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Test Bank For Community Health Nursing Canada 2nd Edition By Stanhope
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Test Bank For Community Health Nursing Canada 2nd Edition By Stanhope
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WITH ANSWERS
Community Health Nursing Canada 2nd Edition Stanhope Test Bank
Stanhope: Community Health Nursing in Canada, Second Canadian Edition
Chapter 01: COMMUNITY HEALTH NURSING
Test Bank
MULTIPLE CHOICE
- Which of the following best describes community health nursing?
| a. | Focusing on the health care of individual clients in the community |
| b. | Giving care with a focus on the groups needs |
| c. | Giving care with a focus on the aggregates needs |
| d. | Working with an approach of unique client care |
ANS: A
By definition, community health nursing is the health care of individual clients in the community.
DIF: Cognitive Level: Knowledge REF: p. 2 OBJ: 1
TOP: CRNE Competency: Changes in Health
- Which of the following best describes primary health care?
| a. | A comprehensive way to address issues of social justice |
| b. | Giving care to manage acute or chronic conditions |
| c. | Giving direct care to ill individuals within their family setting |
| d. | Having the goal of health promotion and disease prevention |
ANS: A
By definition, primary health care is comprehensive and addresses issues of social justice and equity. Social justice in the context of health refers to ensuring fairness and equality in health services so that vulnerable individuals in society have easy access to health care.
DIF: Cognitive Level: Knowledge REF: p. 20 OBJ: 1
TOP: CRNE Competency: Health and Wellness
- The health of which of the following is the primary focus of public health nurses (PHNs)?
| a. | Families |
| b. | Groups |
| c. | Individuals |
| d. | Populations |
ANS: D
PHNs use knowledge of nursing, social sciences, and public health sciences for the promotion and protection of health and for the prevention of disease among populations.
DIF: Cognitive Level: Knowledge REF: p. 4, Table 1-1; p. 24
OBJ: 7 TOP: CRNE Competency: Health and Wellness
- Which of the following is the primary explanation for life expectancy increasing so notably during the twentieth century?
| a. | An increase in findings from medical laboratory research |
| b. | Incredible advances in surgical techniques and procedures |
| c. | Improved sanitation and other public health activities |
| d. | Increased use of antibiotics to fight infections |
ANS: C
Improvement in control of infectious diseases through immunizations, sanitation, and other public health activities led to the increase in life expectancy from less than 50 years in 1900 to more than 77 years in 2002.
DIF: Cognitive Level: Knowledge REF: p. 24 OBJ: 5
TOP: CRNE Competency: Health and Wellness
- Which community health nursing practice area receives funding from the private sector?
| a. | Telenurses |
| b. | Corrections nurses |
| c. | Nurse entrepreneurs |
| d. | Street or outreach nurses |
ANS: C
The nurse entrepreneur receives private funding, whereas all of the other community health nurse (CHN) roles are with provincially or federally funded positions.
DIF: Cognitive Level: Knowledge REF: p. 6, Table 1-1 Examples
OBJ: 7 TOP: CRNE Competency: Professional Practice
- Which of the following definitions reflects client as society?
| a. | Groups within a population working together on a defined activity |
| b. | Systems that incorporate the social, political, economic, and cultural infrastructure to address issues of concern |
| c. | People and the relationships that emerge among them as they develop and share environments |
| d. | A large group of people who have at least one characteristic in common and who reside in close proximity |
ANS: B
Systems that incorporate the social, political, economic, and cultural infrastructure to address issues of concern is the definition of client as society.
DIF: Cognitive Level: Knowledge REF: p. 7, Table 1-2
OBJ: 1 TOP: CRNE Competency: NurseClient Partnership
- A PHN strives to prevent disease and disability, often in partnership with other community groups. Which one of the following is an appropriate summary of the PHNs role?
| a. | The PHN asks the political leaders what interventions should be chosen. |
| b. | The PHN assesses the community and decides on appropriate interventions. |
| c. | The PHN uses data from the main health care institutions in the community to determine needed health services. |
| d. | The PHN works with community members to carry out public health functions. |
ANS: D
It is crucial that the PHN work with members of the community to carry out core public health functions.
