. Ontario d. Alberta

Correct Answer: b (page 388) 3.

Which part of Canada has a more rapidly growing aging population than the rest of Canada? a. The West coast? b. The maritime provinces c. French Canada d. Prairie provinces

Correct Answer: b (page 387)

Jake Chrisoff, 70 years old, has Alzheimer's and his wife, Barbara, is his main caregiver. A nurse is doing a home visit to assess the situation. What comment by the nurse demonstrates preservation of Jake's personhood? a. "Barbara, Jake doesn't know it's his birthday so a celebration isn't necessary" b. "I recommend isolating Jake to de-escalate his agitation or restlessness" c. "Jake, tell me about your life on the cattle ranch" d. "I wouldn't recommend maintaining Jake's tradition of reading the paper with his morning coffee because he can't follow the story lines anymore"

Correct Answer: c (page 389) 5.

Jake Chrisoff, 70 years old, has Alzheimer's and his wife, Barbara, is his main caregiver. A nurse is doing a home visit to assess the situation. The nurse explains to Barbara the importance of maximization of remaining strengths. What example illustrates this tenet? a. Dress Jake because he can't manage buttons b. Take Jake for daily walks c. Cut Jake's food for him and feed him d. Put Jake in an adult diaper rather than use a toileting routine

Correct Answer: b (page 389) 6.

Jake Chrisoff, 70 years old, has Alzheimer's and his wife, Barbara, is his main caregiver. A nurse is doing a home visit to assess the situation. Barbara shares with the nurse that she is feeling housebound because she doesn't drive. What would be an appropriate strategy for the nurse to suggest that is consistent with an age-friendly community? a. "Perhaps a neighbour could watch Jake while you go out" b. "Call a taxi and arrange for a friend to stay with Jake" c. "Ask your daughter to drive you to appointments" d. "This is the contact number for a volunteer and an informal network of drivers"

Correct Answer: d (page 389) 7.

Albert, 79 years old, lives alone in his own home. He has diabetes, glaucoma, and nocturia from an enlarged prostate. A nurse is completing a fall risk

assessment screening tool with Albert. The nurse knows that older people living in the community experience one or more falls each year. What is one example of a modifiable risk factor for falls that the nurse can discuss with Albert? a. Biological make-up b. Improper lighting c. Socian environments d. Review of medications Correct Answer: d (page 392) 8.

What percentage of older adults live in institutions? a. 8 b. 13 c. 26 d. 32

Correct Answer: a (page 389) 9. Albert, 79 years old, lives alone in his own home. He has diabetes, glaucoma, and nocturia from an enlarged prostate. A nurse is completing a fall risk assessment screening tool with Albert. The nurse wants to help Albert fall proof his home. Which suggestion would be most beneficial to Albert? a. The bathroom and bedroom have automatic night lights b. Cupboards are arranged with commonly used items within easy reach c. Stairs are free of obstacles and clutter d. The phone is easy to reach from the bed Correct Answer: a (page 392) 10. Albert, 79 years old, lives alone in his own home. He has diabetes, glaucoma, and nocturia from an enlarged prostate. A nurse is completing a fall risk assessment screening tool with Albert. What health promotion strategy can the nurse suggest to Albert that will decrease his risk for a fall? a. Join a senior's fitness program b. Add contrasting colour strips to first and last steps to identify change of level c. Hire a neighbourhood kid to clear snow and ice from walkways

d. Get a panic button service installed in the home Correct Answer: a (page 392) 11. AA nurse is doing a home visit with an older female client. What behaviour would alert the nurse to the possibility of delirium? a. Low socioeconomic status b. Dishevelled appearance c. A change in cognition d. Continuous cognitive decline Correct Answer: c (page 393) 12. AA nurse is planning the home care requirements for Mrs. Johal, who had a cerebral vascular accident (CVA) and has lost the use of her left arm. Mr. Johal, 69 years old, still runs his family business with other relatives. What level of support would be appropriate for Mrs. Johal? a. Speech-language pathology b. Personal care c. Community adult day care d. Homemaking Correct Answer: b (page 396) 13. There are many aspects to active and positive aging. Which of the following is an example of active and positive aging? a. The number of chronic illnesses b. Past experiences with exercise c. Fear of falling during physical activity d. Supportive social relationships Correct Answer: d (page 387) 14. What is the definition of a baby boomer? a. Someone who is born between 1925 – 1950 b. Someone who is born between 1910 – 1965 c. Someone who is born between 1945 – 1965

d. Someone who is born between 1950 - 1970 Correct Answer: c (page 387) 15. What is the correct term used to describe Stereotyping those that are dependent, frail, and older? a. Ageism b. Sexism c. Classism d. Fatalism Correct Answer: a (page 387) 16. Which one of the following represents one of the eight domains of age-friendly communities? a. Respect and social exclusion b. Outdoor spaces and buildings c. Communication and misinformation d. Unemployment Correct Answer: b (page 389) 17. Why is it important for community health nurses to discuss services that are available to help them to remain independent and aging at home? a. Because seniors build their own support networks and need to know how to volunteer their time b. Because seniors generally have money saved up and need to decide where to spend their money c. Because seniors generally will not ask for help, but will accept help when offered to them d. Because seniors have extended families that will take care of them when they are dependent Correct Answer: c (page 389) 18.

Which of the following represents an official language minority

a. Cantonese-speaking seniors living in British Columbia b. French-speaking seniors living in Quebec c. Italian-speaking seniors living in New Brunswick d. English-speaking seniors living in Quebec Correct Answer: d (page 390) 19. Which of the following terms is used to describe “an area of scholarship focusing on issues affecting quality of life for older persons living in areas of low population density”? a. Urban aging b. Rural aging c. Prairie aging d. Maritime aging Correct Answer: b (page 390) 20. Which of the following is an example of an innovative practice in Aboriginal seniors’ health care? a. Youth caring for elders, and preventing elder abuse b. Offline education for community-based health care providers c. Increasing social isolation of seniors living at home d. Bringing chronic disease self-management to urban regions Correct Answer: a (page 391) 21. What percentage of new immigrant seniors were unable to speak English or French between 2001 and 2009? a. 25% b. 15% c. 50% d. 80% Correct Answer: c (page 390) 22. Which of the following statements is true about immigrant seniors and their health? a. They are more likely to receive home care b. They require less help with activities of daily living

c. They have better psychological health d. They have lower rates of hypertension Correct Answer: c (page 390) 23. In Canada, what proportion of federally incarcerated offenders is over the age of 50? a. 1 in 10 b. 1 in 15 c. 1 in 20 d. 1 in 5 Correct Answer: d (page 390) 24. Which of the following are common underlying health problems that can alter sexual desire and performance in older adults? a. Incontinence b. Lupus c. Using no medications d. Stiff bones Correct Answer: a (page 393) 25. Which of the following is an example of an immunization that should be advised for older adults on a yearly basis? a. Diptheria b. Influenza c. Hepatitis A d. Cholera Correct Answer: b (page 393)

Short Answer Questions 26. List the activities that a CHN may engage in that will contribute to fall prevention in the older adult Correct Answer: -

An assessment of a history of falls, medication, balance and mobility evaluation, and medical history

Education about the proper use of assistive devices

Clinical disease management

Education about environmental modifications

Exercise programs

Medication review

Nutritional assessment

Vision correction (page 392)

27. Although many older adults are aware of Canada’s Food Guide, food choices are related to health status and functional ability. List the factors that contribute to inappropriate food choices. Discuss potential topics that the CHN can discuss in relation to nutrition Correct Answer: Factors: -

Low vision

Altered taste

Poor dentition

Widowhood

loneliness

Topics -

challenges of healthy eating such as transportation to the grocery store

financial worries and meal planning on a budget

cooking for one or two people

need for a referral to a dietician

availability of group meals

visits to the dentist (page 393)

28. Discuss why isolation is a significant problem among older adults and what CHNs can do about this issue. Correct Answer: -

Isolation can lead to depression, loneliness, falls, and hospitalization

Causes of isolation include vision and hearing loss, cognitive impairment, incontinence, and widowhood

CHNs can link older adults to community resources, local social activities for seniors, facilitate seniors joining an online community for support (page 394)

29. Describe the features of an age-friendly community and provide an example for each feature. Correct Answer: -

outdoor spaces and buildings (e.g., doors are easy to open by someone using a walker or in a wheelchair)

transportation (e.g., drop-off and pick-up areas are available, clearly marked, and conveniently located)

housing (e.g., affordable supports available to enable seniors to remain at home)

respect and social inclusion (e.g., older people are visible in the media and are depicted positively without stereotyping)

social participation (e.g., a range of events and activities for seniors of all ages is available, such as courses, crafts, sporting events, and gatherings with food)

communication and information (e.g., printed information uses large lettering)

civic participation and employment (e.g., seniors are well represented on councils, boards, and committees; opportunities for volunteering are flexible and allow for intergenerational involvement)

community support and health services (e.g., medical equipment is available through a loan program or at no cost to seniors; health care facilities include a cluster of services and provide "one stop" health or wellness services) (page 389)

30. What are some issues that represent challenges and opportunities for improvement with aged care? Correct Answer: -

ineffective use of professional skills

high client-to-staff ratios

inadequate servicing of rural communities

poorly integrated services with limited access

limited research-based literature that supports the development and implementation of best practice initiatives (page 395-397)

Chapter 22: Aboriginal Health Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1.

Why are Aboriginal people in Canada a vulnerable population? a. More likely to take health for granted b. Live north of the 60th parallel c. More likely to have adverse health outcomes d. Live in a sensitive physical environment

Correct Answer: c (page 402) 2.

What was the purpose of the Northwest Coast tribes' traditional potlatch? a. Celebration marking the transition from boyhood to manhood b. The post-hunt community meal c. Ceremonial welcoming of a new life into the tribe d. Method of redistributing resources

Correct Answer: d (page 402) 3.

What does it mean to be a status Indian? a. Consider one's ethnic status to be Inuit b. Recognized Indian under the federal Indian Act and has a treaty number c. Has mixed heritage because one parent was Aboriginal and the other nonAboriginal d. Culturally an Indian, but the individual's tribe did not sign a treaty

Correct Answer: b (page 404) 4. What was the purpose of establishing First Nations health authorities? a. Force the provincial governments to give up control of First Nations health care b. Allow regional health authorities to absorb First Nations health care c. Ensure the federal government would always provide First Nations health care d. Prepare for the transfer of control of health services to First Nations Correct Answer: d (page 407) 5.

What disease is currently epidemic among First Nations people?

a. Breast cancer b. Trauma c. Diabetes d. Smallpox Correct Answer: c (page 406) 6.

What would a nurse working in a First Nations community be prepared to do? a. Be an independent care provider needing few networks or contacts b. Work to reduce fetal alcohol spectrum disorders c. Work with preventable conditions such as typhoid d. Combat the effects of a long life expectancy among seniors

Correct Answer: b (page 406) 7.

What was the purpose of the White Paper in 1969? a. To recognize the Métis Nation of Canada b. To set up the current reserve system c. To abolish treaties and the Indian Act d. To allow women who married non-Aboriginals to apply for status

Correct Answer: c (page 404) 8.

A nurse is working as a program planner for the federal department responsible for managing the reserves and treaty Indians. What agency does the nurse work for? a. Public Health Agency of Canada b. Department of Aboriginal Affairs and Northern Development c. First Nations and Inuit Health Branch (FNIHB) d. Health Canada

Correct Answer: b (page 403) 9.

Mrs. Crowfoot attended a residential school in northern Alberta in the 1960s. What was she likely to have experienced during this time? a. Regular visits from her parents b. Traditional language classes c. High-quality education d. Hunger

Correct Answer: d (page 403) 10. Spottedfawn, 55 years old, is an Aboriginal woman living on reserve in a rural northern community. She is a survivor of the residential school experience. Which of the following intergenerational issues is Spottenfawn most likely to have experienced? a. Appropriate use of prescription medications b. Loss of parenting skills c. Ability to take care of nutritional needs d. Smaller social support networks Correct Answer: b (page 403) 11. Spottedfawn, 55 years old, is an Aboriginal woman living on reserve in a rural northern community. She is a survivor of the residential school experience. Spottedfawn lives with her extended family of 10 in a small house. The adults in the home are all female. What health challenge is she most likely trying to manage? a. Obesity b. Breast cancer c. Chronic obstructive pulmonary disease (COPD) d. Respiratory tract infection Correct Answer: a (page 406) 12. Spottedfawn, 55 years old, is an Aboriginal woman living on reserve in a rural northern community. She is a survivor of the residential school experience. A nurse is working with Spottedfawn. How can the nurse enhance Spottedfawn's experience with the health care system? a. Affirming the client's personal and cultural identity b. Understanding the community's oral history c. Being informed of the values and norms of the community d. Using expert nursing knowledge to select appropriate resources for the client Correct Answer: a (page 408)

13. AA nurse is planning a presentation on diet and diabetes to a First Nations community. What dissemination strategy would be most culturally appropriate? a. Incorporate one’s own experiential knowledge into the information session b. Have all pamphlets translated into the local language c. Provide the statistics for diabetes in First Nations communities d. Use family and community networks to share information Correct Answer: d (page 408) 14. Mathew is a nurse working in a remote First Nations community. The client is using traditional medicine to treat a wound. Mathew is experiencing moral distress because he believes that a Western therapy is required to treat the wound. How should Mathew resolve his moral distress? a. Ask another nurse to take on this client so that Mathew does not have to compromise his standards of practice b. Contact the Aboriginal Nurses Association of Canada for guidance c. Transfer care to a Shaman or herbalist in keeping with the client's belief system d. Tell the client that Western medicine is needed because the wound is not healing with the traditional approach Correct Answer: b (page 408) 15. Which of the following statements is true of health care delivery and Aboriginal people? a. Health care services are delivered to First Nations and Inuit people the same way they are delivered to non-Aboriginal people b. Health care services are delivered to First Nations and Metis people the same way they are delivered to non-Aboriginal people c. Health care services are delivered to Inuit and Metis people in a different way than they are delivered to non -Aboriginal people d. Health care services are delivered to First Nations and Inuit people in a different way than they are delivered to non -Aboriginal people Correct Answer: d (page 402)

16. Which of the following represents a linguistic and cultural grouping of Aboriginal people? a. Eastern Subarctic b. Southern Artic c. Western Woodlands d. Northeast Atlantic Correct Answer: a (page 402) 17. Which of the following statements is true of the way of life of Aboriginal people before colonization? a. Childcare and education were the responsibility of the women b. Elders provided for the community c. Sharing of resources was expected d. Transgression was dealt with by the provincial leader Correct Answer: c (page 402) 18. Which of the following are examples of diseases that Europeans brought to Canada? a. Heart disease, tuberculosis, and cancer b. Smallpox, tuberculosis, and measles c. Hypertension, rubella, and mumps d. Syphilis, cancer, and measles Correct Answer: b (page 402)

19. Why were Aboriginal people relegated to living on reserves? a. Because they wanted to live together with people who understood their culture and language b. Because they did not trust the European settlers and did not want to live with them c. Because Britain developed the treaty method to claim land that the Aboriginal people occupied d. Because they decided the European settlers might come want to live close by to experience Aboriginal culture Correct Answer: c (page 403) 20.

