Additional +++ Flashcards
What is the CHN practicing when the primary focus is on populations that live in the community, as opposed to those that are institutionalized, and the emphasis is on strategies for health promotion, health maintenance, and disease prevention, the community health nurse is practicing which one of the following?
A. Population health
B. Public health
C. Primary care
D. Primary health care
B. Public health
Which of the following is considered to be the most important determinant of health?
A. Employment and working conditions
B. Health and social services
C. Personal health practices and coping skills.
D. Income and social status
D. Income and social status
• Income and social status is considered the strongest and most influential determinant of health. • Why? Because it affects everything else: • Your ability to afford food, housing, child care, education, transportation. • Your access to health services. • Even your ability to cope with stress—money might not buy happiness, but it sure buys therapy, meds, and a decent mattress.
Basically: if you’re broke, your health is statistically worse—and not because of “bad choices,” but because the structure of society makes it harder to stay healthy when you’re on the bottom rung
Tertiary prevention is which of the following:
A. Intervention that aims to interrupt the course of disease
B. A process of empowering people to increase control
C. Seeking to detect disease early in its progression
D. Measures taken to prevent the occurrence of disease.
A. Intervention that aims to interrupt the course of the disease.
Primary health care as a philosophy of care includes five principles. Employment of NP’s in under-serviced areas and the use of tele-health to respond to client health care concerns are examples of which of the following principles of primary health care?
A. Equitable distribution of essential health services to all populations
B. Emphasis on services that are preventative and promotive, rather than curative only.
C. Integration of health development with social and economic development.
D. Appropriate utilization of health care resources.
D. Appropriate utilization of health care resources.
The 5 Principles of Primary Health Care:
1. Accessibility – Services for all, no matter who or where.
2. Public Participation – Communities help plan and decide.
3. Health Promotion – Preventive, not just curative.
4. Intersectoral Collaboration – Health + social + economic sectors work together.
5. Appropriate Technology – Use what works best and practically.
⸻
Question: Why is the correct answer D?
D. Appropriate utilization of health care resources
→ Matches Principle 5: Appropriate Technology.
Using NPs in underserved areas and telehealth = practical, efficient care delivery. Smart use of resources.
⸻
What the other choices tie to:
A. Equitable distribution of essential health services
→ Principle 1: Accessibility
Focuses on fair access for all.
B. Emphasis on preventative and primitive services *(lol @ “primitive”)
→ Principle 3: Health Promotion
Pushes prevention over reaction.
C. Integration with social and economic development
→ Principle 4: Intersectoral Collaboration
Health connects with broader development goals.
Mass screening programs to assess dental health and hearing in elementary schoolchildren is an example of which type of prevention?
A. Primary prevention
B. Primordial prevention
C. Secondary prevention
D. Tertiary prevention
C. Secondary prevention
Which one of the following approaches has the aim of reducing health inequalities among population groups through the use of protection, prevention, and promotion strategies.
A. Determinants of health
B. Downstream thinking
C. Population health
D. Primary care
C. Population health
Quick breakdown:
Question: What approach aims to reduce health inequalities with protection, prevention, and promotion?
Correct Answer: C. Population Health
Because population health is the overachiever that says, “Let’s look at the whole group, target root causes, and level the playing field before people even get sick.”
⸻
Why the others are not invited to the winner’s circle:
• A. Determinants of health – These are the factors that affect health (like income, education), not an approach. They’re the problem, not the strategy.
• B. Downstream thinking – This is reactive care. Basically: “Oops, you’re already drowning, here’s a life vest.” It’s the opposite of what the question is asking.
• D. Primary care – Important, but focused on individual care (doctor visits, basic treatment), not on reducing group-level disparities
Which one of the following was established in 2004 to support a sustainable health care system in Canada?
A. Health Canada
B. Community health nurses of Canada
C. Canadian Institutes of Health Research
D. Public health agency of Canada
D. Public Health Agency of Canada
Which one of the following is included among the nine determinants of health outlined in the population health promotion model?
A. Culture
B. Gender
C. Genetics
D. Language
C. Genetics
Population Health Promotion Model (9 determinants):
1. Income and social status
2. Social support networks
3. Education
4. Employment/working conditions
5. Physical environments
6. Healthy child development
7. Biology and genetic endowment (aka: genetics)
8. Health services
9. Personal health practices and coping skills
⸻
Social Determinants of Health (12 – full Canadian list):
1. Income and social status
2. Social support networks
3. Education
4. Employment/working conditions
5. Physical environments
6. Biology and genetic endowment
7. Gender
8. Culture
9. Health services
10. Personal health practices and coping skills
11. Social environments
12. Healthy child development
⸻
TL;DR:
• Genetics = in both
• Gender & Culture = only in SDH, not in the PHP model
Disease prevention, health protection, health maintenance, and palliative are included in which of the following Canadian Community Health Nursing Standards of Practice?
