Community Health Nursing A Canadian Perspective 4th Edition by Lynnette - Test Bank

Community Health Nursing A Canadian Perspective 4th Edition by Lynnette – Test Bank

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Sample Questions Posted Below

 

1. What is a discourse according to Lupton?
a.

Disorderly extended expression about social systems

b.

A dialogue that has a major role in shaping relations of power and what is valued in society

c.

A patterned system that can be identified in communications and located in social structures

d.

A course of action that moves people away from health
2. A nurse is practising within a systems view of health. What statement reflects the nurse’s belief about health?
a.

Created primarily through biological conditions

b.

A resource for preventing illness and injury

c.

Conceptualized as interrelated and integrated

d.

The absence of disease
3. Which statement best illustrates a view of health from the population health perspective?
a.

Health is a state of static interrelatedness and disintegration.

b.

Health involves refinements to achieve a perfectly functioning body.

c.

Health is the capacity of people to adapt to or respond to life’s challenges.

d.

Health is the object of living for the population as a whole.
4. What model is primarily used by governments to fund health care in Canada?
a.

Social determinants model

b.

Systems model

c.

Process model

d.

Medical model
5. Which is the best predictor of an individual’s health?
a.

Alcohol consumption

b.

Yearly income

c.

Cardiac risk factors

d.

Smoking status
6. What is perceived by many community health nurses (CHNs) to be the key to health care reform?
a.

Increases in health spending

b.

Privatization of service delivery

c.

Primary health care

d.

Universal health care insurance
7. What approach would a nurse who is practising within a systems view of health use?
a.

Identifying problems and finding solutions to health issues

b.

Building trusting relationships and fostering clients’ strengths

c.

Predicting the causes of health events

d.

Guarding the social order to ensure health
8. What population health model would most likely be used in a prenatal outreach program for young pregnant teens?
a.

Upstream

b.

Downstream

c.

Side-stream

d.

Mid-stream
9. When did health emerge as a central concept for nursing?
a.

After the Lalonde Report

b.

In the Ottawa Charter of Health Promotion

c.

In the Canadian Nurses Association founding bylaws

d.

In Florence Nightingale’s writings
10. What consistent theme would emerge if a nurse interviewed professionals and lay people about their definition of health?
a.

Health is more than the absence of disease and is an objective state.

b.

Health is desirable because it encompasses positive qualities.

c.

Health is a state of well-being that is easily defined.

d.

Health as a concept has always been embraced by medicine.
11. Jenna, 24 years old, is a single parent of two young children. She is unemployed, lives in subsidized housing, and has type 1 diabetes. What is the most significant social determinant of health for this family?
a.

Gender

b.

Housing

c.

Income

d.

Diabetes
12. What was proposed in the Ottawa Charter document?
a.

Five major strategies for promoting health

b.

The family as the focus of health promotion efforts

c.

The health-field concept of health

d.

Health promotion as a science dominated by nursing
13. A community health nurse recognizes that broad contextual factors, such as family, influence health. What health promotion perspective does this nurse use?
a.

Biomedical

b.

Lalonde approach

c.

Ecological

d.

Population health
14. A community health nurse is writing a funding proposal that seeks to explore alternatives to the medical model. What argument would the nurse use to critique the medical model?
a.

Does not make a healthy society

b.

Serves the needs of society

c.

Is based on prevention

d.

Illuminates the political conditions that support health
15. What description is consistent with the “unfolding fulfillment” theme used to describe the lived experience of health and disease from the lay perspective?
a.

One experiences wholeness and an accompanying attachment to the world.

b.

When one is healthy there is sparkle and animation.

c.

When healthy, one has a sense of harmony and balance.

d.

Engaging with life’s challenges is meaningful.
16. A nurse has received funds to create a heart health project. Which project has the most potential benefit?
a.

Delivering a heart health education session to a group of lawyers and executives

b.

Counselling middle-aged married women to maintain a healthy weight through menopause

c.

Encouraging men in a seniors’ residence to quit smoking

d.

Working together with a single mothers’ support group to assist women as they return to work
17. A community health nurse working in a remote northern community has noticed a sharp increase in the number of teens coming to the clinic with sexually transmitted infections (STIs). What strategy is an example of a mid-stream approach to the increased incidence of STIs?
a.