What was the purpose of residential schools? a. To promote and preserve Aboriginal culture and heritage b. To provide Aboriginal children with a more comfortable living space c. To ensure Aboriginal children had acquired immunity to diseases d. To assimilate Aboriginal children into the general population

Correct Answer: d (page 403) 21. Which of the following statements is true of Inuit people? a. They are treated in the same manner as registered Indians by the federal government b. They are treated differently than status Indians by the federal government c. They are treated in the same manner as non-status Indians by the federal government

d. They are treated in the same manner as Metis by the federal government Correct Answer: a (page 404) 22. Which of the following statements is true of Aboriginal people in Canada? a. Metis make up 53% of Aboriginal people b. First Nations make up 61% of Aboriginal people c. Inuit make up 15% of Aboriginal people d. First Nations make up 85% of Aboriginal people Correct Answer: b (page 405) 23. Which province/territory has the highest proportion of Aboriginal people in comparison to the total population? a. British Columbia b. Manitoba c. Yukon d. Nunavut Correct Answer: d (page 405) 24. The rate of tuberculosis is how many times higher in the Aboriginal population than in the non-Aboriginal population? a. 10 times higher b. 4 times higher c. 6 times higher d. 12 times higher

Correct Answer: c (page 406) 25. Why is healthy child development an important health indicator for Aboriginal populations? a. Because the infant morbidity rate is three times higher than non-Aboriginal populations b. Because one third of the Aboriginal population are classified as children c. Because there is enough food for all of the Aboriginal children d. Because the high immunization rates are a strength of Aboriginal communities Correct Answer: b (page 406) Short Answer Questions 26. Describe with examples three determinants of health that affect the health of First Nations people. Correct Answer: -

Income and social status: most people live in poverty and are discriminated against within the larger Canadian society

Education: lower education levels and access to culturally appropriate education

Biology and genetics: genetic predisposition to alcoholism and diabetes

Healthy childhood development: high rates of fetal alcohol spectrum disorders

Social support networks: residential schools left many families without parenting role models

Working conditions: high unemployment and potentially dangerous traditional work, e.g., hunting

Physical environments: substandard housing

Gender: high percentage of women-headed single families

Culture: loss of cultural practices and language (pages 405-406)

27. Discuss three significant changes that occurred in the health of Aboriginal people after European contact. Correct Answer: -

Communicable diseases decimated the population

Resources became scarce, leading to starvation and malnutrition

Alcohol was introduced, adding to the misery

They were relegated to living on reserves, often with poor-quality land and resources

They became dependent on Indian agents for all aspects of their livelihood

Churches took children away to residential schools filled with sexual abuse and violence

Aboriginal cultures and languages were nearly destroyed, with only a few surviving (pages 402-403)

28. Discuss how First Nations people access acute health care services in their communities. What is the federal government's role? Correct Answer: -

First Nations people access acute health care through the greater Canadian health care system, primarily because hospitals are a provincial responsibility

The more remote and isolated communities will have more comprehensive health care, including short-term acute care

There are few Indian hospitals still run by the federal government

FNIHB funds and/or provides any health services for First Nations people living on reserve

First Nations people who live off reserve access services through the local health regions and the province then asks the federal government for reimbursement

FNIHB has regional branches in each province with policy planned in Ottawa (page 407)

29. List seven of the 14 health determinants that are more focused on Aboriginal world views and ways of being Correct Answer: See Table 22.1 (page 41) 30. Discuss the medicine wheel. Correct Answer: -

The medicine wheel usually represents four quadrants of emotional, physical, mental, and spiritual aspects of health and wellness

The four directions are represented just as the races of humankind are represented

The different teachings of how one can lead a purposeful life are also represented

The four stages of infancy, childhood, adulthood, and the elder are represented

Colors, animals, and characteristics such as strength, humility, and illumination are also assigned to their respective quadrants (page 410)

Chapter 23: Mental Health Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1. In the 1960s, deinstitutionalization caused a shift in mental health care. To which institution did mental health care shift? a. Provincial mental hospitals b. Community hospitals c. Long-term mental health institutions d. Federally funded poor houses Correct Answer: b (page 416) 2. What is true about mental illness in the prison population in Canada? a. About 20% of inmates have a serious mental illness b. Inmates have better access to treatment c. There are inmates who are mentally ill and are addicted d. Over 70% of inmates have a mental disorder Correct Answer: c (page 420) 3. Mr. Charbonneau is a client with a mental illness and diagnosed with cocaine addiction. What is the correct term for this combination? a. Severe anxiety b. Co-morbidity c. Co-dependency d. Co-occurring Correct Answer: d (page 424)

4. A nurse is utilizing a recovery model of rehabilitation. What is the nurse doing? a. Actively collaborating with the consumer and family to develop interventions b. Realizing the eradication of mental illness through teamwork c. Providing the best services and supports at the best time, best place, and best level of intensity d. Delivering a balanced combination of specific services Correct Answer: a (page 424) 5. A nurse is working in crisis management in a community mental health centre. What service would the nurse most likely be providing? a. Comprehensive long-term intensive care b. Risk reduction activities to prevent mental illnesses c. A 24-hour mobile response team d. Education services to promote mental health Correct Answer: c (page 423) 6. What is an outcome of assertive community treatment? a. Improved compliance b. Reduced health care costs c. Increased hospitalizations d. High quality of life Correct Answer: a (page 424)

7. A nurse is planning care for Mrs. Fraser, 50 years old, diagnosed with schizophrenia. What is the first action the nurse should take? a. Assess for a history of childhood sexual abuse, which leads to schizophrenia b. Provide Mrs. Fraser with a list of community support groups c. Examine barriers to Mrs. Fraser's meeting her needs d. Develop a plan of care with Mrs. Fraser Correct Answer: c (page 425) 8. Serious mental illnesses affect what percentage of the Canadian homeless population? a. 30% b. 18% c. 7% d. 3% Correct Answer: a (page 422) 9.

Who is at greatest risk for suicide? a. 18-year-old female

16-year-old Aboriginal male c. 82-year-old woman d. 40-year-old male Correct Answer: b (page 419)

10. Ms. Chauvette has a mental illness. Her nurse critically considers the available treatments before helping Ms. Chauvtte to choose one. What term can be used to describe the nurse? a. Consumer b. Advocate c. Victim d. Survivor Correct Answer: b (page 425) 11. What term is defined by "the ability of all people to enjoy life and deal with its challenges?" a. Health promotion b. Disease prevention c. Mental illness d. Mental health Correct Answer: d (page 415) 12. What child is at greatest risk for depression due to harassment? a. 10-year-old girl in a two-parent family b. 8-year-old boy c. 9-year-old girl of Chinese immigrant parents d. 7-year-old boy of Indo-Canadian parents Correct Answer: c (page 420) 13. What is the standard used to diagnose mental illness in Canada? a. Diagnostic and Statistical Manual (5th edition) b. Merck Manual c. Population Health Promotion Model d. Mosby's Mental Illness Compendium Correct Answer: a (page 417)

14. Jacques, 17 years old, has a Compulsory Treatment Order (CTO) for his severe mental illness. What does this mean? a. Jacques must come to the health unit every day to receive his medications b. Failure to take his medication will result in hospitalization c. If Jacques does not take his medication he will be incarcerated d. A nurse will administer his medications at his home Correct Answer: b (page 423) 15.

What is an assumption about recovery from mental illness? a. Recovery means the person is symptom free

Recovery is based on the cause of the mental illness c. The road to recovery is similar for most people d. Individuals must have people who believe in them Correct Answer: d (page 424) 16. Psychiatric illness is best explained as a combination of complex risk factors between which factors? a. Genetics and environment b. Emotional neglect and personality c. Incarceration and environment d. Bullying and biology Correct Answer: a (page 419) 17. The Mental Health Commission of Canada facilitated a national campaign to focus on mental health issues. What is one of the five strategic initiatives they proposed? a. Increase in mental health beds b. Comprehensive prevention programs c. System to share research and knowledge d. Five-year anti-stigma campaign Correct Answer: c (page 416)

18. Mr. Bianco, 51 years old, suffers from bipolar disorder and addictions. He has been homeless for 10 years. At what age did he likely experience his first symptoms? a. 11 b. 25 c. 18 d. 8 Correct Answer: a (page 419) 19. Which of the following is an example of secondary prevention of mental illness? a. Public education b. Advocacy for more mental health facilities c. Better education of professionals d. Early diagnosis of mental illness Correct Answer: d (page 423) 20. Ms. Myong came to Canada two years ago as a political refugee from Korea. She has two children, age 6 and 8. She is at increased risk for what mental health problem? a. Post-traumatic stress b. Addiction c. Depression d. Anxiety Correct Answer: a (page 420)

21. Ms. Myong came to Canada two years ago as a political refugee from Korea. She has two children, age 6 and 8. What will be the main factor interfering with Ms. Myong seeking mental health services? a. Knowing whom to see b. Difficulty speaking English c. Access to an Asian support group d. Fear Correct Answer: b (page 420) 22. Johnny, 16 years old, lives with his mother in an Aboriginal community in northern Canada. Johnny suffers from depression as a result of harassment and bullying at school. What primary factor would contribute to Johnny not receiving care for his depression? a. No tool available to assess children's mental health b. Lack of effective treatment for children his age c. Lack of services in his community d. Underuse of mental health services by Aboriginal people Correct Answer: d (page 421) 23. Johnny, 16 years old, lives with his mother in an Aboriginal community in northern Canada. Johnny suffers from depression as a result of harassment and bullying at school. Johnny tells a friend he wants to end it all. What is this termed? a. Crisis b. Suicidal ideation c. Mental illness d. Depression Correct Answer: b (page 422)

24. Johnny, 16 years old, lives with his mother in an Aboriginal community in northern Canada. Johnny suffers from depression as a result of harassment and bullying at school. Johnny wrote on a social networking Internet site that he planned to kill his tormentors. Considering the Mental Health Act, what is the best action for the mental health nurse to take? a. Phone the school to have Johnny expelled b. Call Johnny and schedule an appointment with him c. Have Johnny committed to a mental health facility d. Contact the police to incarcerate Johnny Correct Answer: c (page 423) 25. Efforts to reduce stigma toward mental illness in Canadian society include which of the following target group? a. The media b. Elementary school children c. Health care consumers d. Incarcerated people Correct Answer: a (page 416)

Short Answer Questions 26. A nurse works in a community mental health centre in a large urban area. Describe three roles of the nurse and provide a related practice example for each role. Correct Answer: -

epidemiological base for decision-making-e.g., retrieving statistics on mental illness to assist in targeted program planning

case finding and referral-e.g., responding to referrals from acute care hospitals for patients with MI

advocacy-e.g., advocating for supports for families of MI persons

education and counselling-e.g., providing information to families of MI persons on MI and its effects (page 422-425)

27. Outline one predisposing factor, one precipitating factor, and one protective factors that contribute to suicidal behaviour among Canadians. Correct Answer: -

predisposing e.g., mental illness

precipitating e.g., suicide of a friend

protective e.g., positive expectations for the future (page 422)

28. A group of nurses are integrating suicide risk assessment into their work with isolated seniors living in their own homes. Describe the four components they would want to include in their assessment protocols. Give an example of one question that the nurses could ask related to each component. Correct Answer: -

Determine suicidal thoughts, intents, and plans by asking direct questions about suicide ideation, plan, means, and access to means-e.g., Do you have a plan?

Remove ropes, firearms, and medications until the person is under treatment and is able to keep him- or herself safe-e.g., Do you have a gun?

Provide referrals for suicide observation and treatment in a safe environmente.g., Have you been treated for suicide attempts before?

Offer support to family and friends-e.g., What are your connections to family/friends? (page 422)

29. Astrid is a new nursing graduate and is considering a career in mental health nursing. She investigates how mental health services are organized in Canada. Discuss four types of mental health services and provide an example related to community health nursing practice for each area. Correct Answer: -

emergency services: admissions to hospitals and crisis units often through the ER, although includes day programs and specialized clinics. CHN e.g., working on a 24-hour mobile crisis response team

case management: best practice model to provide assistance to people with MI and their families in negotiating the mental health system. CHN e.g., working to provide access to holistic services including education and housing to clients in a group home

assertive community treatment: comprehensive long-term intensive case management approach for clients with functional impairments. CHN e.g., working as a mental health street outreach nurse

primary health care services: first point of contact in primary care may not have time/expertise to help mental illness patients. CHN e.g., onsite mental health nurse at a primary care clinic

acute home treatment: alternative to hospitalization and involves service providers in the home. CHN e.g., providing home visits to acutely ill clients

early intervention programs: arose in response to treatment delays and attempt to intervene before a full-blown episode. CHN e.g., working to address stigma and demoralization for clients with MI

co-occurring disorder programs: created to address both MI and addictions. CHN e.g., working in an outpatient addictions and depression treatment program

self-help and peer support: an integral part of services for clients and families. CHN e.g., providing resources to the local schizophrenia support group

mental health promotion: emphasize positive mental health and personal, social, economic, and environmental factors that contribute to mental health. CHN e.g., developing a local suicide prevention program through a community coalition (page 423-424)

30. List and discuss the recovery principles. Correct Answer:

Chapter 24: Rural and Remote Health Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1. What percentage of Canada's land mass consists of rural and remote areas? a. 85% b. 95% c. 75% d. 65% Correct Answer: b (page 430) 2. What is an example of a social approach to defining a rural area? a. The community coordinates are 64003'39"N and 139024'39"W b. The individuals are living in the countryside outside a centre with a population of 2500 c. The community has one Italian and one Greek restaurant d. Population density per square kilometre is 40.9 Correct Answer: c (page 430) 3. Hans, a nurse manager with the federal government, is using a rurality index to plan for services in several rural/remote communities. What is an example of a community characteristic that is used in a rurality index? a. Number of nurses in a community b. Population under 2500 c. Lack of airport in the community d. Availability of physician specialists Correct Answer: d (page 430)

4. Which industry continues to have one of the highest fatality rates due to injury? a. Oil and gas b. Farming c. Logging d. Mining Correct Answer: b (page 430) 5. Lori is a nurse working in a community that has a Hutterite colony. Lori wants to visit the colony to do some health promotion activities. What type of health behaviour is a concern for Loir? a. Not accessing immunization services b. Engaging in activities leading to traumatic amputation c. Ensuring that family members get adequate nutrition d. Not getting enough exercise during the day Correct Answer: a (page 432) 6. Lori is a nurse working in a community that has a Hutterite colony with a large farming operation. Lori wants to visit the colony to do some health promotion activities. Lori wants to provide culturally appropriate health information to the Hutterite community. What health strategy meets this goal? a. Meet with the men to review farm safety practices b. Invite the women to a local conference on women's health issues c. Develop a YouTube video on heart-healthy diet d. Create a detailed pamphlet on cardiovascular health Correct Answer: a (page 430)