A. Building individual and community capacity
B. Building relationships
C. Facilitating access and equity
D. Promoting health
D. Promoting health
The CHN who advocates for safe playground equipment on school property is demonstrating recognition of which of the following concepts?
A. Advocacy is necessary to champion the purchase of expensive equipment.
B. Healthy child development requires exposure to structured physical play.
C. The human-built environment directly affects the health of children.
D. School boards are primarily concerned about academic matters.
C. The human-built environment directly affects the health of children.
Which one of the following organizations involved in global health efforts assist with economic and technical development in developing countries.
A. Global health council
B. United Nations children’s emergency fund.
C. World bank
D. WORLD health organization
C. World bank
What is the World Bank?
The World Bank is a global organization that provides financial and technical assistance to developing countries to support economic development and reduce poverty. It funds large-scale projects like healthcare systems, infrastructure, education, and economic reforms.
Key Facts About the World Bank:
✔ Founded: 1944 (as part of the Bretton Woods Agreement)
✔ Headquarters: Washington, D.C., USA
✔ Members: 189 countries
✔ Main Purpose: Provide loans, grants, and expertise to help developing nations grow their economies and improve public services.
How Does the World Bank Help with Global Health?
1. Financing Health Projects: Funds public health initiatives, hospitals, and vaccination programs in low-income countries.
2. Strengthening Healthcare Systems: Helps train healthcare workers and improve access to essential medicines.
3. Responding to Health Crises: Provided billions in funding for COVID-19 response, including vaccine distribution.
4. Improving Sanitation & Water Access: Supports projects that provide clean water and sanitation, reducing disease rates.
Why Is the World Bank the Correct Answer in This Question?
• The question asks about an organization that assists with economic and technical development in developing countries.
• The World Bank specializes in economic development and funding large-scale health initiatives to improve public health globally.
Why Not the Other Options?
• (A) Global Health Council – Not a major funding organization, more focused on advocacy and policy.
• (B) United Nations Children’s Emergency Fund (UNICEF) – Primarily focuses on children’s welfare, not broad economic development.
• (D) World Health Organization (WHO) – Provides technical guidance and public health policies but does not fund major infrastructure projects like the World Bank.
Who Uses the World Bank, Where Does the Money Come From, and How Does It Work?
The World Bank is an international financial institution that provides loans and grants to developing countries for projects that reduce poverty and promote economic development. It operates much like a bank for countries, but with a global mission.
Who Uses the World Bank the Most?
The main users of World Bank funds are developing countries that need financial assistance for:
✔ Infrastructure projects (roads, bridges, power plants)
✔ Health systems (hospitals, vaccines, disease control)
✔ Education (schools, teacher training, literacy programs)
✔ Economic development (agriculture, job creation, industry expansion)
Top Borrowers (2023-2024) Include:
• India – Frequently one of the largest borrowers due to its massive population and infrastructure needs.
• Pakistan – Receives funding for social programs, economic reforms, and disaster recovery.
• Nigeria – Uses funds for healthcare, education, and power sector reforms.
• Bangladesh – Receives loans for infrastructure and climate resilience projects.
• Ethiopia, Kenya, Indonesia, Egypt, Vietnam – Also among regular borrowers for economic and public service improvements.
📌 The poorest countries receive low-interest or even grant-based loans through the International Development Association (IDA), a branch of the World Bank. Wealthier developing nations borrow from the International Bank for Reconstruction and Development (IBRD) at higher interest rates.
Where Does the World Bank’s Money Come From?
The World Bank gets its money from multiple sources, but its primary funding comes from:
1. Member Country Contributions:
• 189 countries are part of the World Bank and pay into it based on their economy’s size.
• Wealthy countries (e.g., the U.S., Canada, Germany, Japan) contribute the most.
2. Issuing Bonds on Global Markets:
• The World Bank raises money by selling “World Bank Bonds” to investors worldwide.
• These bonds are backed by the financial strength of member countries, making them very secure.
3. Loan Repayments & Interest:
• Countries that borrow from the World Bank pay back their loans with interest, which helps fund future projects.
4. Donor Contributions (Grants & Aid):
• Richer nations donate money to the World Bank’s International Development Association (IDA), which provides grants to the poorest countries.
Is the World Bank’s Money in U.S. Dollars?
✔ Yes, most of the World Bank’s transactions are in U.S. dollars (USD).
✔ However, it also operates in other major global currencies like euros (EUR), British pounds (GBP), and Japanese yen (JPY).
✔ Countries receiving loans can convert funds into their local currency to spend on projects.
Does Each Country Have Its Own “World Bank Account”?
No, countries do not have separate “bank accounts” within the World Bank. Instead:
✔ The World Bank has a shared pool of money that all countries contribute to and borrow from.