Schedule more nurses to work at the clinic to handle the increased caseload.

b.

Have a condom machine installed in the washrooms at the high school.

c.

Hold an educational session with the students on STIs.

d.

Provide each individual with the appropriate medication to treat the STI.
18. What activity is an example of an upstream approach to health promotion?
a.

A bike safety program for school-aged children in the elementary schools throughout the community

b.

Rehabilitation for a child who experienced a traumatic brain injury due to a bicycle/vehicle collision

c.

A local bike store sponsoring a bicycle-handling skills competition for adolescents

d.

Bike helmet legislation with the provision of a free bike helmet to all children under 18 years of age
19. The Novak family includes Jim, age 40; Brenda, age 39; Tim, age 18; and Lisa, age 15. Jim is a high school dropout and works as long-distance truck driver. Brenda has a high school education and works part time for the postal service. What social determinant of health would have the greatest impact on the development of life-threatening illnesses for this family?
a.

Education levels

b.

Place of residence

c.

Poverty

d.

Culture
20. Which understanding of health is primary health care based on?
a.

Traditional

b.

Ecological

c.

Biological

d.

Medical
21. Define and contrast the medical model and the systems view of health.
22. Provide three rationales for why gender is a critical determinant of health, and give a related example from community health nursing practice for each rationale.
23. Discuss three reasons why it is important for CHNs to be aware of the various discourses on health.
24. Ben is a 50-year-old man who works part time in construction. His common-law partner, Joanne, is 47 years old and works full time at a large box store. They have one child, JP, age 25, who is going to a local college to become a plumber. Ben and Joanne have been together for 25 years. They live in a small duplex in an older working-class neighbourhood. Joanne has recently been diagnosed with lung cancer. Ben has been a smoker since leaving home at age 14. Joanne’s mother died of lung cancer and her father died of emphysema. Ben and Joanne moved to Alberta from eastern Canada three years ago to find work and have no family, but they do have a large group of friends from “back home.”

Describe the factors that influence the health of the above family, using five factors from a medical model and five factors from a systems view.

Activity Name: Chapter 05 

1.

c. A patterned system that can be identified in communications and located in social structures

Learning Objective:

Chapter 5 Multiple Choice Questions

Feedback:

Correct: This is Lupton’s definition of discourse.
Incorrect: This is an inaccurate definition of discourse.
Incorrect: This statement reflects the definition of discourse used in the philosophical literature.
Incorrect: Lupton did not define discourse in this way.

Hints:

2. c. Conceptualized as interrelated and integrated
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: This is a description of the medical model of health.
Correct: The systems view of health is a state of complete physical, mental, and social well-being that is conceptualized in terms of dynamic interrelatedness and integrated.
Incorrect: This is a medical model view of health.
Incorrect: This description is similar to the medical model view of health.
Hints:
3. c. Health is the capacity of people to adapt to or respond to life’s challenges.
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: Health, from a systems point of view, is seen in terms of dynamic interrelatedness and integration.
Incorrect: This is a medical model perspective of health.
Incorrect: The population health approach does not view health in this way. Health is a resource for everyday living, not the objective of living.
Correct: This is the definition of health from the population health approach.
Hints:
4. d. Medical model
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: The systems model is not used to fund health care in Canada.
Incorrect: Many health researchers argue that the social determinants of health model should be used to fund health care, but this is not current practice.
Correct: Canadian governments prioritize the funding of health care based on the medical model.
Incorrect: This is not a model the Canadian government uses to fund health care.
Hints:
5. b. Yearly income
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Correct: The social determinants of health such as socioeconomic status are key predictors of health.
Incorrect: Although smoking definitely has a negative effect on health, large-scale studies point to poverty, income, place of residence, and education levels, rather than medical and lifestyle factors, as better predictors of individuals’ health.
Incorrect: This is not the best predictor of an individual’s health.
Incorrect: Although alcohol has a negative effect on health, it is income that is the best predictor of an individual’s health.
Hints:
6. c. Primary health care
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: This is not the solution to reforming health care.
Correct: Primary health care (PHC) is perceived to be the key to reforming a health care system.
Incorrect: Privatization of health care is not the approach supported by CHNs.
Incorrect: Canada has universal health care insurance, but the coverage is based on the medical model and not primary health care.
Hints:
7. b. Building trusting relationships and fostering clients’ strengths
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: This is a medical model approach.
Incorrect: This is not systems view of health.
Correct: A nurse using the systems view of health will be focused on capacity-building social and economic relationships, including the relationship between practitioner and client.
Incorrect: A nurse working in a systems view of health will not try to predict causes of health events.
Hints:
8. d. Mid-stream
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: A downstream approach is focused on the medical model.
Incorrect: A population health model does include an upstream approach for dealing with macro-level issues like policy development.
Incorrect: There is no such thing as a side-stream approach to population health.
Correct: A mid-stream approach of population health is at the community level and would be the appropriate approach to use for a prenatal program.
Hints:
9. d. In Florence Nightingale’s writings
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Correct: Health emerged as a central concept for nursing in the writings of Florence Nightingale.
Incorrect: The Ottawa Charter of Health Promotion was written in 1986.
Incorrect: The Lalonde Report on health was written in 1974.
Incorrect: Florence Nightingale wrote about health long before the Canadian Nurses Association was founded.
Hints:
10. b. Health is desirable because it encompasses positive qualities.
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: Health is a state of well-being but has many definitions and is not easily defined.
Incorrect: Health from a medical model perspective is the absence of disease, and it is both objective and subjective.
Incorrect: Health as a concept has been embraced by many disciplines such as nursing, psychology, sociology, and lay perspectives.
Correct: What is agreed upon is that health is desirable and has positive qualities.
Hints:
11. c. Income
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: Place of residence is an important social determinant of health, but currently this family has appropriate housing.
Incorrect: Poverty, income, place of residence, and education levels are better predictors of an individual’s health than medical or lifestyle factors.
Incorrect: Gender is an important social determinant of health, but income has a more significant impact on health.
Correct: Socioeconomic status or income is the single most important determinant of individual health.
Hints:
12. a. Five major strategies for promoting health
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Correct: The five major strategies for promoting health in the Ottawa Charter are building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health services.
Incorrect: The health-field concept of health was proposed in the Lalonde Report.
Incorrect: The Lalonde Report advanced the idea of health promotion as a science.
Incorrect: This perspective is known as the ecological perspective of health promotion.
Hints:
13. c. Ecological
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: The biomedical perspective views health as the absence of disease.
Incorrect: In the population health approach, health is the capacity of people to adapt to, respond to, or control life’s challenges and changes.
Correct: An ecological perspective on health promotion reflects a systems view and does much to highlight broad contextual factors (such as family and culture) that influence health.
Incorrect: The Lalonde Report shifted the focus of a vision for the health of a population from illness care to health care and advanced health promotion as a science.
Hints:
14. a. Does not make a healthy society
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Correct: This is the argument used by many critics of the medical model.
Incorrect: It has been stated that the medical model obscures the political conditions that render society unhealthy.
Incorrect: Research has shown that the social determinants of health serve the needs of society better than the medical model.
Incorrect: The medical model is not based on prevention but is disease focused.
Hints:
15. d. Engaging with life’s challenges is meaningful.
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: This is abiding vitality.
Correct: This is unfolding fulfillment.
Incorrect: This is rhythmic connectedness.
Incorrect: This is transitional harmony.
Hints:
16. d. Working together with a single mothers’ support group to assist women as they return to work
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: To create the most benefit one needs to target a larger population than seniors living in a particular residence.
Incorrect: Again, this is a small sector of the population and for the program to have the most benefit it needs to reach low-income women.
Incorrect: The population focus is too narrow to have broad benefit.
Correct: Income is a strong predictor of individual health; therefore, supporting mothers to return to work helps not only the women but their children as well. Targeting this population will provide the most potential benefit.
Hints:
17. c. Hold an educational session with the students on STIs.
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: Mid-stream approaches address the root cause of the problem to promote population health. Installing a condom machine will not address the problem if the students don’t use the condoms. The teens need to understand how STIs are transmitted and how to prevent transmission.
Incorrect: Having more nurses work at the clinic is a downstream approach because this strategy focuses on treatment rather than on health promotion.
Incorrect: Downstream approaches focus on the individual and are oriented to treatment and cure.
Correct: Mid-stream approaches support community initiatives that create environments conducive to living healthfully, such as the sexual health program.
Hints:
18. d. Bike helmet legislation with the provision of a free bike helmet to all children under 18 years of age
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: A downstream approach has an individual focus oriented to treatment and cure.
Incorrect: This is not an example of a downstream, mid-stream, or upstream approach to health promotion.
Incorrect: Mid-stream approaches support at the community and organization level to create environments conducive to living healthfully.
Correct: An upstream approach focuses on healthy public policies, programs, and services that deal with macro-level issues of employment, education, and reimbursement mechanisms that affect everyone in a community (e.g., bike helmet legislation).
Hints:
19. a. Education levels
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: Poverty is a significant social determinant of health, but there is no indication in this scenario that the family lives in poverty.
Incorrect: Marmot (2007) found that culture had a significant impact on the development of life-threatening illnesses, but in this scenario there is no mention of the family’s culture.
Correct: Level of education is a strong predictor of individual health. The educational level of the parents is low.
Incorrect: There is no information provided about the place of residence.
Hints:
20. b. Ecological
Learning Objective:
Chapter 5 Multiple Choice Questions
Feedback:
Incorrect: The medical view of health is the absence of disease.
Correct: The ecological perspective reflects a systems view and does much to highlight broad contextual factors such as family and culture that influence health.
Incorrect: A traditional view of health is the biomedical model.
Incorrect: A biological view of health is similar to the medical model.
Hints:
21. Medical model-health is the absence of disease. Dominated our culture for 300 years. Has the power to influence massive activities and expenditures. Goal of health care is to diagnose malfunctioning of the human “machine” and “fix it.”