DIF: Cognitive Level: Application REF: p. 25, How To box
OBJ: 7 TOP: CRNE Competency: Health and Wellness
- Which of the following is used as a measurement of population health?
| a. | Health status indicators |
| b. | Awareness of levels of prevention |
| c. | The number of memberships at the local fitness centre |
| d. | Reported provincial alcohol and tobacco sales in any given month |
ANS: A
The focus of community health nursing practice is disease prevention, which is broken down into three levels of prevention: primary, secondary, and tertiary.
DIF: Cognitive Level: Knowledge REF: p. 8 OBJ: 2
TOP: CRNE Competency: Changes in Health
- Ms. LeBlanc, BSc, registered nurse (RN), has just been employed as a CHN. Which of the following questions might be very relevant to her practice as she begins her position?
| a. | Which community groups are at greatest risk for problems? |
| b. | Which patients should I see first as I begin my day? |
| c. | With which physicians will I be collaborating most closely? |
| d. | Who is the nursing assistant to whom I can refer patients? |
ANS: A
CHNs apply the nursing process to the entire community; asking which groups are at greatest risk reflects a community-oriented perspective. The other possible responses focus on particular individuals.
DIF: Cognitive Level: Application REF: p. 20 OBJ: 8
TOP: CRNE Competency: Health and Wellness
- Whenever Ms. LeBlanc, BSc, RN, talks to the women at the senior citizens centre, she reminds them that the only way the centre will be able to afford a driver and a van service for those who cannot drive themselves is to continue to write letters to their local city council representatives, requesting funding for such a service. What is Ms. LeBlanc doing?
| a. | Ensuring that the women do not expect Ms. LeBlanc herself to do anything about their problem |
| b. | Demonstrating that she understands the womens concerns and needs |
| c. | Expressing empathy, support, and concern |
| d. | Helping the women engage in political action locally |
ANS: D
PHNs have an imperative to work with the members of the community to carry out public health functions.
DIF: Cognitive Level: Application REF: p. 25, How To box
OBJ: 7, 8 TOP: CRNE Competency: NurseClient Partnership
- Which one of the following is an example of the advocate role of the CHN?
| a. | Organizing home care support for a newly discharged older adult client |
| b. | Acting as a member of a community action group for provision of accessible transit choices |
| c. | Doing prenatal assessments |
| d. | Facilitating a self-help group for smoking cessation |
ANS: B
An advocate provides a voice to client concerns when acting as a member of a community action group for provision of accessible transit choices.
DIF: Cognitive Level: Application REF: p. 28, Table 1-6
OBJ: 7 TOP: CRNE Competency: Health and Wellness
- In which of the following scenarios is the PHN most probably fulfilling required employment responsibilities?
| a. | The PHN meets with several groups about community recreation issues. |
| b. | The PHN spends the day attending meetings at various health agencies. |
| c. | The PHN talks to several people about their particular health concerns. |
| d. | The PHN watches television, including a telecast of a city council meeting on the local cable station. |
ANS: B
Any of these might represent a PHN communicating, cooperating, or collaborating with community residents or groups about health concerns. However, the PHN who spends the day attending meetings at various health agencies is most probably fulfilling requirements effectively, since health is broader than recreation, individual concerns are not as important as aggregate priorities, and watching television is only one-way communication.
DIF: Cognitive Level: Synthesis REF: pp. 46, Table 1-1
OBJ: 8 TOP: CRNE Competency: Health and Wellness
- A CHN often has to make resource allocation decisions. In such cases, which of the following approaches will help the CHN to arrive at the decision?
| a. | Choosing a moral or ethical principle |
| b. | Choosing the cheapest, most economical approach |
| c. | Choosing the most rational outcome |
| d. | Choosing the needs of the aggregate, rather than the needs of a few individuals |
ANS: D
Although all of the answers represent components of the CHNs decision-making process, the predominant needs of the population outweigh the expressed needs of one person or a few people.
DIF: Cognitive Level: Application REF: pp. 2, 7 OBJ: 7, 8
TOP: CRNE Competency: NurseClient Partnership
- Which one of the following situations represents public health nursing?
| a. | Assessing the services and effectiveness of the school health clinic |
| b. | Caring for patients after their outpatient surgeries |
| c. | Giving care to schoolchildren at the school clinic and to the childrens families |
| d. | Treating paediatric patients at an outpatient clinic |
ANS: A
A public health or population-focused approach would consider the entire group of children receiving care, to see if services are effective in achieving the goal of improving the health of the school population.