✔ It operates like a cooperative fund, where wealthier nations contribute more and poorer nations borrow from it.
🔹 Example:
• Canada, the U.S., and Germany contribute billions to the World Bank.
• Countries like Bangladesh and Nigeria borrow from the shared funds for healthcare and infrastructure projects.
• When loans are repaid, the money goes back into the fund for future borrowers.
Key Takeaways:
✔ The main users of the World Bank are developing countries needing loans for healthcare, education, and infrastructure.
✔ Funding comes from member countries, bonds, loan repayments, and donations.
✔ Most transactions are in U.S. dollars, but other currencies are also used.
✔ Countries do not have separate World Bank accounts—it’s a shared global fund.
Would you like to see a real-world example of a World Bank-funded project?
Climate change is an example of which on of the following?
A. A determinant of health
B. A transnational health issue
C. A social justice issue
D. An international health issue
D. An international health issue
Within the context of primary health care, which of the following term refers to ensuring fairness and equity in health services so that everyone has equal access to health care ?
A. Distributive justice
B. Beneficence
C. Global health
D. Social justice
D. Social justice
Which of the following is a social determinant of health?
A. Biology
B. Genetics
C. Personal health
D. Income
D. Income
For a community health nurse, which of the following describes the goal of advocacy?
A. Gaining organizational and government support for the promotion of nursing objectives.
B. Improving community service needs identified by research findings.
C. Integrating evidence/informed practice guidelines in the provision of community nursing service.
D. Promoting self-determination in a client, family, group, or community.
D. Promoting self determination in a client, family, group, or community.
A health care provider is concerned about the high number of clients with type 2 diabetes who have poor glucose control. In order to implement evidence-informed practice to manage this problem, what would be the best reference for the health care provider to use?
A. Published protocols
B. Current research findings
C. Opinions of colleagues
D. Media reports
B. Current research findings.
How can a community health nurse best facilitate incorporation of evidence-informed practice in the clinical settings?
A. Elimination of all protocols and standards that are not evidence based.
B. Group reflection on the ideals and expectations nursing care.
C. Incorporation of more client/practice- oriented research into decision making.
D. Revision of mission statements and organizational philosophies.
C. Incorporation of more client/ practice- oriented research into decision making.
What best represents the first step to take when using evidence informed practice in the clinical settings?
A. Eliminating all protocols and standards that are not evidence based.
B. Gathering data on the clinical problem
C. Formulating the clinical question
D. Revising mission statements and organizational philosophies.
C. Formulating a clinical question
What is the first and most crucial step in the ethical decision-making process?
A. Assessing the context or environment in which a decision must be made.
B. Considering the various ethical principles or theories.
C. Identifying the ethical concerns.
D. Making a decision and acting on it.
C. Identifying the ethical concerns.
A CHN has been asked to meet with a couple who recently emigrated from Botswana. The clinic doctor told the man about his wife’s diagnosis of breast cancer, and the couple was about to leave. Although all of the following actions by the CHN might be appropriate, which is the most important action, ethically?
A. Insisting that the family set up a surgical appt for the wife immediately.
B. Assessing the family’s current living situation, including insurance and other assets.
C. Educating the family about breast cancer, including the standard treatment and the prognosis.
D. Interviewing the family to find out about their perception of the threat to the family’s wellbeing.
D. Interviewing the family to find out about their perception of the threat to the family’s wellbeing.
A team of CHN’s disagree about the appropriate action to take in relation to a family with an ill family member who have chosen to continue working at their jobs instead of take time off to care for the ill family member. The CHN asks, “what sort of example does this behaviour set for the community? What if everyone always put their jobs before their families?” What type of thinking is the CHN applying?
A. Communitarianism
B. Deontological ethics
C. Principlism
D. Utilitarianism
A. Communitarianism
A team of CHN’s disagree about the appropriate action to take in relation to a family with an ill family member who have chosen to continue working at their jobs instead of take time off to care for the ill family member. One CHN states, “but it doesn’t have to be either-or. Perhaps the family members could take turns calling in sick for just 2 or 3 days. That way, they could all help and yet not upset their employers. Wouldn’t that be fair?” What type of thinking is this CHN applying?
A. Communitarianism
B. Deontologicsl ethics
C. Principlism
D. Utilitarianism
C. Principlism
Why is this Principlism and Not Utilitarianism?
At first glance, utilitarianism might seem like the right answer because the CHN is proposing a compromise that benefits multiple people (family members and employers). However, this reasoning aligns more with principlism due to how the decision-making process is structured.
Why This is Principlism:
✔ Principlism is based on balancing four ethical principles:
1. Autonomy – Respecting the family’s right to make their own choices.
2. Beneficence – Promoting well-being by ensuring the sick family member gets care.
3. Non-Maleficence – Avoiding harm (ensuring no single family member bears the entire burden or risks losing their job).
4. Justice – Striving for fairness in distributing caregiving responsibilities.
✔ The CHN is applying a fair and balanced ethical approach.