Systems view of health-health is a state of complete physical, mental, and social well-being, not merely the absence of disease and infirmity. Health is conceptualized in terms of dynamic interrelatedness and integration. Health is a resource for living, not the objective of living. Health is a dynamic process embedded in a web of relationships within which capacities for living are constructed.
Learning Objective:
Chapter 5 Essay Questions
Feedback:
Hints:
22. – Social determinants of health do not affect women and men in the same way-i.e., women are relatively disadvantaged compared to men, particularly in terms of income, education levels, and social status. CHN e.g., women after age 16 are less likely to be involved in recreational physical activities.
– Reduced funding to health and social services reduced job opportunities for women, created more unpaid care work by women, and reduced access to health care. CHN e.g., a CHN whose hours were reduced during cutbacks may also have to care for her aging parents because their home-support benefits were reduced.
– Low income is especially concentrated for women, particularly female-headed households. CHN e.g., 80% of lone mothers aged 16-24 live below the low-income cutoff, creating a poverty cycle for many of the young families a CHN works with.
Learning Objective:
Chapter 5 Essay Questions
Feedback:
Hints:
23. – provides a lens on health that CHNs can draw on as they perform their roles
– various views on health can be applied to or incorporated into practice
– allows CHNs to understand how various discourses shape health care practice
– provides alternative ways of doing things and ways of being as a CHN
– may explain the tension that CHNs often feel in their varied roles/functions
– allows the CHN to better understand the perspectives of colleagues, other professionals, community members, and clients
Learning Objective:
Chapter 5 Essay Questions
Feedback:
Hints:
24. Medical model
– Joanne developed lung cancer because of second-hand smoke.
– Ben’s addiction to cigarettes exposed Joanne to second-hand smoke for 25 years.
– Joanne most likely has a genetic predisposition to lung cancer.
– Ben’s addiction to cigarettes could have been cured with nicotine replacement therapy.
– Joanne’s lung cancer may be cured with surgery, radiation, and chemotherapy.

Systems view
– Joanne was more likely to develop lung cancer because she has a lower income, which limited her job opportunities and ecessitated the move to Alberta, which may have been very stressful for her and her family.
– Ben’s addiction to cigarettes most likely began in a family that smoked.
– Ben left home at age 15 possibly to escape a cycle of childhood poverty.
– Ben may have continued smoking to deal with the stress of poverty and difficult working conditions.
– Joanne may be in a stable, supportive relationship with Ben and has a large group of friends to offer support. Possibly she can connect with other women who have also had lung cancer.
Learning Objective:
Chapter 5 Essay Questions
Feedback:
Hints:

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