DIF: Cognitive Level: Application REF: p. 25, How To box
OBJ: 7 TOP: CRNE Competency: Health and Wellness
- Which one of the following public health services represents primary prevention?
| a. | Developing a health education program about the dangers of smoking |
| b. | Providing a diabetes clinic for adults in low-income neighbourhoods |
| c. | Providing an influenza vaccination program in a community retirement village |
| d. | Teaching school-aged children about the positive effects of exercise |
ANS: C
Although all the services listed are appropriate and valuable, providing influenza vaccines to healthy adults represents the primary level of health prevention.
DIF: Cognitive Level: Application REF: p. 8 OBJ: 2
TOP: CRNE Competency: Health and Wellness
- What term is used interchangeably with the term subpopulations?
| a. | Groups |
| b. | Aggregates |
| c. | Clients |
| d. | Communities |
ANS: B
Generally, subpopulations are referred to as aggregates within the larger community population.
DIF: Cognitive Level: Knowledge REF: p. 8 OBJ: 1
TOP: CRNE Competency: NurseClient Partnership
- Which one of the following public health services represents secondary prevention?
| a. | Administering the influenza vaccine to a community of seniors |
| b. | Initiating an infant car seat safety screening program for parents in low-income housing |
| c. | Starting a rehabilitation clinic for middle-aged adults residing in low-income housing |
| d. | Setting up a support group for teenage mothers of infants with Down syndrome |
ANS: B
Secondary prevention seeks to detect disease early in its progressionfor example, through mass screening programs.
DIF: Cognitive Level: Application REF: p. 8 OBJ: 1
TOP: CRNE Competency: Health and Wellness
- Which type of thinking is most reflective of looking at a macroscopic, big-picture population focus?
| a. | Collaborative thinking |
| b. | Upstream thinking |
| c. | Holistic thinking |
| d. | Downstream thinking |
ANS: B
Upstream thinking uses a macroscopic, big-picture population focus, whereas downstream thinking is a microscopic, individual curative focus.
DIF: Cognitive Level: Knowledge REF: p. 9 OBJ: 1
TOP: CRNE Competency: Health and Wellness
- What were the first determinants of health as identified by the Lalonde Report in 1974?
| a. | Biology, lifestyle, health care, environment |
| b. | Resources, social justice, stable ecosystem, equity |
| c. | Biology, genetics, education, social supports |
| d. | Income, social status, education, health services |
ANS: A
The Lalonde Report first identified four determinants of health: biology, lifestyle, health care organization, and environment.
DIF: Cognitive Level: Knowledge REF: p. 15 OBJ: 3
TOP: CRNE Competency: Health and Wellness
- Which of the following ethical principles indicates that the CHN is ethically bound to do good within the limitations of time, place, and talent?
| a. | Justice |
| b. | Beneficence |
| c. | Nonmaleficence |
| d. | Distributive justice |
ANS: B
Beneficence is the ethical principle that states that CHNs are ethically bound to do good within the limitations of time, place, and talent.
DIF: Cognitive Level: Knowledge REF: p. 20 OBJ: 5
TOP: CRNE Competency: Professional Practice
- Which of the following is a requirement for reaching the goal health for all?
| a. | Self-actualization |
| b. | A system for health |
| c. | Elimination of lower- and upper-class categories |
| d. | Total compliance with immunizations and vaccines with all groups |
ANS: B
The requirements identified to reach the health for all goal include 1) basic needs, 2) belonging and engagement, 3) healthy living, and 4) a system for health.
DIF: Cognitive Level: Knowledge REF: p. 23 OBJ: 5
TOP: CRNE Competency: Health and Wellness
- Which of the following is the simplest definition of primary health care?
| a. | It is based on a multidisciplinary group of health care providers working as a team. |
| b. | It provides essential care that is universally accessible to persons in a community and encourages self-management, self-reliance, and competence. |
| c. | It focuses on health promotion and disease prevention among those who can afford to engage in behaviours that facilitate them. |
| d. | It is based on local efforts to meet the Declaration of Alma-Ata, known as Health for All. |
ANS: B
Primary health care is generally defined as essential care made universally accessible to individuals and families in a community with their full participation and at a cost that the community can afford.