• They acknowledge that both caring for the sick and keeping jobs are important.
• Instead of enforcing a single “correct” action, they offer a solution that respects autonomy and fairness.
Why It’s NOT Utilitarianism:
Utilitarianism focuses on achieving the greatest good for the greatest number, often at the expense of some individuals. If the CHN was applying utilitarian thinking, they might argue:
• “Who would suffer less?” If forcing one family member to stay home maximizes the overall well-being, then that would be the ethical choice—even if it negatively impacts that person.
• The CHN’s response, however, doesn’t sacrifice anyone’s well-being; instead, they create an equitable solution that respects individual rights while still promoting the overall good.
Final Takeaway:
✔ Principlism balances multiple ethical principles rather than just focusing on overall happiness.
✔ Utilitarianism would prioritize the majority’s well-being, even if it meant an unfair burden on one person.
✔ The CHN’s approach respects autonomy, fairness, and shared responsibility, which is why Principlism is the best fit.
Yes! Here’s a breakdown of classic ethical perspectives similar to how you framed utilitarianism (“Kill one to save many”). Each ethical theory has a distinct way of approaching moral dilemmas.
- Utilitarianism → “Kill one to save many.”
✔ Outcome-based ethics (consequentialism).
✔ Maximizing happiness and minimizing suffering for the majority.
✔ Individual rights don’t matter as much if the greater good is achieved.
🔹 Example: If a pandemic could be cured by testing an experimental drug on one unwilling person, utilitarian thinking might justify it if it saves millions.
- Deontology (Duty-Based Ethics) → “Never kill, no matter the consequences.”
✔ Moral rules are absolute—right and wrong are fixed, regardless of outcomes.
✔ The duty to act morally outweighs any benefits from breaking the rule.
✔ Intentions matter more than consequences.
🔹 Example: A doctor refuses to administer a lethal injection to a terminally ill patient, even if it ends suffering, because killing is always wrong.
- Principlism → “Balance harm and fairness.”
✔ Ethical decisions are based on four principles:
• Autonomy (respect for choice).
• Beneficence (do good).
• Non-maleficence (do no harm).
• Justice (fairness).
✔ Weighs multiple ethical concerns instead of following just one rule.
🔹 Example: A nurse respects a terminally ill patient’s right to refuse treatment (autonomy), even if it leads to their death, while ensuring pain relief (beneficence).
- Communitarianism → “Do what’s best for the community.”
✔ The good of society outweighs individual concerns.
✔ Social responsibility and shared values matter.
✔ Focuses on long-term societal impact over personal rights.
🔹 Example: Mandatory vaccines—even if one person objects, society benefits from herd immunity, so they must comply.
- Virtue Ethics → “What would a good person do?”
✔ Morality is based on character, not just rules or outcomes.
✔ Focuses on developing virtues (honesty, courage, compassion).
✔ A good person naturally does the right thing.
🔹 Example: A nurse chooses to spend extra time comforting a dying patient not because it’s required, but because compassion is a virtue.
- Ethical Relativism → “It depends on culture and beliefs.”
✔ No universal moral truths—right and wrong depend on cultural, historical, or personal context.
✔ What is ethical in one society may be unethical in another.
🔹 Example: In some cultures, assisted suicide is compassionate, while in others, it is morally unacceptable. Neither side is “right” universally.
- Feminist Ethics (Ethics of Care) → “Relationships and context matter.”
✔ Focuses on care, relationships, and empathy over rigid rules.
✔ Morality should be based on compassion and real-life human connections.
✔ Opposes traditional ethics that ignore social inequalities.
🔹 Example: A social worker prioritizes a single mother’s financial struggles when deciding if she should lose custody—rather than just following strict welfare policies.
A team of CHN’s disagree about the appropriate action to take in relation to a family with an ill family member who have chosen to continue working at their jobs instead of take time off to care for the ill family member. A CHN states “it’s not up to us; it’s the family’s decision.” What type of thinking is this CHN applying?
A. Communitarianism
B. Deontological ethos
C. Principlism
D. Utilitarianism
C. Principlism
A team of CHN’s disagree about the appropriate treatment for Mrs. Mehta, who is likely an excellent candidate for hospice care. The first CHN says that deciding on care, rather than cure, is up to Mrs. Mehta, and no one else can decide for her. The second CHN says that it is the responsibility of the health care team to do what is best for Mrs. Mehta, and if the physician thinks there is still a possibility of cure, then the CHNs should do everything they can to implement the treatment plan. The third CHN says it’s not fair for the family to expend all their resources on Mrs. Mehta, who is probably going to die in spite of the care provided by the health care team. What conclusions can be drawn from this dispute?
A. Ethical principles can conflict with each other.