7. Which of the following is included in the definition of a semi-isolated community? a. A community with road access of less than 75 km to physician services b. A community with road access greater than 90 km to physician services c. A community with good telephone service, good air transport, but no roads d. A community with no telephone service, good air transport, and accessible roads Correct Answer: b (page 430) 8. Which of the following statements is true of rural Canada? a. The communities in rural Canada are homogenous b. The economies in rural Canada are only farming and fishing c. People who live in rural Canada have the same health profile d. The rural base of the community will influence the health status of the people Correct Answer: d (page 430) 9. Why do people who work on medium-sized farms have the highest incidence of injury? a. Because there is too much turnover in staff b. Because they work long hours with little hired help c. Because they have too many children to look after d. Because they don’t prioritize their tasks appropriately Correct Answer: b (page 430) 10. Which of the following rural industry has the lowest reported fatality rate? a. Logging b. Mining c. Fishing d. Farming Correct Answer: d (page 431)

11. Which of the following issues are the result of the impacts of shift work in rural areas? a. Obesity and emotional distress b. Bi-polar disorder and emotional distress c. Alcohol abuse and fractures d. Fractures and substance abuse Correct Answer: a (page 431) 12. Which of the following statements is true of the socioeconomic status of rural communities? a. In all natural-resource-dependent areas, industrial camps are set up for the long term b. The global pricing and demands are always high of natural resources that are accessed in rural communities c. Communities may seek alternate economic ventures such as tourism to sustain their social viability d. The global pricing and demands are always low of natural resources that are access in rural communities Correct Answer: c (page 431) 13. Sandi is a registered nurse working in a rural and remote community. What should be a focus for Sandi when working with the community? a. Understand that all rural people reported higher proportions of people who low income b. Seek to understand the intersection between rural living and what this means for health c. Find out why education is not a priority for people who live in rural and remote communities d. Identify people who can help her understand who is more at risk for cardiovascular disease Correct Answer: b (page 431)

14. Jerry is a rural nurse working in a community that has a high incidence of domestic abuse. What is the reason why this is likely an issue in this rural community? a. People are too focused on trying to increase their income levels b. People value the importance of gender equity in rural areas c. People feel comfortable reaching out to their registered nurse d. People lack the legal and social resources to deal with these issues Correct Answer: d (page 431) 15. Nylah is a nurse who is working in a northern rural community. Which of the following pieces of information does Nylah need to be particularly aware of? a. People who live in northern regions have a higher prevalence of hypertension b. Women who live in northern regions have a lower incidence of mental health concerns c. Men who live in northern regions have a higher incidence of prostate cancer d. People who live in northern regions have a lower prevalence of respiratory diseases Correct Answer: a (page 432) 16. What is an example of a secondary prevention intervention that a rural and remote nurse can implement? a. Health education for individuals to maintain their higher incidence of cause specific cancers b. Developing a diabetes screening program for rural women c. Monitoring the effectiveness of treatment for circulatory conditions d. Identifying treatment plans for respiratory conditions Correct Answer: b (page 432)

17. The Standfords are a family considering moving to a rural area based on a job transfer. Which is a challenge facing rural communities? a. Rural areas within commuting distances are decreasing in population b. Youth migration out of rural communities has escalated c. Retail businesses are thriving in rural communities d. More distant rural areas are experiencing an in-migration of all age groups Correct Answer: b (page 432) 18. Why is rural poverty a significant issue in rural communities? a. Because of the increasing number of resources in rural communities b. Because they have to pay less for services in their communities c. Because they have to travel long distances for services in communities d. Because of the increasing population in their rural communities Correct Answer: c (page 433) 19. Amar is a community health nurse working in community that is dependent on oil and gas extraction. What would be a priority for Amar? a. Identifying social support for the young men in the community who work in the industry b. Identify the cardiovascular health promotion initiatives for the seniors c. Acknowledge the religious and political contexts of the community d. Support the community in increasing tourism to the region Correct Answer: a (page 433) 20. Which nurse is most likely to use the Internet to access continuing education materials? a. A public health nurse with more than 10 years of experience b. A home health nurse who has worked in the area for 15 years c. A new public health manager with less than 5 years of nursing experience d. A seasoned home health nurse with 30 years of experience Correct Answer: c (page 433)

21. Which of the following statements is true of rural nurses? a. They have a higher level of education due to the decision-making autonomy b. They have a lower level of education than their urban counterparts c. They are more likely to leave the nursing profession in less than one year d. They are more likley to be males willing to work alone Correct Answer: b (page 433) 22. Who has a higher risk of dying from diabetes? a. Mr. Oppenheimer from Halifax, Nova Scotia b. Madame Blanc, who works in retail in Montreal c. Ms. Mantla, who lives in Inuvik, Northwest Territories d. Mr. Geier, who works on a farm in rural Alberta Correct Answer: c (page 432) 23. How does the First Nations and Inuit Health Branch of Health Canada define an isolated community? a. Good telephone service, scheduled air transportation flights, but no roads b. Road access greater than 90 kilometres to physician services c. No scheduled air flights, minimal telephone or radio access, and no roads d. Road access less than 90 kilometres to physician services Correct Answer: a (page 430) 24. What is the most common reason nurses reported their intent of leaving their positions in rural and remote nursing? a. To settle down and raise children in urban parts of the country b. To find a less stressful job with more available resources c. To find another career outside of the health care arena d. To undertake further nursing education to develop more skills Correct Answer: d (page 436)

25. Which of the following are examples of leadership issues in rural and remote nursing? a. Working through a clear list of priorities b. Coping with having leaders at a distance c. Working in environments with sufficient resources d. Working in environments with sufficient support networks Correct Answer: b (page 436) Short Answer Questions 26. List and define the five principles of cultural safety as they relates to rural and remote nursing Correct Answer: -

Protocols – respect for cultural forms of engagement

Personal knowledge – understanding one’s own cultural identity

Process – engaging in mutual learning

Positive purpose – ensuring the process yields the right outcome for the client

Partnerships – promoting collaborative practice (page 432)

27. Explain why elder people who experience abuse is of particular concern in rural areas. Correct Answer: -

Rural elderly who experience abuse are most often women who are reluctant to come forward and alter their identity as good wives who protect their husbands

Service delivery for those who experience abuse in rural communities is under threat through the centralization of services, including the removal of clergy, police, and care providers

Rural issues are often seen to be of marginal concern to those responsible for policy making (page 431)

28. List the factors that contribute to quality work environments in rural and remote nursing practice. Provide a community health nursing example for each strategy. Correct Answer: -

Developing consistent expectations and approaches among managers and nurses to address practice issues at the site level (e.g. up to date policy and procedures manuals)

Relevant rural practice standards (e.g. travel standards)

Policies that support rural nurses’ scope of practice (e.g. prescribing emergency contraception)

Practice-driven, rural-focused nursing education programs (e.g. rural practicums for students)

Rural reality-based preceptorship and mentorship programs (e.g. virtual mentors for rural nurses)

Development of sustained process for direct rural nursing involvement in local and regional planning (e.g. time to engage in program planning initiatives) (page 437)

29. Discuss how the geography and the economy of rural communities influence the services available. Give a community health nursing practice example to illustrate the above influences. Correct Answer: -

The geography influences the types of services

The economy influences the impact on the cycle of activities within the community

CHN e.g., the type of natural resource like oil fields will influence what services are available in the community, such as large mechanical supplies. A farming community will have natural cycles of activity and down times. (pae 430-431)

30. Most health policies in Canada are based upon an urban perspective with little consideration of their applicability in rural environments. What key issues need to be addressed in order to this situation to be changed? Correct Answer: -

Having a specific individual champion in Canada who focuses on the importance of addressing the unique situation experienced by rural residents

Few RNs are educationally prepared for work in the policy arena, this needs to be incorporated into nursing curriculum

Have relevant information about the nature of rural communities and their health issues be readily available

Respect the perspectives of rural residents and involve them in setting policy agendas (page 437)

Chapter 25: Chronic Care, Long-Term Care, and Palliative Care Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1. Over the next 20 to 30 years, the number of Canadians living with and dying from chronic diseases will increase. Why is this the case? a. Because new registered nurses will be introduced to the workforce b. Because the aging population will be increasing c. Because many nurses will retire and we will have a nursing shortage d. Because the aging population will be decreasing Correct Answer: b (page 443) 2. Which concept is used to describe integrating palliative care principles into any setting of care? a. Palliative nursing b. Palliative care c. Palliative approach d. Palliative community Correct Answer: c (page 444) 3. What is the correct number of Canadians over the age of 20 years that live with Diabetes? a. 2.4 million b. 3.5 million c. 1.3 million d. 4.7 million Correct Answer: a (page 444)

4. What is the best definition for the term “chronic care”? a. Persistent conditions that require ongoing medical management over many years b. An interprofessional team that engages with the patient to arrive at clinical outcomes c. Population health promotion that aims to prevent illness and enhance community participation d. Patients with chronic conditions require access to comprehensive, coordinated health care from professionals Correct Answer: d (page 444) 5. Which of the following models is the best known comprehensive model to address chronic care needs of patients? a. The Functional Chronic Care Model b. The Chronic Care Population Health Model c. The Chronic Care Model d. The Chronic Health Outcomes Model Correct Answer: c (page 444) 6. Why was the Expanded Chronic Care Model developed in Canada? a. To broaden the focus of chronic care to include elements of population health b. To acknowledge that chronic care requires professionals to have a special skill set c. To guide professionals working in chronic care in their clinical decisionmaking d. To include the patients to participate in the decisions about their chronic health Correct Answer: a (page 444)

7. How many Canadians are known to live with Dementia in 2011? a. More than 2 million b. Less than 1 million c. More than 3 million d. Less than half a million Correct Answer: b (page 444) 8. What term is used to describe a variety of services that are necessary for the physical and psychological needs of patients who are no longer able to function independently? a. Functional Care b. Hospice Care c. Community Care d. Long-Term Care Correct Answer: d (page 446) 9. Which of the following statements is true? a. Hospice Care is Community Care b. Chronic Care is Long-Term Care c. Functional Care is Community Care d. Hospice Care is Preventative Care Correct Answer: b (page 446) 10. Sally is a community health nurse who works to provide a seamless transition among various types of interventions and services based on the needs of patients. What type of care is Sally providing? a. Community-based population care b. Hospice-based illness prevention care c. Community-based long-term care d. Hospital-based chronic care Correct Answer: c (page 446)

11. What is the best term used to describe the largest component of communitybased long term care services in Canada? a. Home care b. Hospice care c. Community care d. Palliative care Correct Answer: a (page 446) 12. Home and community-based service are intended to be used by which population group? a. People who do not yet qualify for admission to a palliative care facility b. People who do not yet qualify for admission to an acute care facility c. People who do not yet qualify for admission to a long-term care facility d. People who do not yet qualify for admission to a rehabilitative care facility Correct Answer: c (page 446) 13. What type of long-term care services are the most intense type of service delivery on the long-term care continuum? a. Those provided in an acute care setting b. Those provided in a residential setting c. Those provided in a hospice setting d. Those provided in a rehabilitative setting Correct Answer: b (page 446) 14. What percentage of older adults in Canada live in a collective dwelling because they are unable to live alone? a. 12% b. 32% c. 23% d. 8% Correct Answer: d (page 446)

15. Which of the following is an example of a collective dwelling? a. Living in a chronic care hospital b. Living with family members in the family home c. Living with friends in the same position d. Living alone in an apartment building for seniors Correct Answer: a (page 446) 16. Which of the following contribute to altered social structures that lead to an increased need for long-term care solutions? a. Men deciding to stay at home b. Children going to university c. Women undertaking paid work d. Women deciding not to have children Correct Answer: c (page 447) 17. The goal of hospice care is quality end-of-life care in any setting. Where and when did the first hospice open? a. In England in the 1960s b. In Canada in the 1950s c. In England in the 1940s d. In Canada in the 1930s Correct Answer: a (page 447) 18. Mr. Singh is experiencing a form of terminal cancer. When is it appropriate to discuss the option of palliative care with Mr. Singh? a. When Mr. Singh’s daughter signs off on this approach b. When Mr. Singh and his family are prepared to accept it c. When Mr. Singh cannot express his wishes and is in a comma d. When Mr. Singh’s health care team makes this decision Correct Answer: b (page 448)

19. Joel is a community health nurse working in palliative care with Mrs. Martinez. He is evaluating the integration of services and supports for Mrs. Martinez and her family. Which Canadian Community Health Nursing Standard of Practice does this work best align with? a. Professional responsibility and accountability b. Capacity building c. Professional relationships d. Access and equity Correct Answer: d (page 448) 20. Pat is a community health nurse working in palliative care. Pat is preparing the Strong family for their roles in the end-of-life care of their grandmother. Pat is discussing the issues of negative caregiver outcomes including strain, burden, and role breakdown. What type of activity is Pat engaging in? a. Secondary prevention b. Tertiary prevention c. Primary prevention d. Quaternary prevention Correct Answer: c (page 449) 21. Jason is providing excellent palliative care to his patients with the goal of implementing a comfortable dying process. Which term below best describes Jason’s work? a. Secondary prevention b. Tertiary prevention c. Primary prevention d. Quaternary prevention Correct Answer: b (page 449)

22. Jesse is a community health nurse working in palliative care with Mrs. Wang’s family. Jesse is assessing the level of care-giver burn out. Which term below best describes Jesse’s? a. Secondary prevention b. Tertiary prevention c. Primary prevention d. Quaternary prevention Correct Answer: a (page 449) 23. In 2012, how many family caregivers were there in Canada? a. 7 million b. 4.5 million c. 12 million d. 10.5 million Correct Answer: b (page 450) 24. Angie lives next door to Mrs. Ling. Over the years, Angie has noticed that Mrs. Ling has experienced trouble engaging in her personal care. Angie goes to Mrs. Ling’s home once a day and helps to shower her. What term is used to describe Angie? a. A good neighbour b. A close friend c. A family caregiver d. A surrogate daughter Correct Answer: c (page 450)

25. Which of the following statements is true of caregivers: a. Caregivers often have sufficient funds to take care of ailing family members b. It is okay to ask caregivers to pick up the slack when health care services are reduced c. Caregivers often have lower rates of depression because of engaging in social activities d. Caregivers often have higher rates of depression and are socially isolated Correct Answer: d (page 450) Short Answer Questions 26. List the three components of facility-based long-term care. Correct Answer: -

Providing accommodations

Providing hospitality services

Providing health services (page 447)

27. What might be some of the reasons to decide to move from one’s own home to a collective dwelling? Correct Answer: -

Lack of availability of willing family care-givers

Declining health

Becoming frail

Concerns for safety (page 447)