DIF: Cognitive Level: Knowledge REF: p. 22 OBJ: 1
TOP: CRNE Competency: Health and Wellness
Stanhope: Community Health Nursing in Canada, Second Canadian Edition
Chapter 03: COMMUNITY HEALTH NURSING IN CANADA: SETTINGS, FUNCTIONS, AND ROLES
Test Bank
MULTIPLE CHOICE
- Which of the following best describes the concept of public health?
| a. | A population health approach designed to prevent disease, promote health, and protect populations |
| b. | Health care provision offered in primary and secondary institutions or in clients homes |
| c. | Provision of health care services in institutions located in the community but outside the hospital |
| d. | Use of the nursing process and evidence-informed practice to meet the objectives for community health improvement |
ANS: A
In Canada, public health takes a population health approach to protecting and promoting health and preventing disease for all Canadians. Public health nurses (PHNs) work with many partners, both within the public health unit or health authority (e.g., nutritionists, epidemiologists, dental hygienists, health inspectors) and external to the health unit (e.g., community coalitions for heart health, cancer screening, diabetes, and obesity prevention; school and hospital administrators; regional planners; social service and child-care workers; lobbyists for health issues such as antismoking legislation and homelessness).
DIF: Cognitive Level: Comprehension REF: pp. 7879 OBJ: 9
TOP: CRNE Competency: Health and Wellness
- The increasing complexity of societal needs and rapid changes in public health no longer allow adequate time for on-the-job training and education. As a result, which of the following is the current minimum level of educational preparation for a military nurse?
| a. | Training as a registered practical nurse |
| b. | Training as a registered nurse |
| c. | A baccalaureate degree in nursing |
| d. | A master of science degree in nursing |
ANS: C
Educational preparation for military nurses should be at least a baccalaureate degree.
DIF: Cognitive Level: Knowledge REF: p. 79 OBJ: 5
TOP: CRNE Competency: Professional Practice
- Which of the following is a core competency required of PHNs?
| a. | Advanced knowledge in the use of high-technology diagnostics |
| b. | Familiarity with current life-support technology |
| c. | Highly tuned skills for assessment of critically ill clients |
| d. | Skill in developing policy and planning programs to improve health |
ANS: D
Skill in developing policy and planning programs to improve health is part of the set of core public health competencies, which are divided into the following eight domains: 1) Public Health and Nursing Sciences; 2) Assessment and Analysis; 3) Policy and Program Planning, Implementation, and Evaluation; 4) Partnerships, Collaboration, and Advocacy; 5) Diversity and Inclusiveness; 6) Communication; 7) Leadership and Professional Responsibility; and 8) Accountability. The other competencies listed are better suited to nurses who work in tertiary facilities, such as hospitals.
DIF: Cognitive Level: Comprehension REF: p. 78, Box 3-5
OBJ: 3 TOP: CRNE Competency: Professional Practice
- A public health administrator is in the process of hiring a new PHN. Which of the following statements by a potential employee would raise the greatest concern for the employer?
| a. | I like to be the only person working on a project because individual team members have their own ideas and plans, and the resulting debate slows progress. |
| b. | I prefer to work in teams because no single person has too much responsibility and the burden is shared. |
| c. | Teamwork is better than work done by individuals because teamwork incorporates different perspectives. |
| d. | Whether teamwork is better than work done by individuals depends on the nature of the work being performed. |
ANS: A
Working in collaborative partnerships is an essential role of public health nursing. Partnerships and collaboration among groups are much more powerful in making changes than are the individual client and the PHN working separately. Part of the reason for this is that multiple perspectives are examined in the process of arriving at the best solution.
DIF: Cognitive Level: Analysis REF: pp. 7879 OBJ: 3
TOP: CRNE Competency: Professional Practice
- Which one of the following is a primary prevention activity for decreasing the incidence of communicable diseases?
| a. | Identifying and treating clients in a clinic for sexually transmitted infections (STIs) |
| b. | Partnering with school teachers to teach handwashing to elementary school children and observe their techniques |
| c. | Providing case management services that link clients with communicable diseases to health care and community support services |
| d. | Providing directly observed therapy (DOT) to clients with active tuberculosis (TB) |
ANS: B
An example of primary prevention is to educate daycare centres, schools, and the general community about the importance of hand hygiene to prevent transmission of communicable diseases.