28. The World Health Organization defines palliative care as an approach focused on improving quality of life for both the patient faced with a life-threatening illness and their family. Discuss palliative care from this perspective Correct Answer: Palliative care: -

Provides relief from pain and other distressing symptoms

Affirms life and regards dying as a normal process

Intends neither to hasten nor postpone death

Integrates the psychological and spiritual aspects of patient care

Offers a support system to help patients life as actively as possible until death

Offers a support system to help the family cope during the patient’s illness and in their own bereavement

Uses a team approach to address the needs of patients and their families, including bereavement counselling if indicated

Will enhance the quality of life, and may also positively influence the course of illness

Is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such a chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications (page 447-448)

29. What are the three aims of hospice palliative care? Correct Answer: -

To treat all active issues

To prevent new issues from occurring

To promote opportunities for meaningful and valuable experiences, personal and spiritual growth, and self-actualization (page 448)

30. Discuss when it is appropriate for a patient to consider hospice palliative care. Correct Answer: -

Hospice palliative care is appropriate for any person and/or family living with or at risk of developing a life-threatening illness due to any diagnosis, with any prognosis, regardless of age, and at any time they have unmet expectation and/or needs and are prepared to accept care. Hospice palliative care may complement and enhance disease-modifying therapy or it may become the total focus of care. (page 448)

Chapter 26: Corectional Health Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1. How does a nurse in a correctional facility build trust with inmates? a. Becoming involved with disciplining an inmate b. Protecting confidential health care information c. Meeting all requests for health care services d. Having a correctional officer within hearing distance at all times Correct Answer: b (page 464) 2. A nurse is working in a provincial correctional facility. What skill will be essential in this setting that is less important in a federal facility? a. Gerontological assessment b. Addiction counselling c. Caring for inmates with mental health concerns d. Assessment and triage Correct Answer: d (page 457) 3. What infectious disease has the potential to increase in prevalence through overcrowding in correctional settings? a. Hepatitis C b. Tuberculosis (TB) c. HIV d. Salmonella Correct Answer: b (page 463)

4. What infection is 30 times higher in the incarcerated population? a. HIV b. Chlamydia c. Syphilis d. Hepatitis C Correct Answer: c (page 462) 5. Nurses in correctional facilities are able to develop policy that will improve the health of inmates. What is an example of such a policy? a. Creating a methadone initiation program b. Creating a needle exchange program c. Implementing a ban on tattooing d. Pandemic planning Correct Answer: d (page 465) 6. A nurse in a correctional facility learns that an inmate is HIV positive. What should the nurse do? a. Request that the inmate be transferred to hospital b. Teach the correctional officers standard precautions c. Tell the corrections officers of the HIV status d. Have the inmate moved into a cell with another inmate who is HIV positive Correct Answer: b (page 464) 7. A nurse in a federal correctional facility responds to an inmate with a possible cardiac arrest. When is this care most likely to occur? a. During the time inmates are out of their cells b. Between 8 a.m. and 8 p.m. c. During the night d. At any time

Correct Answer: d (page 457) 8. What activity might a nurse engage in while working in a correctional facility? a. Informing correctional staff about an inmate's HIV status b. Supplying inmates with toothbrushes and floss to keep in their cells c. Initiating a methadone maintenance treatment program d. Using magazines and folded paper as safety splints for injured limbs Correct Answer: d (page 462) 9. What has contributed to the increase in people with mental illness being incarcerated? a. An increase in violence on television and in society b. Overcrowding in correctional facilities c. An increase in stress in people's lives d. The deinstitutionalizing of the mentally ill Correct Answer: d (page 457) 10. What is an example of dynamic security in a correctional facility? a. Managing professional boundaries b. Personal protection alarms c. Counting equipment d. Video monitoring Correct Answer: a (page 465) 11. Kris, 22 years old, has been sentenced to five years in prison for trafficking. What type of facility will he be sent to? a. Territorial correctional centre b. Federal correctional institution c. Provincial correctional centre d. Remand centre

Correct Answer: b (page 456) 12. How should a new nurse develop therapeutic relationships with children in a young offenders' facility? a. Get caught up in the sensationalism that surrounds a particular offender b. Managing professional boundaries c. Suppress her reactions to the inmates' alleged offences or crimes d. Change security regulations that interfere with nursing care Correct Answer: b (page 465) 13. Which statement is true about people of Aboriginal descent in correctional facilities? a. They are sent to facilities that specialize in Aboriginal offenders b. A large percentage is HIV positive c. In Quebec, Aboriginal offenders are less likely to be incarcerated d. Aboriginal people are overrepresented in corrections Correct Answer: d (page 461) 14. What is an example of a primary prevention in a correctional facility? a. Crisis intervention b. Substance abuse program c. Social skills training d. Advocacy Correct Answer: d (page 456) 15. Ms. Blackstone, 19 years old, has been sentenced to an 18-month sentence. What type of facility will Ms. Blackstone be sent to? a. Provincial correctional centre b. Youth detention centre c. Remand facility d. Federal correctional centre

Correct Answer: a (page 456) 16. Ms. Blackstone, 19 years old, has been sentenced to an 18-month sentence.The nurse does an intake assessment. What is true of women who are incarcerated? a. Higher rate of diagnosed infections b. Higher rate of HIV antibody prevalence c. Less likely to have anxiety compared to male inmates d. Less likely to hurt themselves Correct Answer: a (page 459) 17. Ms. Blackstone, 19 years old, has been sentenced to an 18-month sentence. Ms. Blackstone is three months pregnant upon admission to the facility. What action would the nurse take? a. Tell Ms. Blackstone she will serve her sentence in the community b. Arrange for Ms. Blackstone to attend community prenatal classes c. Do an HIV test d. Discuss options with Ms. Blackstone regarding the pregnancy Correct Answer: d (page 460) 18. Ms. Blackstone, 19 years old, has been sentenced to an 18-month sentence. While conducting the intake assessment, Ms. Blackstone states that she will not be examined while the correctional officer is present. What should the nurse do? a. Tell her that the correctional officer is required to be present b. Request that the correctional officer leave c. Postpone the examination d. Ask another nurse to replace the correctional officer Correct Answer: a (page 459)

19. Ms. Blackstone, 19 years old, has been sentenced to an 18-month sentence. What is an example of a secondary prevention the nurse may use with Ms. Blackstone? a. Crisis intervention b. Suicide prevention c. Advocacy d. Appropriate referrals Correct Answer: a (page 456) 20. Which of the following is true of correctional facilities that provide mental health services? a. Correctional facilities generally provide a higher quality of mental health services than those found within the community b. Correctional facilities generally provide the same quality of mental health services as those found within the community c. Correctional facilities generally provide a sub-standard quality of mental health services than those found within the community d. Correctional facilities have the best mental health practitioners across the country Correct Answer: c (page 457) 21. Which of the following is among the fastest growing groups subgroups found within correctional environments? a. Children aged 12 years and younger b. Youth between the ages of 14 – 24 years c. Adults aged 35-45 years d. Seniors aged 50 years and older Correct Answer: d (page 459)

22. What percentage of female inmates report physical and/or sexual abuse? a. 25 – 35% b. 50 – 70% c. 40 – 60 % d. 80 – 90% Correct Answer: b (page 459) 23. Which of the following problems has become a critical issue among women in correctional facilities? a. Suicides b. Heart disease c. Non-suicidal self-injuries d. Diabetes Correct Answer: c (page 459) 24. Which of the following can be classified as a harm-reduction strategy that is available to incarcerated persons if they request them? a. Dental dams b. Clean needles c. Antibiotics d. Isolation Correct Answer: a (page 463) 25. Which of the following contribute to conflict with the criminal justice system among Aboriginal youth? a. Self-harm b. Suicidal ideation c. Cultural assimilation d. Tuberculosis

Correct Answer: c (page 46) Short Answer Questions 26. For nurses in the correctional system, health programs may create conflict with correctional system's main concerns of security and protection of the public. Describe two such health programs, giving pros and cons for each. Correct Answer: -

methadone maintenance programs: reduce illicit drug use while incarcerated but provide inmates with a substance that can be diverted and abused

needle exchange programs: reduce spread of diseases such as Hep B/C and HIV but provide inmates with potential weapons and support illicit drug use (page 462)

27. Luc is an inmate in a provincial correctional facility. Discuss three reasons why being in custody may improve his health status. Give a specific practice example related to each reason. Correct Answer: -

many inmates have previously neglected their health (e.g., poor diabetes management)

many inmates may have had limited exposure to the health care system (e.g., cycle of poverty created a mistrust of institutions)

nurse has inmates' undivided attention (e.g., teachable moments to provide new information and skills)

being in the system may motivate inmate to change behaviour (e.g., being incarcerated can be a life-altering event that may help to recover from addictions)

nurse may identify previously unknown problems (e.g., inmate may never have had access to a comprehensive mental health assessment before) (page 457)

28. Barbara is a nursing manager within Correction Services Canada. She has been asked to maximize public health opportunities within her nursing services. Discuss what would be required to move this issue forward. Correct Answer: -

integrating more harm reduction strategies

interdisciplinary and intersectoral collaboration

bringing together health care, criminal justice, education, social services, NGOs, and the volunteer sector to develop, maintain, and evaluate partnerships

asking new research questions

developing new policies

implementing new health and social service programs

emphasizing community reintegration

supporting alternatives to incarceration

offering more placement opportunities for community health nursing students

(page 465 – 466) 29. List the key elements of the mental health strategy for corrections in Canada. Correct Answer: -

Mental health promotion

Screening and assessment

Treatment, services, and supports

Suicide and self-injury prevention and management

Transitional services and supports

Staff education, training, and support

Community supports and partnerships (page 458)

30. List three examples of primary, secondary, and tertiary prevention activities that are applicable to correctional health. Correct Answer: -

Primary prevention: political involvement, classification of stressors, advocacy

Secondary prevention: first aid, health screening, life and social skills training

Tertiary prevention: vocational training, relapse prevention, palliative care (page 456)

Chapter 27: Environmental and Occupational Health Multiple Choice Questions 1.

What is the most common disease that can be attributed to modifiable environmental factors? a. HIV b. Diarrhea c. Upper respiratory infections d. Myocardial Infarction

Correct Answer: b (page 472) 2.

What percentage of deaths can be attributed to environmental causes? a. 46% b. 23% c. 38% d. 12%

Correct Answer: b (page 473) 3.

Which Canadian document was the first to link the environment to health? a. Ottawa Charter b. The Report of the Walkerton Inquiry c. A New Perspective on the Health of Canadians d. Building on Values: The Future of Health Care in Canada

Correct Answer: c (page 473) 4.

Using the DPSEEA Framework, what is a driving force that can influence the state of the environment? a. Poverty b. Water quality and supply c. Air pollution d. Public policy

Correct Answer: a (page 475) 5.

At what level in the DPSEEA Framework are community health nurses involved? a. Exposure and effects

b. State of the environment c. Pressures d. Driving forces Correct Answer: a (page 475) 6.

Environmental hazards that impact health can exist in the home, workplace, and neighbourhood. What is an example of a hazard in the neighbourhood that can impact health? a. Working in a car assembly plant b. Winter driving c. Use of Lysol spray in the bathroom d. Substandard housing

Correct Answer: b (page 474) 7.

What is an example of pressure in the DPSEEA framework? a. Poverty b. Overcrowding c. Air pollution d. Greenhouse gases

Correct Answer: d (page 475) 8.

Mr. Chagnon works in a coal mine. What type of environmental factor will most likely influence his health? a. Ergonomic b. Chemical c. Biological d. Physical

Correct Answer: b (page 477) 9.

Mr. Salle works in a plant producing solvent. How might he be exposed to environmental hazards? a. Absorption b. Penetration c. Ingestion d. Inhalation

Correct Answer: a (page 477) 10. What is an example of the first line of defence to control exposure to environmental hazards? a. Changing jobs b. Respirators c. Limiting repetitive motion d. Ventilation systems Correct Answer: d (page 477) 11. What is used to show the relationship between the amount of exposure to an agent and the elicited response in the population? a. Susceptibility b. Dose-related histogram c. DPSEEA framework d. Epidemiology Correct Answer: b (page 477) 12. What is the purpose of an environmental health assessment? a. Determine the level of exposure b. Determine a possible link between an environmental exposure and health c. Discover the relationship between the dose of the environmental agent and the response d. Identify toxins in the environment Correct Answer: b (page 478) 13. The federal government reports on what environmental indicator? a. Ultraviolet (UV) index b. Population density c. Ozone levels d. Fluoride levels in water Correct Answer: c (page 479) 14. AA tire dump is burning upwind from a small community. An environmental risk assessment is done. What information will this provide?

a. Who in the community is at greatest risk b. The financial cost of the exposure c. Current information for the community d. The level of exposure that will impact health Correct Answer: d (page 480) 15. What is an example of federal environmental legislation? a. Food and Drug Act b. Environmental Protection Act c. Occupational Health and Safety Act d. Clean Air Act Correct Answer: a (page 482) 16. Where would an occupational health nurse work? a. Hockey arena b. Community centre c. Sawmill d. Elementary school Correct Answer: c (page 474) 17. What organization has a national voice influencing health and safety regulations across Canada? a. Worksafe b. Labour Ministry c. Canadian Nurses Association d. Occupational Health Nursing Association Correct Answer: d (page 474) 18. AA nurse who is assessing hazard control would consider which to be an administrative control? a. Wearing gloves when working with biological hazards b. Rotating workers for two-hour periods through a high heat area c. Replacing the dangerous cleaning solution with a safe product d. Enclosing workers in a noise-free control room

Correct Answer: b (page 477) 19. What is an occupational health nurse? a. A nurse with an occupational health nursing certificate through the Canadian Nurses Association b. A nurse certified through the American Association of Occupational Health Nurses c. A nurse with additional training in health and safety d. A nurse registered with the Canadian Occupational Nurses Association Correct Answer: c (page 474) 20. Mr. Chevez and Mr. Ferris work in a fertilizer plant. What type of environmental factor may have an influence on their health? a. Occupational b. Physical c. Inhalation d. Chemical Correct Answer: d (page 477) 21. Mr. Chevez and Mr. Ferris work in a fertilizer plant. Despite similar exposure, Mr. Chevez develops a respiratory condition. What would account for Mr. Ferris remaining healthy? a. Mr. Ferris is resistant b. Mr. Chevez had a pre-existing health condition c. Mr. Ferris had less exposure d. Mr. Chevez is hypo-susceptible Correct Answer: a (page 478) 22. Mr. Chevez and Mr. Ferris work in a fertilizer plant. What type of nurse would work with the employees of the fertilizer plant? a. Public health nurse b. Occupational health nurse c. Hazard control nurse d. Community health nurse Correct Answer: b (page 474)