DIF: Cognitive Level: Comprehension REF: p. 83, Levels of Prevention box
OBJ: 4 TOP: CRNE Competency: Health and Wellness
- A PHN is participating in which activity when tracing the sexual contacts of clients with STIs for screening purposes?
| a. | Primary prevention |
| b. | Secondary prevention |
| c. | Tertiary prevention |
| d. | Secondary and tertiary prevention |
ANS: A
Primary prevention activities include contacting and tracing individuals exposed to a client with an active case of TB or an STI. Once contact has been made, the actual screening is a secondary prevention activity.
DIF: Cognitive Level: Comprehension REF: p. 83, Levels of Prevention box
OBJ: 4 TOP: CRNE Competency: Health and Wellness
- Through which one of the following actions can the community health nurse (CHN) provide tertiary prevention?
| a. | Disseminating information about mental health to community organizations |
| b. | Partnering with PHNs for early identification of children with mental health challenges |
| c. | Providing case management services that link clients with serious mental illnesses to mental health and community support services |
| d. | Screening clients at high risk for mental disorders |
ANS: C
An example of tertiary prevention is the provision of case management services that link clients identified with serious mental illnesses to mental health and community support services.
DIF: Cognitive Level: Comprehension REF: p. 83, Levels of Prevention box
OBJ: 4 TOP: CRNE Competency: Health and Wellness
- Which of the following represents the primary difference between parish nursing and all other fields of nursing?
| a. | Affiliation with a church or congregation |
| b. | Incorporation of spiritual aspects into nursing care |
| c. | Provision of holistic nursing care |
| d. | Residence within the community of service |
ANS: A
Parish nurses are found in faith congregations, including communities that serve diverse cultures. Parish nurses also serve faith communities in other countries.
DIF: Cognitive Level: Comprehension REF: p. 75 OBJ: 9
TOP: CRNE Competency: Professional Practice
- To help congregation members better meet their nutritional needs, a parish nurse encourages them to participate in activities that focus on fellowship, as well as serving healthy meals to both attending and homebound church members. What do programs such as this exemplify?
| a. | Entitlement programs |
| b. | Health ministries |
| c. | Partnerships |
| d. | Pastoral care practices |
ANS: B
Health ministries comprise those activities and programs in faith communities that are organized around health and healing to promote whole health across the lifespan. Health ministries services may be specifically planned or informal and may include visiting the homebound, providing meals for families in crisis or for those returning home after hospitalization, organizing prayer circles, volunteering in community HIV/AIDS care groups, serving heart healthy church suppers, and holding regular grief support groups.
DIF: Cognitive Level: Comprehension REF: p. 76 OBJ: 9
TOP: CRNE Competency: Professional Practice
- As part of primary prevention, a parish nurse wants to encourage some elementary school students to increase their vigorous exercise. Which action by the parish nurse will help these students attain an improved health status?
| a. | Encouraging families to ensure that the students receive healthy diets and plenty of rest |
| b. | Fostering relationships among families with children of similar ages so that they can work together toward goal attainment |
| c. | Partnering with a youth pastor to establish sports activities that will include those individuals with special needs |
| d. | Working with faith-based school teachers to include in the curriculum teaching about healthy diet and food selection |
ANS: C
Parish nursings goal is to develop and sustain health ministries within faith communities. Some of the usual functions of parish nurses include providing personal health counselling and health education, acting as a liaison between the faith community and the local community, facilitating activities, and providing pastoral care.
DIF: Cognitive Level: Analysis REF: pp. 7677 OBJ: 4
TOP: CRNE Competency: Health and Wellness
- Which statement by a parish nurse exhibits a misunderstanding of the concept of pastoral care?
| a. | By working with my clients to help them identify their spiritual strengths, I am drawing on the pastoral care aspects of practice. |
| b. | I incorporate pastoral care in my practice when I involve the pastor in ministering to the members of the congregation. |
| c. | I am practising pastoral care when I emphasize the spiritual dimension of nursing while providing care. |
| d. | Lending support to clients during their times of joy as well as times of sorrow is part of providing pastoral care. |
ANS: B
Pastoral care by a parish nurse implies providing care by stressing the spiritual dimension of nursing, lending support during times of joy and sorrow, guiding the person through health and illness throughout life, and helping identify the spiritual strengths that assist in coping with particular events. The parish nurse is able to provide pastoral care; she or he does not have to involve the pastor.
DIF: Cognitive Level: Analysis REF: pp. 7677 OBJ: 9
TOP: CRNE Competency: Professional Practice
- Through which one of the following interventions can the parish nurse implement primary prevention of obesity in school-aged church members?
| a. | Establishing a walking program that is sufficiently challenging, yet not too strenuous, for those who are obese |
| b. | Partnering with youth camp cooks to ensure that a nutritious diet is provided |
| c. | Supervising height and weight measurements taken by clinic assistants |
| d. | Working with parents of obese children to implement lifestyle changes in the family |
ANS: B
An example of primary prevention is encouraging the provision of healthy snacks and meals to children and adults at all events inside and outside of school.
DIF: Cognitive Level: Comprehension REF: p. 77, Levels of Prevention box
OBJ: 4 TOP: CRNE Competency: Health and Wellness
- What is the basic difference between home health care and other types of health care?
| a. | Home health care is individualized care for the client and family. |
| b. | Home health care is provided in the clients environment. |
| c. | Reimbursement for home health care is different from that of care provided in institutions. |
| d. | Home health care focuses on community health. |
ANS: B
Home health care differs from other types of health care in that home health care providers practice in the clients environment.
DIF: Cognitive Level: Comprehension REF: pp. 6162 OBJ: 9
TOP: CRNE Competency: Professional Practice
- A CHN has just received word that the provincial health care plan will provide compensation for the care that she provided to a homeless man with schizophrenia, who was unwilling to come to the clinic to receive health care. How can this type of nursing service be best classified?
| a. | Community-oriented nursing |
| b. | Home health nursing |
| c. | Hospice nursing |
| d. | Private duty nursing |
ANS: B
Home health nursing is provided in the clients environment, wherever that may be. Home may be a house, apartment, trailer, boarding and care home, shelter, car, makeshift shelter under a bridge, or cardboard box.
DIF: Cognitive Level: Comprehension REF: pp. 6162 OBJ: 2
TOP: CRNE Competency: Professional Practice
- Which of the following is the best way a home health nurse (HHN) can help a client who has right-sided paresis secondary to a stroke?
| a. | Arranging for private duty nurses to assist the client with daily needs |
| b. | Assisting the client with activities of daily living (ADLs) |
| c. | Teaching self-care to the client |
| d. | Teaching the family to assist the client with ADLs |
ANS: C
Because home health care is often intermittent, a primary objective for the HHN is to facilitate self-care. This allows clients to have some control over their lives and activities and can help prevent hopelessness and a loss of self-esteem. Although assistance may be provided occasionally, this comes after helping clients help themselves.
DIF: Cognitive Level: Analysis REF: p. 64 OBJ: 3
TOP: CRNE Competency: Changes in Health
- An HHN in training states, I dont understand why we have to collaborate with so many other disciplines. Doesnt this conflict with the concept of holistic nursing practice? Which of the following statements would be the best response by an experienced colleague?
| a. | The nurse still functions holistically; however, interdisciplinary collaboration is necessary to prevent fragmentation of care. |
| b. | Holistic nursing is a concept applied to care in tertiary facilities such as hospitals, where materials are centrally located in one facility. In home health, this is not possible. |
| c. | Even though home health nursing is not as holistic as other areas of community health nursing, each discipline contributes to client needs from its special knowledge base. |
| d. | Yes, it does create conflict, but we as nurses are mandated to practise interdisciplinary collaboration. |
ANS: A
Home health nursing involves interdisciplinary care. Coordination of care provided by an interdisciplinary team is an essential indirect function of the HHN. Team conferences are an ideal time for enhancing collaboration and continuity of services for optimal client care and use of resources and services. Without effective collaboration, there would be no continuity of care and the clients home care program would be fragmented. This does not conflict with the concept of holism, however. Holism does not require that the HHN provide all services (i.e., direct client care). Many services, such as coordination of care, provide indirect care and contribute to holistic nursing care provision.