23. Mr. Chevez and Mr. Ferris work in a fertilizer plant. The nurse institutes hazard controls at the plant. What would be the first line of defence? a. Developing a policy to limit exposure b. Changing jobs within the plant c. Improving ventilation d. Using personal respirators Correct Answer: c (page 477) 24. What term is best used to describe conditions that occur from exposures that are unique to the workplace and unlikely to occur in concentrated form in daily life? a. Occupational diseases b. Environmental health c. Environmental factors d. Workplace exposures Correct Answer: a (page 473) 25. Jane is completing an environmental health assessment. She is collecting information about Mrs. Jones’s social activities. What type of information is Jane collecting? a. Residential information b. Occupational information c. Environmental information d. Recreation information Correct Answer: d (page 479) Short Answer Questions 26. Describe components of the DPSEEA framework. Give an example of each component using an earthquake in a third-world country. Correct Answer: Driving forces (D): Driving forces are factors that create pressures, which can influence the state of the environment, e.g., poverty, population density. Pressures (P): The environment can be altered by pressures, e.g., food shortages, disposal of wastes, decomposing bodies and animals. State of the environment (S): The state of the environment can be altered in response

to pressures (i.e., resource availability, air pollution), e.g., water pollution, contaminated food. Exposure and Effects (EE): Exposures occur through inhalation, ingestion, and absorption of hazards. These exposures will result in an effect on health in individuals, e.g., drinking contaminated water (diarrhea, cholera), food shortages (violence, hunger). Actions (A): Actions are undertaken to affect the environmental factor, including policy changes, pollution monitoring, environmental improvements, and education/awareness programs, e.g., safety re: water treatment, hygiene; policy re: food and water distribution. (page 475) 27. A nurse needs to do a personal exposure history on a 35-year-old woman who has severe diarrhea. What are the components of the personal exposure history? Describe what the nurse would assess under each component. Correct Answer: The questions should relate to: Occupational Information (present and past jobs, work exposures, protective measures, duration of the exposure) Residential Information (water sources, history of floods, indoor air quality) Recreational Information (social exposures, community exposures) (page 478-479) 28. Describe three types of health and safety hazards that a nurse could expect to encounter in her practice. Give two examples of specific hazards related to each type. Correct Answer: -

physical, e.g., noise, vibration, radiation, heat/cold

chemical, e.g., liquids, solids, gases

biological, e.g., bacteria, viruses, insects, plants, birds, animals, humans

ergonomic, e.g., lighting, repetitive work, postures, tool design

psychosocial, e.g., workload, harassment, arrangements, shiftwork, conflict (page 477)

29. List four of the six CNA OHN Certification Competencies. Give three components for each major competency. Correct Answer: •

Provision of Occupational Health, Safety, and Environmental Services (practices in accordance with standards, practices in compliance with legislation, complies with legislative requirements)

•

Recognition, Evaluation, and Control of Workplace, Environmental Health, and Safety Hazards (identifies hazards, assesses risk and severity of hazards, applies principles of hazard control, makes recommendations for control measures)

•

Health Assessment, Planning, Implementation, Monitoring, and Evaluation (assesses, plans, implements, recommends, and monitors interventions to promote health; develops, implements, and evaluates programs/procedures for health surveillance; collects, analyzes, uses, and communicates aggregate data)

•

Assessment, Care, and Case Management of Injuries and Illnesses (applies the nursing process to minimize effects, uses data gathering to evaluate ill/injured employees, identifies fitness-to-work implications)

•

Environment, Health, Safety, Wellness Promotion, and Prevention (provides leadership, empowers employees, empowers management)

•

Environmental, Health, Safety, and Wellness Management (manages environmental services, manages health and safety services, manages wellness services) (page 475)

30. List and define the four common routes of entry for individual environmental factors. Correct Answer: -

Inhalation: inhaling agents directly into the respiratory tract and lungs

Absorption: refers to entrance through the skin, regardless of whether the skin is intact or damaged. Some substances may be absorbed by way of openings or through hair follicles, while others may dissolve in fats and oils of the skin. Some compounds can produce systemic poisoning through direct contact with the skin

Injection: can involve accidental or intentional injection of agents from either a high-velocity source or a point source

Ingestion: includes knowingly or unknowingly eating or drinking a harmful agent and subsequently having a toxic compound absorbed from the gastrointestinal tract into the bloodstream (page 477)

Chapter 28: Violence inSocieties Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1. Jason is a student in grade seven. He often experiences bullying in school. Bullying is classified as what type of violence? a. Political violence b. Interpersonal violence c. Intimate partner violence d. Collective violence Correct Answer: b (page 487) 2. Which of the following is among the top 10 causes of death for all age groups in Canada? a. Injuries b. Post-traumatic stress disorder c. Suicide d. Substance abuse Correct Answer: c (page 487) 3. Sandra is a community health nurse working with victims of sexual abuse. Sandra has noticed that many of her clients experience pain with no detectable source. This type of pain in known as which of the following? a. Somatic pain b. Referred pain c. Secondary pain d. Biological pain Correct Answer: a (page 487)

4. What percentage of women experience post-traumatic stress disorder after sexual assault? a. 10 – 15% b. 20 – 35% c. 65 – 80% d. 40 – 60% Correct Answer: d (page 487) 5. Jasdeep is a community health nurse working with abused children. She notices that the children she works with often display aggressive behaviour. What is this aggressive behaviour referred to as? a. Externalizing behaviour b. Internalizing behaviour c. Vertical display of behaviour d. Transcultural behaviour Correct Answer: a (page 488) 6. Which theory of violence suggests that after witnessing or experiencing child abuse, all abused children would become violent? a. Psychological theory of violence b. Political theory of violence c. Social learning theory of violence d. Biological theory of violence Correct Answer: c (page 489)

7. Which of the four major groups presented below are part of the socioecolocial model of violence? a. Individual, friendship, community, structure b. Individual, family, system/structure, society c. Individual, community, system, society d. Individual, relationship, community, society Correct Answer: d (page 489) 8. Alcohol use by perpetrators has been linked to increased incidents of sexual assault. Sally is a community health nurse and would like to work at the societal level to address this issue. What is an example of the work that Sally is involved in? a. Educating alcoholics on the importance of reducing their drinking b. Lobbying government to have bars close earlier c. Working with Mothers against Drinking and Driving d. Assisting young girls obtain self-defense training Correct Answer: b (page 491) 9. Which of the following statements is true of mental illness and violence? a. The majority of those who are violent are not mentally ill b. The majority of those who are violent are mentally ill c. Those with mental illness are more likely to be perpetrators d. The strongest predictor of violence is having one form of mental illness Correct Answer: a (page 491)

10. Mae Ling is a community health nurse working with victims of violence. She realizes that there is a correlation between the number of adverse childhood experiences and the risk for committing violent acts. This is known as what type of influence? a. Individual influence b. Relationship Influence c. Societal influence d. Political influence Correct Answer: b (page 491) 11. People belonging to which of the following groups are most often victims of violence in Canada? a. Older adults between the ages of 65 – 80 years b. Young mothers between the ages of 25 – 35 years c. Youth and young adults between the ages of 15 – 24 years d. Young children between the ages of 4 – 12 years Correct Answer: c (page 493) 12. Juan is a community health nurse who understands that females of any age are at particular risk for violence. In which type of setting should Juan’s interventions be targeted at? a. The workplace setting b. The home setting c. The structural setting d. The social setting Correct Answer: b (page 493)

13. Which of the following statements is true of violence and Aboriginal Canadian women a. Aboriginal Canadian women face rates of violence significantly higher than those of non-Aboriginal Canadian women b. Aboriginal Canadian women face rates of violence equal to those of nonAboriginal Canadian women c. Aboriginal Canadian women face rates of violence lower than those of other visible minority Canadian women d. Aboriginal Canadian women face rates of violence equal to those of other visible minority Canadian women Correct Answer: a (page 493) 14. Which of the following groups are considered vulnerable populations in the violence discourse? a. Youth, women, and preschool children b. Seniors, people with abilities, and women c. Sexual minorities, youth, and women d. Older adults, preschool children, and women Correct Answer: c (page 493-494) 15. Samar is a community health nurse working at a Canadian university. She observes hypersexualized chants and violent freshman activities. Samar attributes these behaviours to what type of influence? a. Family influence b. Societal influence c. Individual influence d. University influence Correct Answer: b (page 492)

16. Which of the following is considered to be a risk for violence relating to the community aspect of the socioecological model of influences on violence? a. Minority groups b. Rapid social change c. Multiple partners d. High-crime neighbourhoods Correct Answer: d (page 490) 17. Which of the following terms is used to describe the negative response to disclosure of experiencing any form of violence? a. Primary victimization b. Resilience victimization c. Secondary victimization d. Tertiary Victimization Correct Answer: c (page 495) 18. Which of the following may serve as a protective factor for being a victim of bullying? a. A strong friendship with a peer b. Affectionate relationships with parents c. Involvement of teachers in home life d. Involvement in extra-curricular activities Correct Answer: b (page 498) 19. What percentage of Canadian students are thought to be involved in cyberbullying? a. 15% b. 25% c. 30% d. 45% Correct Answer: c (page 499)

20. Which of the following statements is true of gangs in Canada? a. Half of gang members are under 18 years old b. Gangs are only present in urban settings c. The highest gang involvement has been in Nova Scotia d. Most members of gangs are female Correct Answer: a (page 500) 21. Maria is a community health nurse. She is working with Lee and Barb. She notices that both Lee and Barb are violent towards each other and attempt to control one another. What type of violence does Maria identify this as? a. Intimate terrorism b. Mutual violence c. Situational Violence d. Violent resistance Correct Answer: b (page 505) 22. Alexandra is a community health nurse. She regularly screens for intimate partner violence with her clients. What type of prevention is this? a. Tertiary prevention b. Quaternary prevention c. Primary prevention d. Secondary prevention Correct Answer: d (page 506)

23. Matthew is a community health nurse working with his client Sunil. Matthew and Sunil are putting a plan in place to assist Sunil to leave a violent relationship. What type of prevention would Matthews work be classified as? a. Quaternary prevention b. Primary prevention c. Tertiary prevention d. Secondary prevention Correct Answer: c (page 511) 24. Community health nurses who work on issues of violence, may also experience indirect violence. What term is used to describe this indirect violence? a. Precarious violence b. Vicarious violence c. Societal violence d. Community violence Correct Answer: b (page 509) 25. There are three steps to assist any victim of trauma. These three steps include which of the following? a. Look, listen, link b. Assess, diagnose, intervene c. Look, link, assess d. Look, listen, remove Correct Answer: a (page 508) Short Answer Questions 26. Please list and give examples of the symptom clusters of post-traumatic stress disorder Correct Answer: See table 28.1 (page 488)

27. List and define the four major groups of the socioecological model of violence. Correct Answer: There are 4 major groups or levels of influences that can affect risks for violence. -

Individual factors: the biological, genetic, or personal factors that place one at risk

Relationship factors: those from family, significant others, or peers that influence attitudes or behaviours

Community factors: include attitudes, beliefs in organizations, or communities that support or tolerate violence or inequality

Societal factors: include cultural norms, societal values, or policies allowing violence or condoning inequality, such as income distribution or social exclusion of individuals or groups. (page 489)

28. List and provide examples of trauma responses by developmental stage Correct Answer: See table 28.3 (page 496) 29. The community health nurse has many opportunities to prevent child abuse. List potential interventions related to preventing child abuse and classify them according to the levels of prevention. Correct Answer: Primary prevention -

Educate children to facilitate friendships, develop social and emotional skills, and learn about healthy relationships

Educate parents on skills and links to services

Conduct community home visits, looking for risk factors and building on strengths

Secondary prevention -

Participate in any surveillance initiatives for adverse childhood experiences

Report suspected child abuse to authorities, carefully document physical and behavioural findings, link with key resources, and maintain an attitude of objectivity

Tertiary prevention -

Link parents and children with support resources in the community

Determine and ensure the immediate safety of the child and nurse (page 498)

30. Identify the risks for gang involvement and strategies for prevention. Correct Answer: See Table 28.5 (page 500)

Chapter 29: Poverty, Homelessness and Food Security Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1. How many people in Canada are estimated to experience homelessness in a year? a. 150 000 b. 30 000 c. 100 000 d. 200 000 Correct Answer: d (page 527) 2. Which statement is true about homelessness in Canada? a. More people in the Maritimes are homeless b. Aboriginal people account for 20% of the homeless c. One in 15 Canadians has either been homeless or come close to it d. Rates are highest for unattached individuals in the 45 to 64 age group. Correct Answer: d (page 528) 3. Poverty can be determined by many criteria. One criterion is, "any family that had to spend more than 70% of its income on food, clothing and shelter." What criterion of poverty is this? a. Basic needs approach b. Market basket measure c. Highest attainable income measure d. Low-income cut-off measure Correct Answer: d (page 527) 4. Who is at greatest risk for poverty? a. A 26-year-old single male b. An immigrant family living in Canada 15 years c. A single mom with a 5-year-old child d. Aboriginal couple living on reserve Correct Answer: c (page 528) 5. Mr. and Mrs. Charbonneau lost their home in a fire. They are staying with friends for the time being. What type of physical living condition are Mr. and Mrs.

Charbonneau experiencing? a. Unsheltered b. Emergency sheltered c. Provisionally accommodated d. At risk for Homelessness Correct Answer: c (page 529) 6. Stacey, 26 years old, lives in poverty with her two children. What would be true about this family unit? a. The children are likely to become bullies b. The children may have difficulty problem solving c. The children will develop supportive friendships with children at school d. They will not live in poverty long Correct Answer: b (page 531) 7. Which of the following may be classified as a structural issue causing homelessness? a. Discrimination b. Early discharge c. Family violence d. Personal crisis Correct Answer: a (page 529) 8. Cathy is a community health nurse working with the homeless population in Toronto. She is trying to communicate the importance of “homefullness” to her clients. What is she including in this discussion? a. A place for identifying strangers as friends b. A place for social and family relations c. How to maintain order in disorder d. How to participate in social exclusion Correct Answer: b (page 529) 9. Research of the homeless population is difficult. What can a nurse do to increase the participation of the homeless in research studies? a. Use a community participation approach b. Offer skills training to participants

c. Increase funding to feed participants d. Give assurance that this will improve lives for future homeless people Correct Answer: a (page 538) 10. What is considered a threat to human development, health, and quality of life? a. Poverty b. Unemployment c. Homelessness d. Hunger Correct Answer: a (page 527) 11. Holly is a new community health nurse in a large city. As part of her orientation she learns that people who live in poverty have few supports and experience low self-esteem and shame. What term describes this view of poverty? a. Social exclusion b. Social justice c. Stigma d. Equity Correct Answer: a (page 531) 12. Paul is a community health nurse working with low-income populations. He notices that his clients often are lacking in their social support networks. In which of the following ways are people living in poverty unable to meet this determinant of health? a. Having a fixed address in a low-income neighbourhood b. Having sufficient funds to travel to visit with family members c. They begin to create new relationships quickly when old ones fade d. They may have exhausted the assistance that can be asked of friends Correct Answer: d (page 530) 13. What is a federal social program that has worked at eliminating poverty? a. Charter of Rights and Freedoms b. Shelters c. Minimum wage d. Child benefits

Correct Answer: d (page 530) 14. The Lu'ma Native Housing Society in Vancouver recently began to provide a helpful service to the homeless. What does this group give to the homeless? a. Web access b. Accommodation c. A daily meal d. Voice mail Correct Answer: d (page 538) 15. What is an effective way to access health care services in remote and rural areas? a. Mobile health bus b. Telehealth c. Internet health services d. Sending specialists to visit small communities Correct Answer: b (page 536) 16. Which of the following is an example of a personal health practice for poor people? a. Poor people may delay seeking help due to their inability to pay for medication b. Poor people with no fixed address have difficulty getting identification papers c. Poor people who are poorly educated are less likely to qualify for high paying jobs d. Low-income housing is more likely to be located in a poor neighbourhood Correct Answer: a (page 531)

17. Mary, 32 years old, lives with her 14-year-old daughter. Mary earns $18 000 per year. What is a perceived barrier to health for Mary and her daughter? a. Fragmented health care system b. Poor understanding of health issues c. Feelings of prejudice d. Competing priorities Correct Answer: c (page 532) 18. Mary, 32 years old, lives with her 14-year-old daughter. Mary earns $18 000 per year. Mary and her daughter live in a small rental unit. What would the community health nurse predict about the neighbourhood Mary lives in? a. They live in a middle class neighbourhood b. There is no central heating c. There is an increased presence of nurses d. There is an increased risk for violence Correct Answer: d (page 531) 19. Jessica is a community health nurse working in a low-income neighbourhood. What can Jessica identify as a predictor of food insecurity for the clients that she is working with? a. Owning a house in a low-income neighbourhood b. Being a lone-parent, male-led family c. Having non-Aboriginal status d. Being on social assistance Correct Answer: d (page 534)

20. Cathy Crowe is a community health nurse in Toronto. What is her contribution to the homeless and people who live in poverty? a. Establishing Street Haven b. Legal action against the federal government for affordable housing c. Formation of a federal homelessness ministry d. Created Tent City outside Toronto Correct Answer: b (page 537) 21. Which of the terms below is used to describe “the ability to acquire or consume an adequate diet quality or sufficient quantity of food in socially acceptable ways, or the uncertainty that one will be able to do so”? a. Poverty b. Low-income household c. Food insecurity d. Social injustice Correct Answer: c (page 533) 22. Which of the following examples of inequity are related to physical environment as a determinant of health? a. The inability to maintain or enhance one’s house can lead to increased disease b. People who work in low-paying jobs may be more susceptible to workplace injury c. Many people who are poor or homeless are victims of violence d. Poverty increases the barriers to meeting one’s cultural tasks Correct Answer: a (page 531) 23. How many food programs currently run in Canada? a. 800 b. 3000 c. 500 d. 1000 Correct Answer: b (page 534) 24. Which province or territory has the highest percentage of food insecure

households? a. Nunavut b. Newfoundland c. Yukon d. Quebec Correct Answer: b (page 535) 25. Which of the following is an example of a socially exclusionary consequence for children who are poor? a. Being able to play at the park outside b. Going to the daycare 5 days a week c. Having cousins to help with homework d. Being fed minimal nutritious food Correct Answer: d (page 533) Short Answer Questions 26. List two factors contributing to the worsening state of poverty in Canada. Given an example for each factor to illustrate how it links to poverty. Correct Answer: -

free trade, leading to more temporary, part-time, contract, seasonal work-e.g., less hours to earn enough money to live on

federal government withdrawal from social programs-e.g., less social benefits available for those who earn low incomes

sales tax

shift to privatization-e.g., less benefits for those who can't purchase them privately

government budgets that have shifted the burden of federal and provincial taxes onto lower-income workers-e.g., lower-income workers have had lower increase in after-tax percentage of their income than high-income workers. (page 527-528)

27. Provide an example from the 12 determinants of health related to either poverty or homelessness. Correct Answer:

Income and social status: More people of low income rate their health as poor.

Social support networks: Homeless people may have exhausted relationships with family.

Education and literacy: People with less education are less likely to get highpaying jobs.

Employment/working conditions: Homeless people may have difficulties getting a job without an address.

Social environments: Homeless people have often been deinstitutionalized, leaving them with few social supports.

Physical environments: Low-income people may have few choices of safe affordable housing.

Personal health and coping skills: Homeless people may not have access to basic hygiene products.

Healthy child development: Low-income people may have difficulties accessing low-cost or free activities to do with their children.

Biology and genetics: Poverty exacerbates vision and hearing problems.

Health services: Access to services may be decreased with a follow-up address and phone number.

Gender: More women are low income due to longer life expectancy.

Culture: People of low income may have greater difficulties meeting cultural tasks and expectations. (pages 530-532)

28. Discuss how two organizations use technology to help the poor. Correct Answer: Lu'ma Native Housing Society - provides homeless free telephone number and voice mail - allows the homeless to stay connected (page 538)

Homeless Individuals and Families Information System (HIFIS)

- software program that collects data on the homeless using shelter services (page 529) 29. List four predictors of food insecurity in Canada Correct Answer: -

Low income

Aboriginal status

Renting instead of owning one’s domicile

Being a lone-parent, female-led family (page 534)

30. List 10 specific health issues for the homeless and poor. Correct Answer: -

Skin and foot disorders

Poor oral hygiene

Respiratory tract infections

Hypertension

Cardiovascular disease

Diabetes

Asthma

Renal disease

Mental illness

Cancer

Sexually transmitted infections

Substance abuse

Violence (page 532)

Chapter 30: Substance Use, Abuse and Addictions Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1.

The recent surge in the abuse of prescription opioid pain relievers can cost up to $50 billion a year. These costs mostly account for which of the following? a. Lost productivity and crime b. Health care costs at public facilities c. Costs for rehabilitation in private facilities d. Counselling for close family members

Correct Answer: a (page 542) 2.

Which of the following statements is true of people who develop addictions? a. People who start smoking later in life are more likely to develop an addiction b. People who start drinking early in life are more likely to develop an addiction c. People who use medical marijuana are more likely to develop an addiction d. People who use pain medications post operatively are more likely to develop an addiction

Correct Answer: b (page 543) 3.

Which of the following terms is used to describe drugs that are used for medicinal purposes? a. Illicit drugs b. Licit drugs c. Street drugs d. Legitimate drugs

Correct Answer: b (page 543)

What term is used to describe a maladaptive pattern of substance use that results in harmful consequences due to repeated use? a. Substance dependence b. Substance use c. Substance abuse d. Substance experimentation

Correct Answer: c (page 544) 5.

James is a community health nurse working with his client Joseph. Joseph is currently experiencing withdrawal symptoms. What term is best used to describe Joseph’s experience? a. Addiction b. Psychological dependence c. Substance use disorder d. Physical dependence

Correct Answer: d (page 544) 6.

What is the average age of first alcohol use among youth in Canada? a. 15 years b. 13 years c. 17 years d. 14 years

Correct Answer: a (page 544) 7.

What is the leading cause of preventable death in Canada? a. Alcohol use b. Illicit drug use c. Tobacco use d. Licit drug use

Correct Answer: c (page 544)

Which of the following is a classification of products containing synthetic amphetamine-type stimulants? a. Energy drinks b. Bath salts c. Alcohol d. Heroin

Correct Answer: b (page 545) 9.

What is the substance that is most used by Canadians? a. Alcohol b. Cannabis c. Hallucinogens d. Ecstacy

Correct Answer: a (page 547) 10. What is the most widely used illicit drug in Canada? a. Alcohol b. Cannabis c. Hallucinogens d. Ecstacy Correct Answer: b (page 547) 11. What percentage of Canadian adults are affected by varying levels of problem gambling? a. 20% b. 10% c. 15% d. 3% Correct Answer: d (page 548)

12. Cheryl is a community health nurse who is working with a male client who abuses non-prescription opioids. What is a significant concern for Cheryl? a. The fact that the client may not have the money to keep up his drug use b. The fact that the client may not have the ability to maintain a relationship c. The fact the drug may be “cut” repeatedly before the client buys it d. The fact that the drug may actually be helpful for the client Correct Answer: c (page 549) 13. Which of the following populations in Canada can be at increased risk for prescription drug abuse? a. Health care professionals in any specialty b. Young children living in lone parent homes c. Young adults with full time jobs d. Families with more than 4 individuals Correct Answer: a (page 549) 14. What substance poses a serious public health problem in rural Canada? a. Snorting cocaine b. Inhaling glue c. Smoking marijuana d. Drinking alcohol Correct Answer: b (page 548) 15. Ally, 22 years old, is addicted to a prescription medication. What type of medication is she most likely abusing? a. Tranquilizer-diazepam (Valium) b. Opioid-oxycodone (Oxycotine) c. Sedative-secobarbital (Seconal) d. Antidepressant -fluoxetine (Prozac) Correct Answer: b (page 545)

16. AA group of nurses are working in an impoverished area of a large city where substance abuse is rampant. The nurses are an integral part of the city's fourpillar drug strategy. Which example is consistent with a harm reduction approach to substance abuse? a. Targeting drug traffickers b. A needle exchange program c. An Al-Anon group d. Students against drunk driving Correct Answer: b (553) 17. AA group of nurses are working in an impoverished area of a large city where substance abuse is rampant. The nurses are an integral part of the city's fourpillar drug strategy. The nurses want to focus on substance abuse prevention strategies for youth in this neighbourhood. What would be the best strategy to use with this population? a. Initiate a medically supervised safe injection site b. Hold a weekend drug education workshop for at risk youth c. Encourage the development of a home drinking policy d. Engage police in closing down drug houses Correct Answer: b (page 550) 18. AA group of nurses are working in an impoverished area of a large city where substance abuse is rampant. The nurses are an integral part of the city's fourpillar drug strategy. The nurses are working with an advocacy group to develop alternative health recovery options for individuals struggling with addiction. What initiative would meet this goal? a. Develop a more accessible methadone maintenance treatment program b. Start a drug treatment court (DTC) program c. Develop stronger health warning labels d. Supply free crack kits at shelters and soup kitchens Correct Answer: b (page 552)

19. AA group of nurses are working in an impoverished area of a large city where substance abuse is rampant. The nurses are an integral part of the city's fourpillar drug strategy. The nurses are assessing the community using the community resilience framework. What would be an example of a social risk factor? a. Many personal social supports b. Poor economic base c. Low individual literacy levels d. Strong volunteer network Correct Answer: b (page 549) 20. Sherry is a community health nurse doing a postpartum home visit. She notices that the infant may be experiencing neonatal abstinence syndrome? Which of the following types of drugs is the mother most likely to have used? a. Opioid drugs b. Alcohol c. Non-opioid drugs d. Bath salts Correct Answer: a (page 545) 21. Alcohol is the most commonly used psychoactive substance in which of the following groups? a. Stay at home moms b. Teenagers c. Seniors d. Young adult males Correct Answer: c (page 549)

22. Which of the following disorders is manifested by developmental, neurological, and behavioural delays in infants and young children that persist into adulthood? a. Neonatal abstinence syndrome b. Concurrent disorder c. Fetal alcohol spectrum disorder d. Physiological dependence disorder Correct Answer: c (page 549) 23. Sameer is a community health nurse working with clients who abuse drugs. He notices that his clients are at increased risk for overdose, suicide and contracting blood-borne infections. What type of drugs are Sameer’s clients likely using? a. Drugs that are smoked b. Drugs that are snorted c. Drugs that are swallowed d. Drugs that are injected Correct Answer: d (page 549) 24. Mae Lee is a community health nurse working with a client who has a concurrent disorder. What does this mean? a. The client has a co-occuring mental health and substance use problem b. The client has a co-occuring physiological and substance abuse problem c. The client has a co-occuring gambling and substance abuse problem d. The client has a co-occuring social and substance abuse problem Correct Answer: a (page 548) 25. Methadone maintenance treatment programs were introduced across Canada in response to the increasing use of opioids and the extensive cycle of this devastating drug dependency. Methadone alleviates the symptoms of opioid withdrawal by creating stable and sufficient blood levels of methadone. Methadone maintenance treatment programs are an example of which level of prevention? a. Primary b. Quaternary c. Secondary d. Tertiary

Correct Answer: d (page 553) Short Answer Questions 26. Define resiliency. Apply resiliency theory to substance abuse. Describe and give an example related to substance use for each of the two fundamental concepts that are involved in resiliency. Correct Answer: -

Resiliency: the capability of individuals, families, groups, and communities to cope successfully in the face of significant adversity or risk

Resiliency theory related to substance abuse is particularly valuable as both risk and protective factors must be examined and analyzed in order to recognize the aspects of health that can be enhanced or reduced.

Risk factors: stresses that challenge individuals, including their own personal and environmental characteristics, e.g., friends and family who continue to smoke around a person who has just quit smoking and offer no support

Protective factors: skills, personality factors, and environmental supports that act as buffers when people are faced with stressful events, e.g., interpersonal skills to resist peer pressure to drink at teen parties (page 556)

27. Differentiate between substance use and substance abuse and relate these terms to dependency. Provide an example from community health nursing practice related to working with clients experiencing use and an example related to abuse. Correct Answer: -

Substance use is any consumption of psychoactive drugs, which can result in benefits or harm.

Substance abuse or misuse refers to drug use that leads to adverse physical and/or psychological consequences, which may or may not involve dependency.

Dependency is progressive in nature and involves physiological, cognitive, behavioural, and psychological dimensions of a person's health.

Dependency is manifested by continuous use despite the presence of problems

that are caused by continuous patterns of tolerance, withdrawal, and compulsive substance-taking behaviours. -

Dependency can be physical and/or psychological.

CHN e.g. for substance use: providing resources to teachers about how to help kids stay tobacco-free

CHN e.g. for substance abuse: working with problem drinkers through a lifecoaching program (page 543-544)

28. Give three examples of appropriate activities a CHN could implement in a high school as part of a substance use prevention program. Correct Answer: -

develop school drug/alcohol policies

encourage an integrated drug/alcohol education curriculum

provide ongoing training for teachers and others involved

hold special events that are drug/alcohol free

organize student interest groups

provide early identification and intervention programs in the school (page 554556)

29. List 8 risky drinking practices. Correct Answer: -

Drinking more than 10-15 standard drinks in a week

Drinking more than 3 drinks a day for men and 2 drinks a day for women

Drinking more than one standard drink in an hour

Drinking and driving

Drinking before or during work

Drinking before or during sports or other physical activities

Drinking during pregnancy

Drinking while on medication or with other drugs

Drinking with the intention of becoming intoxicated

Drinking to cope with difficulties or negative outlook

Drinking out of habit

Drinking underage (page 551)

30. List 4 harmful medical consequences and 4 social consequences of substance abuse. Correct Answer: Medical consequences: -

Lung damage from long term tobacco use

Alcohol abuse can cause liver damage

Sniffing cocaine can cause damage to nasal passages

Injecting drugs can put people at risk for blood-borne infections

Social consequences: -

Domestic and interpersonal violence

Increased crime

Strained relationships

Workplace and school absenteeism (page 548-549)

Chapter 31:SexualyTransmited Infections and Blood-Borne Pathogens Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1.