DIF: Cognitive Level: Analysis REF: p. 64 OBJ: 3
TOP: CRNE Competency: Health and Wellness
- A family member asks an HHN to explain the concept of hospice care. Which of the following actions would the HHN need to include as the fundamental underlying philosophy of hospice?
| a. | Making it possible for the client to die at home |
| b. | Ensuring that the clients living will is honoured |
| c. | Placing experts in the position of power of attorney |
| d. | Providing comfort measures before death |
ANS: D
Hospice care refers to the delivery of palliative care to the very ill and dying, offering both respite and comfort. If the client and family agree, hospice care can be comfortably delivered at home with family involvement under the direction and supervision of health care providers, especially a home health nurse.
DIF: Cognitive Level: Comprehension REF: p. 65 OBJ: 3
TOP: CRNE Competency: Changes in Health
- In an effort to prevent drug abuse among junior highschool students, a CHN has enlisted the assistance of high-school role models in the areas of both sports and scholarship for an antidrug presentation. Which level of prevention is represented by this activity?
| a. | Primary prevention |
| b. | Secondary prevention |
| c. | Tertiary prevention |
| d. | Both primary and secondary prevention |
ANS: A
CHNs partner with the community to develop programs in response to identified needs. Primary prevention interventions by the CHN include educating children and adolescents about the effects of illegal drugs (e.g., marijuana, cocaine, and heroin) and alcohol abuse. By educating students, the CHN helps them stay away from these harmful substances. It is not both primary and secondary because secondary prevention involves screening, which would not take place in this instance.
DIF: Cognitive Level: Application REF: p. 83, Levels of Prevention box
OBJ: 4 TOP: CRNE Competency: Health and Wellness
- The CHN has arranged for students in all classes at the local school to receive visual acuity testing to determine if they need glasses. Which level of prevention is represented by this activity?
| a. | Primary |
| b. | Secondary |
| c. | Tertiary |
| d. | Both primary and secondary |
ANS: B
CHNs implement screening programs for genetic disorders or metabolic deficiencies in newborns; breast, cervical, and testicular cancers; diabetes; hypertension; and sensory impairments in children. They also ensure follow-up services for clients with positive test results. Secondary prevention involves screening children for illnesses or conditions. In this instance, visual acuity testing is being used to screen for visual problems requiring corrective lenses.
DIF: Cognitive Level: Application REF: p. 83, Levels of Prevention box
OBJ: 4 TOP: CRNE Competency: Health and Wellness
- A CHN is demonstrating the use of a peak flow meter to help children with chronic asthma recognize when they need to use a rescue inhaler. Which level of prevention is represented by this activity?
| a. | Primary |
| b. | Secondary |
| c. | Tertiary |
| d. | Both primary and secondary |
ANS: C
CHNs provide case management services that link clients with chronic illnesses to health care and community support services. Tertiary prevention includes caring for children with long-term health concerns, such as asthma, and disabling conditions. At first glance, this appears to have elements of primary and secondary prevention, but this is not the case because primary prevention aims at ensuring that a condition does not develop (whereas these children already have the disease). Furthermore, although the children are being taught techniques for recognizing respiratory danger, it is in the context of disease management (i.e., when to use an inhaler).
DIF: Cognitive Level: Analysis REF: p. 83, Levels of Prevention box
OBJ: 4 TOP: CRNE Competency: Health and Wellness
- Which of the following is being implemented by the occupational health nurse (OHN) who removes a foreign body from a clients eye?
| a. | Primary care |
| b. | Primary prevention |
| c. | Secondary prevention |
| d. | Tertiary prevention |
ANS: A
The nurse is implementing primary care of the client. This action does not meet the criteria for injury prevention because the injury has already occurred and the OHN is providing treatment for the injury. Prevention strategies will need to follow treatment to prevent recurrence and to prevent development of secondary problems related to the foreign body.