What is the most prevalent reportable bacterial sexually transmitted infection (STI) seen in Canada? a. Genital herpes b. Gonorrhea c. Hepatitis B d. Chlamydia

Correct Answer: d (page 563) 2.

A nurse is working with a new immigrant group to prevent STIs. What is the nurse most likely to encounter with this population? a. Ability to seek out health services b. Positive beliefs surrounding traditional herbal medicine c. Good access to translated resources d. Low stress levels within the group

Correct Answer: b (page 569) 3.

A nurse is working with injection drug users. What infection is the nurse most concerned about preventing in this population? a. Hepatitis B b. Hepatitis A c. Syphilis d. Genital herpes

Correct Answer: a (page 569)

Jo has a 10-year history of injection drug use and uses a safer injection facility. What city does Jo live in? a. Toronto b. Winnipeg c. Halifax d. Vancouver

Correct Answer: d (page 570) 5.

The local health department recognized that there are high rates of various STIs among women who work as exotic dancers. Which intervention has the best chance of success in reducing the high rates of STIs? a. Encouraging women to work at large box stores instead of dancing b. Supplying free condoms to the dancers c. Installing condom machines in the washrooms of strip clubs d. Working with the strip club employers and dancers to develop a peer education program

Correct Answer: d (page 568) 6.

Leslie is 50 years old and presents at the community health centre with complaints of anal discharge and bloody stools. Leslie does not use condoms with common-law partner Terry. What testing should the nurse offer to provide Leslie? a. Gonorrhea and chlamydia b. Syphilis and genital herpes c. Genital warts d. Candidiasis

Correct Answer: a (page 562)

Tony is seen by a nurse at the STI clinic. The nurse observes red tracks and bumps in the genital area around his groin and thighs. Tony reports itchiness in the same region. What sexually transmitted infection should the nurse suspect? a. Trichomoniasis b. Pubic lice c. Scabies d. Genital herpes

Correct Answer: c (page 564) 8.

What would be an appropriate method of testing for chlamydia? a. Culture of the fluid drawn from a sore b. Dark-field microscopy c. Blood test d. Urine testing

Correct Answer: d (page 563) 9.

Thomas has contracted herpes from his new partner. How will this STI be treated? a. There is no cure b. Antivirals c. Laser therapy d. A course of antibiotics

Correct Answer: b (page 564) 10. Which are typical acute HIV symptoms that occur two to four weeks after infection? a. Itchiness and red bumps on the skin b. Flu-like symptoms and fever c. Pain and fluid-filled blisters d. Lower abdominal pain and burning on urination Correct Answer: b (page 565) 11. In 2012, what percentage of all positive adult HIV tests was among the men who

have sex with men (MSM)? a. 31 b. 45 c. 50 d. 19 Correct Answer: c (page 565) 12. AA nurse is utilizing a harm reduction approach to prevent the spread of blood borne infections. What would be an appropriate strategy to meet this goal? a. Increasing clients' access to bleaching kits and clean needles b. Providing the HPV vaccine (Gardasil) for free to girls in grade 6 c. Offering chlamydia urine testing in outreach vans d. Promoting an abstinence-only approach with teens Correct Answer: a (page 570) 13. Juan is HIV positive and attending the STI clinic. Adriana, the community health nurse is communicating to Juan that in addition to being HIV positive, Juan also has Syphilis. Which of the following statements is true about this situation? a. Juan is more likely to transmit HIV to his unaffected partner b. Juan is less likely to transmit HIV to his unaffected partner c. Juan odds of transmitting HIV to his unaffected partner are no less and no greater than if he did not have HIV d. Juan should decide to abstain from having sexual intercourse with any partners. Correct Answer: a (page 562) 14.

Which of the following is true representation of the term vertical transmission? a. An HIV positive male transmitting HIV to his unaffected male partner b. An HIV positive male transmitting HIV to his infant

An HIV positive female transmitting HIV to her unaffected male partner d. An HIV positive female transmitting HIV to her infant Correct Answer: d (page 562) 15. Which of the following are classified as bacterial sexually transmitted infections? a. Chlamydia, scabies, and herpes b. Syphilis, candidiasis, and human papillomavirus c. Gonorrhea, syphilis, and chlamydia d. Vaginitis, hepatitis A, and gonorrhea Correct Answer: c (page 562) 16. Carmen is working with a group of university students to implement an awareness campaign about the importance of obtaining regular Papanivolaou tests. Which of the following pieces of information is relevant for Carmen to include in the awareness campaing? a. Half of adults with hepatitis B will not show specific symptoms b. Some human papillomavirus strains can cause abnormal cell changes on the cervix c. Symptoms for genital herpes include burning while urinating and flu-like symptoms d. Vaginitis is the most common reasons for gynecologic visits Correct Answer: b (page 564) 17. In 2011, what percentage of Canadians infected with HIV are unaware of their HIV status? a. 50% b. 75%

c. 45% d. 25% Correct Answer: d (page 565) 18. Carlita is seeking care for vaginitis. What information should the community health nurse give Carlita about the most common cause of vaginitis? a. Bacterial vaginosis is the most common cause of vaginitis and is not usually sexually transmitted b. Viral vaginosis is the most common cause of vaginitis and is not usually sexually transmitted c. Bacterial vaginosis is the most common cause of vaginitis in is usually sexually transmitted d. Viral vaginosis is the most common cause of vaginitis and is usually sexually transmitted Correct Answer: a (page 565) 19. In Canada, what is the national rate of HIV-positive infections? a. 12.5 per 100,000 persons b. 3.5 per 100,000 persons c. 5.9 per 100,000 persons d. 8.9 per 100,000 persons Correct Answer: c (page 565)

20. Heidi is working with high school students to discuss the importance of safe sex practices. The students appear uninterested and distracted. What should Heidi be worried about? a. Students are aware of where to obtain treatment for potential STIs and will seek out services b. Students are apathetic about hearing about and complying with safer-sex messages c. Students already are aware of safer-sex messages and will comply if they engage in sexual activity d. Students may not be engaging in sexual activity so this information is not relevant at this this Correct Answer: b (page 567) 21. Which of the following statements true about the Aboriginal population in Canada? a. Aboriginal people have disproportionately high rates of STIs compared to non-Aboriginal people b. Non-Aboriginal people have disproportionately high rates of STIs compared to Aboriginal people c. Aboriginal people have proportionally appropriate rates of STIs compared to non-Aboriginal people d. Aboriginal people have equal rates of STIs compared to non-Aboriginal people Correct Answer: a (page 569)

22. Which of the following statements is true of inmates in Canada’s correctional facilities? a. Inmates have disproportionately high rates of STIs compared to nonInmates b. Non-inmates have disproportionately high rates of STIs compared to Inmates c. Inmates have proportionally appropriate rates of STIs compared to noninmates d. Inmates have equal rates of STIs compared to non-inmates Correct Answer: a (page 569) 23. Which of the following terms is used to describe “a program-planning process that applies commercial marketing concepts and techniques to promote voluntary behavior change”? a. Needle exchange programs b. Harm reduction programs c. Social marketing programs d. Capacity building programs Correct Answer: c (page 571) 24. Timothy is working to increase the ability of his clients to promote their sexual health. What is Timothy engaging in? a. Harm reduction b. Capacity building

c. Social marketing d. Health protection Correct Answer: b (page 572) 25. Sangeeta is a community health nurse who works with clients who are at increased risk of obtaining blood-borne pathogens. Why do blood-borne pathogens need special consideration? a. Because they are only transmitted via using unclean needles b. Because they are only transmitted via sexual intercourse c. Because they are not solely transmitted by sexual activity d. Because they are only transmitted via blood transfusions Correct Answer: c (page 565) Short Answer Questions 26. Describe four areas that influence clients to be unable or unwilling to prevent the spread of HIV. Give two specific examples related to each area that a CHN might see in practice. Discuss one type of program that CHNs may be involved in to support these clients' efficacy at implementing risk-reduction practices. Correct Answer: -

psychiatric deficits, e.g., fetal alcohol syndrome, mental illness

additions, e.g., injection drug use, alcohol use

social deficits, e.g., lack of housing, low education level

health deficits, e.g., lack of HIV knowledge, other chronic illnesses

CHN involvement-in comprehensive referral systems that provide housing and treatment fordeficits plus support (page 569)

27. Describe four innovative interventions that have been used in Canada to lower

the rates of STI. Provide one rationale for each intervention. Give an example of why each intervention has been controversial. Correct Answer: -

Needle exchange programs: clinics/vans/drop-off stations that provide injection drug users with free sterile injecting equipment to reduce their risk of injection. Rationale: minimize the harm of blood borne infections and provide opportunities for education. Controversy: supporting continued drug usage

Safer injection facilities: a place for drug users to inject their drugs with clean equipment under the supervision of trained professionals. Rationale: minimize the harm of blood borne infections, provide opportunities for education, minimize overdoses, increase safety of users. Controversy: condoning drug use as acceptable

Social marketing campaigns: poster campaigns that provide blatant and provocative messages to different target groups. Rationale: to create awareness, raise interest, and challenge ideas. Controversy: messages that may not be suitable or appreciated by everyone

Telehealth and web-based resources: sexual health websites to provide accurate, relevant, community-focused sexual health resources to a target audience. Rationale: increase people's access to information and resources. Controversy: consider diverse issues that some people don't want to acknowledge (page 570 – 572)

28. What does HPV stand for? How does HPV manifest and why is it important? How is HPV diagnosed? How is HPV prevented? Correct Answer: -

HPV: human papilloma virus; highly virulent viral STI, has 140 different strains

can cause abnormal cell changes on the cervix, some of which lead to cervical cancer. Can show up as genital warts (cauliflower-like growth anywhere on the

genital/anal area) -

important because it is the cause of cervical cancer

can have more than one type of HPV

diagnosed through abnormal changes on cervical Pap tests and genital warts are diagnosed on visual exam. Blood tests are in development to test for certain strains

some prevention from condom use (although limited if any genital contact is involved)

main prevention is through HPV vaccination (page 573)

29. List 4 social marketing campaigns that have been used to decrease the rates of sexually transmitted infections Correct Answer: Vagfluenza Dickgitis Don’t you get it Plenty of Syph (page 571) 30. What is the purpose of safer injection facilities (SIF)? Correct Answer: -

They provide a safe location for drug users to inject their own drugs with clean equipment under the supervision of medically trained professionals

SIFs aim to decrease the spread of infectious disease, improve contact between the health care system and injection drug users, decrease the use of drugs in public places, decreased fatal and non -fatal overdoses, and increase enrolment of injection drug users into addiction treatment and rehabilitation programs (page 570)

Chapter 32: Emergency Preparedness and Disaster Nursing Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1. What is essential for nurses to have in order to respond effectively in a disaster situation across different communities? a. Some information on disaster planning b. Recognition that each disaster is similar c. Specific expertise in emergency management d. An effective disaster plan Correct Answer: c (page 579) 2. What statement is correct as it relates to natural disasters? a. Their impacts can sometimes be mitigated b. They always happen quickly c. They include infectious diseases d. They are predictable Correct Answer: a (page 579) 3. Using the Canadian Disaster Database, what is the most common disaster in Canada? a. Fuel spills b. Tsunamis c. Tornadoes d. Cold waves Correct Answer: a (page 579) 4. The Canadian government adopted NIMS in 2004 as a framework for all levels of government in Canada to develop emergency response plans. What does NIMS stand for and who developed it? a. National and International Model for Security, United Kingdom b. National Incident Management System, United States c. Natural Incident Modelling Sphere, Canada d. National Information and Military System, United Nations Correct Answer: b (page 582)

5. Which of the following Canadian disasters claimed the most lives? a. 1998 Peggy's Cove, Nova Scotia, aircraft crash b. 1918-1925 across Canada, Spanish influenza c. 1927 Newfoundland, hurricane d. 2003 Toronto, Ontario, SARS Correct Answer: b (page 579) 6. In Canada, at what level of government are emergency management and preparedness responses initiated? a. Coordinated through Emergency Management Agency b. Provincial/territorial c. Federal d. Municipal Correct Answer: d (page 580) 7. A nurse is attending a classroom exercise on disaster management. What stage of the emergency management programming is this exercise? a. Preparedness b. Response c. Prevention d. Mitigation Correct Answer: c (page 581) 8. Using the Incident Management System, what is an example of an operations function during a pandemic influenza? a. Conducts mass immunization of the general public b. Identifies objectives and develops action plans c. Procures supplies and physical space d. Ensures that purchasing of supplies is completed in a timely manner Correct Answer: a (page 582) 9. What would be an example of a technological man-made disaster? a. The 2001 anthrax-contaminated letters sent to news media offices b. The 2010 eruption of the volcano in Iceland c. Hurricane Katrina levee failure in 2005

d. Peggy's Cove airline crash in 1998 Correct Answer: d (page 580) 10. What is an example of an activity that a nurse would undertake in Phase II of the Jennings Model? a. Assess victims of a disaster for serious mental illness b. Coordinate community services to assist residents in their personal recovery c. Provide the public with information on how to make a disaster survival kit d. Implement infection control measures during the recovery operation Correct Answer: a (page 587) 11. The Public Health Agency of Canada devised criteria for the order in which the public would receive the H1N1 flu vaccine during the pandemic. What principle was used in responding to this situation? a. Medical triage b. Surge capacity c. Public health triage d. Public health surge interventions Correct Answer: c (page 584) 12. What is the name of the organization that provides assistance to countries in disaster planning and has policies that condemn violations of human rights commonly seen during and after a disaster? a. World Bank b. International Council of Nurses (ICN) c. International Union of Health Promotion and Education (IUHPE) d. Public Health Agency of Canada (PHAC) Correct Answer: 13. The listeriosis outbreak in 2008 linked to deli meats produced at a Maple Leaf plant in Ontario was a significant public health event. How what this situation dealt with? a. School children were told not to bring deli meats to school b. Supermarkets were asked to pull all deli meats off shelves c. The management of food-borne outbreaks were improved

d. Doctors’ offices were asked to follow news stories Correct Answer: c (page 583) 14. “Learning from SARS: Renewal of Public Health in Canada: A Report of the National Advisory Committee on SARS and Public Health” is known as which of the following? a. The Naylor Report b. The Romanow Report c. The Taylor Report d. The Lalonde Report Correct Answer: a (page 583) 15. There should be one common emergency response system “to bring an orderly, consistent, and flexible chain of command and control within an emergency response”. This would help build what type of a model to establish infection control networks and standards, improve emergency preparedness, develop a communications infrastructure, and enhance surveillance? a. A traditional biomedical model b. A screening and surveillance model c. A cohesive public health model d. An acute healthcare model Correct Answer: c (page 584) 16. Which of the following is the largest group of health care professionals who must play pivotal advocacy and leadership roles to facilitate agency-specific, community-wide preparation for health-related emergencies and disasters? a. Physicians who work in the community b. Resident physicians who work in acute care c. Registered nurses who work in the community health d. Registered nurses who work in acute care Correct Answer: c (page 584)