DIF: Cognitive Level: Application REF: p. 73 OBJ: 4, 6
TOP: CRNE Competency: Health and Wellness
- Which of the following is being practised by the OHN who periodically conducts spirometry testing of employees working with hazardous gases?
| a. | Primary prevention |
| b. | Secondary prevention |
| c. | Tertiary prevention |
| d. | Tertiary care |
ANS: B
Secondary prevention involves health surveillance and periodic screening to identify an illness at the earliest possible stage and elimination or modification of the hazard-producing situation.
DIF: Cognitive Level: Application REF: p. 73 OBJ: 4
TOP: CRNE Competency: Health and Wellness
- An employee in a laboratory drops a flask, resulting in the chemical splashing into her eyes. Which of the following is the agent in this scenario?
| a. | Chemical |
| b. | Employee |
| c. | Flask |
| d. | Laboratory |
ANS: A
The agents, or factors associated with illness and injury, comprise occupational exposures that are classified as biological and infectious, chemical, ergonomic, physical, or psychosocial hazards.
DIF: Cognitive Level: Application REF: p. 70 OBJ: 8
TOP: CRNE Competency: Health and Wellness
- A hospital nurse working in employee health notes that several nurses from one unit are missing from work after having contracted a communicable disease from a client. In this scenario, which one of the following is the host?
| a. | Each sick nurse |
| b. | The communicable disease |
| c. | The hospital |
| d. | The client |
ANS: A
The host is described as any susceptible human being; each sick nurse represents a host within the worker population group.
DIF: Cognitive Level: Application REF: p. 70 OBJ: 8
TOP: CRNE Competency: Health and Wellness
- Which one of the following hazards tends to particularly affect employees who work in 2-week shifts?
| a. | Biological hazards |
| b. | Environmental hazards |
| c. | Physical hazards |
| d. | Psychosocial hazards |
ANS: D
Psychosocial hazards are factors and situations encountered or associated with ones job or work environment that create or potentiate stress, emotional strain, or interpersonal problems.
DIF: Cognitive Level: Comprehension REF: p. 70 OBJ: 8
TOP: CRNE Competency: Health and Wellness
- Which of the following is the primary role of the forensic nurse in Canada?
| a. | Health promoter |
| b. | Disaster planner |
| c. | Sexual assault nurse examiner (SANE) |
| d. | Outreach worker |
ANS: C
In Canada, forensic nurses primarily work as SANEs.
DIF: Cognitive Level: Knowledge REF: p. 83 OBJ: 9
TOP: CRNE Competency: Professional Practice
- From which of the following health care professionals is a rural resident with asthma more likely to receive health care services?
| a. | Allergist |
| b. | Nurse practitioner |
| c. | Pediatrician |
| d. | Pulmonologist |
ANS: B
In rural communities, often a health care professional may live and practise in a community for decades, also providing care to people who live in several other communities. A limited number of CHNs, such as PHNs or nurse practitioners, may offer a full range of services for all residents in a specified area, which may span more than 150 km. Consequently, rural physicians and CHNs provide care to individuals and families with all kinds of conditions, in all stages of life, and across several generations. In urban communities, residents are more likely to seek care from a medical specialist.
DIF: Cognitive Level: Comprehension REF: pp. 8889 OBJ: 10
TOP: CRNE Competency: Professional Practice
- In addition to the common barriers faced by most rural residents, which one of the following is an additional barrier to health care that a Mexican migrant farm worker is more likely to encounter?
| a. | Absence of culturally appropriate care |
| b. | Availability of specialists |
| c. | Distance of health care facilities from the place of residence |
| d. | Lack of anonymity |
ANS: A
Barriers to health care affecting all rural clients may be the availability, affordability, or accessibility of services and professionals. Two pertinent identified barriers to health care in rural areas are language barriers and lack of culturally appropriate care and services.
DIF: Cognitive Level: Comprehension REF: p. 90, Box 3-10
OBJ: 10 TOP: CRNE Competency: NurseClient Partnership
- For the CHN who plans to move from an urban centre to a rural region of the country, which one of the following statements should be included in the advice on preparing for role alterations?
| a. | Community members will probably hold you in higher regard and will look up to you. |
| b. | Expect to have less autonomy than you have working as a CHN in the city. |
| c. | You can expect more resources and supplies because there are fewer clinics. |
| d. | You will need to focus on developing specialized knowledge and skills. |
ANS: A
CHNs working in rural areas have a prestigious status in t
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