17. A small city in Canada has experienced and earthquake. Shemila is a community health nurse who is involved in measuring the overall impact of the disaster to organize the coordination of community services. What phase of the Jennings Disaster Nursing Management Model is Shemila working in? a. Phase 1 b. Phase 2 c. Phase 3 d. Phase 4 Correct Answer: d (page 587) 18. Cheveyo is a community health nurse who is working with community stakeholders on his reserve to plan for any long term health concerns following a flood in his community. What phase of the nursing process is Cheveyo working in? a. Planning b. Preparedness c. Response d. Recovery Correct Answer: a (page 589) 19. Cheveyo is a community health nurse who is working with community stakeholders on his reserve to conduct an evaluation of the long-term impact of the flood on the whole community. What phase of disaster is Cheveho working in? a. The phase that involves assessing resources and risks to plan for primary prevention b. The phase in which nurses need to work in multiple roles to improve the health of victims c. The phase in which nurses implement secondary prevention initiatives d. The phase in which nurses organize community services to help residents in their recovery Correct Answer: d (page 589)

20. Which of the following terms is used to describe the “healthcare systems ability to expand quickly beyond normal services to meet an increased demand for medical care in the event of bioterrorism or other large-scale public emergency”? a. Public health triage b. Medical triage c. Surge capacity d. Increased capacity Correct Answer: c (page 587) 21. In some provinces in Canada, emergency management programming is organized into five stages. Which of the following terms below is one of these five stages? a. Planning b. Mitigation c. Evaluation d. Surveillance Correct Answer: b (page 585) 22. The Public Health Agency of Canada and Public Safety Canada work with the provincial and territorial governments to coordinate a unified response to any national public health emergency. When was the Public Health Agency of Canada established? a. November 2001 b. February 2005 c. September 2004 d. June 2004 Correct Answer: c (page 584)

23. In 2000 there was a public health emergency in Walkerton Ontario. What was this public health emergency? a. E-coli contaminated the town’s water supply b. Listeriosis outbreak at the Maple Leaf plant c. SARS outbreak at the local hospital d. Pandemic H1N1 flu virus hit seniors homes Correct Answer: a (page 583) 24. Which of the following terms is used to describe the intentional use of a microorganism to cause infection or death? a. An epidemic b. Man-made disaster c. Bioterrorism d. A pandemic Correct Answer: c (page 580) 25. There are four categories of national emergency. Which of the following is one of these? a. Private order emergencies b. International emergencies c. A state of turmoil d. Internal emergency Correct Answer: b (page 581)

Short Answer Questions 26. A team of nurses and other emergency professionals are working with an Incident Command System (ICS) during a large train wreck outside their medium-sized community. What is the ICS and what does it do? Where, when, and why was it developed? Correct Answer: -

ICS is a standardized, on-scene incident management concept designed specifically to allow public health officials to respond efficiently in an emergency situation by implementing an organized and integrated response across jurisdictional boundaries, irrespective of the nature of the emergency.

ICA was developed in the early 1970s in California to assist firefighters in responding to any size or type of wildfire emergency. (page 582)

27. Discuss the four categories of a national emergency and give an example for each. Correct Answer: -

Public welfare emergencies: natural disaster or accident beyond the authority of the province/territory, e.g., Quebec ice storms

Public order emergencies: serious security threat to the nation, e.g., terrorist bombing of a large city

International emergencies: arising from acts of coercion or intimidation or serious use of force or violence, which threaten Canada, e.g., 9/11 in the United States

A state of war: either active or imminent involving Canada or its allies, e.g., World War II (page 581)

28. An industrial community has a higher risk of having a hazardous materials disaster. Describe the three phases of such a potential disaster according to Jennings Disaster Nursing Management Model. Give an example related to community health nursing for each phase. Correct Answer: -

Pre-disaster: prevention, mitigation, and preparedness. Plans are developed, people are trained and educated, and the public is informed. CHN e.g., CHNs can educate families about personal preparedness plans

Disaster occurs: includes a warning that a disaster is imminent, the actual impact of the disaster, and the response to the disaster through nursing care, education, and case management. CHN e.g., CHNs may work at a walk-in clinic or evaluation shelter doing first aid and crisis interventions.

Post-disaster: focus is on tertiary prevention through assessment, planning, and implementation. CHN e.g., CHNs will apply infection control measures.

Positive client/population outcomes: measure the overall impact and plan for recovery and rehabilitation. The whole disaster response is evaluated and the plan improved. CHN e.g., CHNs may take part in evaluating the impact of the disaster on the community. (page 587)

29. List and describe the five components of the Incident Management System (IMS) structure. Correct Answer: -

See Table 32.2 on page 582

30. List and describe the key components of the Emergency Preparedness Standard and Protocol. Correct Answer: -

Identifying and assessing the relevant hazards and risk to public health

Developing a continuity of operations plan

Developing an emergency response plan utilizing the IMS

Developing and implementing 24/7 notification protocols for communications with staff, community partners and government bodies

Increasing public awareness regarding emergency preparedness activities

Delivering emergency preparedness and response education and training for board of health staff and officials

Exercising or testing the continuity of the operations plan, the emergency response plan, and the 24/7 notification protocols (page 585-586)

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Chapter 33: Global Health Community Health Nursing A Canadian Perspective 5th Edition Stamler

Multiple Choice Questions 1. What term best describes the statement "a constellation of processes by which nations, businesses, and people are becoming more connected and interdependent via increased economic integration, communication exchange, and cultural diffusion"? a. World health b. Globalization c. World trade d. Global village Correct Answer: b (page 594) 2. There is strong evidence indicating that most of the global burden of disease are caused by which of the following? a. Political instability b. Nurse migration c. Social determinants of health d. Global health diplomacy Correct Answer: c (page 594) 3. A nurse is working for a non-profit health agency in Afghanistan. The nurse is working with a multidisciplinary team on the Sustainable Development Goals (MDG). What goal will be particularly difficult to achieve in the context of this country? a. Improved communication b. Recruitment of qualified nurses c. Gender equality d. Environmental sustainability Correct Answer: c (page 597) 4. A nurse is working for a non-profit health agency in Afghanistan. What is a significant challenge for majority countries like Afghanistan in achieving "Health for All" as a result of globalization?

a. Partnerships with the West b. Nurse migration c. Use of traditional healers d. Attaining peace Correct Answer: b (page 600) 5. A nursing instructor is teaching a class about global citizenship. What statement is consistent with the concept of narrative imagination? a. Believing that all people have the same status b. Having the ability to envision what it might be like to be a person different from oneself c. Having the ability to scrutinize one's own beliefs and customs d. Understanding that all persons are fellow citizens who have equal moral worth Correct Answer: b (page 605) 6. A group of nurses from Alberta are doing research on the effects of the 2010 tsunami in Indonesia. The nurses want to make sure their research is consistent with the principle of solidarity. What initiative would support this principle? a. Invite a nurse from Indonesia to be a part of the research team b. Vent the research proposal through an ethics committee c. Seek direction from the host country in the development of the survey questions d. Familiarize the research team with the political and human rights issues of Indonesia Correct Answer: a (page 607) 7. A group of nurses from Alberta are doing research on the effects of the 2010 tsunami in Indonesia. The nurses are conscious of the principle of introspection. Which question would best help the research team to consider this principle? a. What is the motivation for doing this global health research? b. How will the indigenous views of health be included in this research? c. What sources of funding are available? d. Which methodology would be appropriate for this research study? Correct Answer: a (page 607)

8. A group of nurses from Alberta are doing research on the effects of the 2010 tsunami in Indonesia. The nurse researchers are concerned about the potential exploitation of the study participants while obtaining informed consent. What strategy would be best at addressing potential exploitation? a. Have the research proposal approved by an in-country ethics committee b. Review and renew consent prior to each interaction c. Make sure that research outcomes are shared with the Indonesian community d. Tie research to the achievement of the Millennium Development Goals (MDG) Correct Answer: b (page 607) 9. A group of nurses from Alberta are doing research on the effects of the 2010 tsunami in Indonesia. What theoretical perspective would the research team use to guide their research? a. Postcolonial feminism b. Critical gender c. The nursing process d. Neolibralism Correct Answer: a (page 606)

10. What is the identified percentage gap between research funding and the investigation done on health problems affecting the world's population? a. 60/40 b. 30/70 c. 90/10 d. 20/80 Correct Answer: c (page 607) 11.

Which of the following statements is true about globalization? a. Globalization does not result in advances in technology b. Globalization has decreased disparities in access to resources c. Globalization results in those with power having less

d. Globalization has increased disparities in health around the world Correct Answer: d (page 594) 12. Hasan is a community health nurse working in global health. What an important action for Hasan to take? a. Give voice to vulnerable population b. Discuss issues with experts in global health c. Dominate discussions as he sees fit d. Assess the best way to help nurses migrate Correct Answer: a (page 594) 13. Which of the following is part of the five global factors that affect health according to the Bangkok Charter of the World Health Organization? a. Increased political change b. Global environmental change c. Increased movement to rural areas d. Decreasing inequality within countries Correct Answer: b (page 594) 14. Which of the following terms is used to describe an areas for study, research, and practice that places a priority on improving health and achieving equity for all people worldwide? a. Political activism b. Globalization c. Global health d. Global citizenship Correct Answer: c (page 595) 15. Which document was the first to identify the need for urgent action for all governments, all health and development workers, and the world community to protect and promote the health of all people around the world? a. The Millennium Development Goals b. The Sustainable Development Goals c. The Bangkok Charter for Health Promotion d. The Declaration of Alma-Ata

Correct Answer: d (page 597) 16. Which of the following is included as one of the Millennium Development Goals? a. Improving maternal health b. Increase child morbidity c. Achieve universal primary globalization d. Eradicating prosperity in rich countries Correct Answer: a (page 597) 17. Which of the following statements is true about the Sustainable Development Goals? a. The 12 thematic groups are research oriented b. The 12 thematic groups are solutions oriented c. The 12 thematic groups are poverty oriented d. The 12 thematic groups are environmentally oriented Correct Answer: b (page 597) 18. Which of the following terms is used to describe the learned, shared, and transmitted values, beliefs, norms, and life ways of a particular culture that guides thinking, decisions, and actions in patterned and often in intergenerational ways? a. Cultural relativism b. Homogenization c. Culture d. Hybridization Correct Answer: c (page 602) 19. Shyma is a community health nurse who values and honors all cultures equally. Which of the following is important to Shyma? a. Global health diplomacy b. Cultural pluralism c. Cultural hybridization d. Global citizenship Correct Answer: b (page 602)

20. Sherry is working with nursing students to become sensitized to their own culturally established perspectives on healthcare. What is Sherry working towards? a. Global health diplomacy b. Globalization and health c. Critical social reflection d. Global citizenship Correct Answer: d (page 604) 21. Sherry is working with nursing students to develop their capacity for global citizenship. She is discussing the pros and cons of adopting the fundamental view of all people as fellow citizens who have equal moral worth and deserve equal moral consideration. What capacity is Sherry is developing in the students? a. Moral reflexivity b. Moral cosmopolitanism c. Moral narrative imagination d. Moral health diplomacy Correct Answer: b (page 605) 22. Judith is a community health nurse who is teaching her students that when working in global health, it is important to recognize one’s limitations and being open to learning from all sources. Which ethical principles is Judith instilling in her students? a. Introspection b. Solidarity c. Equity d. Humility Correct Answer: d (page 607)

23. Judith is a community health nurse who is teaching students that when working with people from other cultures, it is important to reject assumptions of superiority of one’s culture. What term is used to describe this concept that Judith is teaching? a. Cultural relativism b. Cultural pluralism c. Cultural homogenization d. Cultural hybridization Correct Answer: a (page 602) 24. Charlene is working with women from Somalia who have experienced female genital mutilation (FGM). Why might these Somali women experience stigmatization from people who do not understand their culture? a. Because the long term consequences of FGM are not understood b. Because Western discourse has identified FGM as harmful c. Because Charlene needs to make all Canadians aware of the practice d. Because the Somali women did not protest this cultural practice Correct Answer: b (page 603) 25. Which of the following perspectives proposes that global cultures are becoming increasingly dichotomized around Western and non -Western ways of life? a. Homogenization b. Hybridization c. Polarization d. Global citizenship Correct Answer: c (page 603)

Short Answer Questions 26. Compare global health with international health in terms of geographical reach, level of co-operation, individual or population, access to health, and range of disciplines. Correct Answer: -

See Table 33.2 on page 569

27. Identify the health outcome indicators for the Millennium Development Goal of combating HIV/AIDS, malaria, and other diseases. Correct Answer: -

A decrease in HIV prevalence among pregnant women aged 15-24 years

Condom use at last high-risk sex

Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years

Decrease in prevalence and death rates associated with malaria

Proportion of population in malaria-risk areas using effective malaria prevention and treatment measures

Decrease in prevalence and death rates associated with tuberculosis

Proportion of tuberculosis cases detected and cured under Direct Observation Treatments (DOTs) (page 598 -599)

28. Define the term global citizenship, describe the three necessary capacities, and provide an example of how a nursing student can enact these capacities. Correct Answer: -

Global citizenship: calls for all persons across the globe to extend their thinking about moral responsibility and health beyond their local communities and national citizenship and to become citizens of the world.

Three capacities: -

Reflexivity: the capacity to examine ourselves; involves scrutinizing our traditions, beliefs, and habits to ensure they are consistent and justifiable. e.g., A nursing student becomes more aware of own beliefs about health care and is better able to challenge underlying values and assumptions about their education, nursing practice, and the health care system.

Moral cosmopolitanism: adopting a fundamental view of all persons as fellow citizens who have equal moral worth and deserve equal moral consideration. e.g., A nursing student going on an international field school will show respect and concern for the people of that country regardless of their economic, social, or political position in their society.

Narrative imagination: the ability to imagine what it might be like to be a person different from oneself, and to allow such imagination to inform understanding of others' experiences, emotions, desires, and life stories. e.g., A nursing student is exposed to another culture during a field school and is now better able to understand that cultural group's experiences. (page 604-605)

29. The Bangkok Charter of the World Health Organization (2005) identifies five global factors that affect health. List these five factors Correct Answer: -

Increasing inequalities within and between countries

New patterns of consumption and communication

Commercialization

Global environmental change

Urbanization (page 594)

30. List 5 of the 17 Sustainable Development Goals Correct Answer: -

End poverty in all its forms everywhere

Achieve gender equality and empower all women and girls

Ensure sustainable consumption and production patterns

Ensure availability and sustainable management of water and sanitation for all

Ensure healthy lives and promote well-being for all, at all ages (page 600)

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