Chapter 1 Flashcards
Which of the following best describes community health nursing?
a). Giving care with a focus on the aggregate’s needs
b). Giving care with a focus on the group’s needs
c). Focusing on the health care of individual clients in the community
d). Working with an approach of unique client care
c). Focusing on the health care of individual clients in the community.
Community Health Nursing (CHN):
• Focuses on individuals and families in a community setting
• Provides direct care (ex: wound care, teaching diabetes management at home, vaccinations)
• Still considers broader health needs of the community, but works one-on-one
• Think of it as clinical nursing that escaped the hospital and moved into your neighborhood
Public Health Nursing:
• Focuses on populations and aggregates
• Looks at prevention, surveillance, policy, and systems-level interventions
• Think vaccine campaigns, outbreak tracking, health education at schools
• Way more spreadsheets and less blood pressure cuffs
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
a. A comprehensive way to address issues of social justice.
Primary care = the actual medical services you get at your doctor’s office.
Primary health care = a global model for equitable, just, people-centered care.
The health of which of the following is the primary focus of public health nurses?
a. Families
b. Groups
c. Individuals
d. Populations
d. Populations
Which change is the primary explanation for life expectancy increasing so notably since the early 1900’s?
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
c. Improved sanitation and other public health activities.
Which community health nursing practice area receives funding from the private sector?
a. Telenurses
b. Correction nurses
c. Nurse entrepreneurs
d. Street or outreach nurses
c. Nurse entrepreneurs
(Only nurse entrepreneurs receive private funding. All other community health nurse roles are either provincially or federally funded positions)
A public health nurses strives to prevent disease and disability, often in partnership with other community groups. Which statement is an appropriate summary of the public health nurses (PHN) 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.
d. The PHN works either community members to carry out public health functions.
Which of the following is used as a measurement of population health?
a. Health status indicators
b. The levels of prevention
c. The number of memberships at the local fitness centre
d. Reported provincial alcohol and tobacco sales in any given month
a. Health status indicators
What is a Health Status Indicator?
A health status indicator is a measurable characteristic used to assess the overall health of a population. These indicators help public health officials, policymakers, and researchers understand trends in health, identify issues, and evaluate the effectiveness of health interventions.
Types of Health Status Indicators:
1. Mortality Indicators (Death-related)
• Life expectancy
• Infant mortality rate
• Maternal mortality rate
• Age-specific death rates
2. Morbidity Indicators (Disease-related)
• Prevalence and incidence of chronic diseases (e.g., diabetes, cancer)
• Rates of infectious diseases (e.g., tuberculosis, HIV)
• Disability-adjusted life years (DALYs)
3. Health Behaviors & Risk Factors
• Smoking rates
• Physical activity levels
• Obesity rates
• Substance abuse rates
4. Healthcare Access & Utilization
• Number of hospital admissions
• Vaccination rates
• Health insurance coverage
5. Social & Environmental Determinants of Health
• Air and water quality
• Education levels
• Socioeconomic status
• Food security
Why Are Health Status Indicators Important?
• Help identify public health priorities
(e.g., a high infant mortality rate signals a need for better maternal and child health services).
• Evaluate the success of public health programs
(e.g., tracking smoking rates after anti-smoking campaigns).
• Compare health across different regions or countries
(e.g., WHO uses indicators like life expectancy to assess global health progress).
Why “Health Status Indicators” Is the Correct Answer?
The question asks about a measurement of population health, and health status indicators directly assess health outcomes and determinants of health.
• Why Not the Other Options?
• (b) The levels of prevention – This refers to different stages of disease prevention (primary, secondary, tertiary) rather than measurement.
• (c) The number of memberships at a local fitness center – This is not a reliable measure of population health since it only represents a specific behavior in a limited group.
• (d) Reported alcohol and tobacco sales – While these provide insight into consumption trends, they do not directly measure health outcomes.
Final Takeaway:
A health status indicator provides objective, measurable data to track and improve the health of populations, making it a critical tool in public health and epidemiology.
A registered nurse (RN), has just been employed as a community health nurse (CHN). Which question would be most relevant to practice as the nurse 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?”
a. “Which community groups are at greatest risk for problems?”
(CHNs apply nursing process to the entire community; asking which groups are at greatest risk reflects a community-oriented perspective. The other responses focus on particular individuals)
The community health nurse who is working with women at the senior citizens centre 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 the community health nurse doing?
a. Ensuring that the women do not expect the CHN herself to do anything about their problem.
b. Demonstrating that she understands the women’s concerns and needs
c. Expressing empathy, support and concern.
d. Helping the women engage in political action locally.
d. Helping the women engage in political action locally.
Which activity is an example of the “advocate” role of the community health nurse?
a. Organizing home care support for a newly discharged older 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
b. Acting as a member of a community action group for provision of accessible transit choices
In which scenario is the public health nurse most comprehensively practising interprofessional collaboration?
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.
b. The PHN spends the day attending meetings at various health agencies.
Why is “Attending Meetings at Various Health Agencies” Considered Interprofessional Collaboration?
Interprofessional collaboration involves healthcare professionals from different disciplines working together to improve health outcomes. The correct answer (b) reflects true interprofessional collaboration because the public health nurse (PHN) is engaging with multiple health agencies, which likely include professionals from different fields, such as:
• Physicians
• Social workers
• Public health officials
• Community health workers
• Policy makers
How This Reflects Interprofessional Practice:
✔ Cross-disciplinary Approach: The PHN is engaging with various healthcare sectors rather than just focusing on individual clients or a single issue.
✔ Coordinated Care: By attending meetings at health agencies, the PHN is involved in broader health initiatives that require input from multiple professionals.
✔ Policy and System-Level Impact: Instead of addressing only individual concerns, the nurse is involved in strategic planning, public health programs, and community-wide solutions.
Why the Other Options Are Not True Interprofessional Collaboration:
• (a) Meeting with several groups about community recreation issues
• This might involve community engagement, but it is not necessarily an interprofessional collaboration between healthcare workers.
• (c) Talking to individuals about their health concerns
• This is direct client interaction, which is part of public health nursing but does not necessarily involve working with other healthcare professionals.
• (d) Watching a televised city council meeting
• Passive observation does not involve active participation in collaboration with professionals.
Final Takeaway:
Interprofessional collaboration means working directly with other professionals across different fields to improve healthcare delivery and outcomes. The PHN attending meetings at various health agencies represents this collaboration, as it involves coordinated efforts among professionals to address public health concerns.
A community health nurse often has to make resource allocation decisions. In such cases, which approach will most 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.
d. Choosing the needs of the aggregate, rather than the needs of a few individuals.
Which situation most closely represents the focus of 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 children’s families
d. Treating paediatric patients at an outpatient clinic
a. Assessing the services and effectiveness of the school health clinic.
Why is “Assessing the Services and Effectiveness of the School Health Clinic” the Best Answer?
Public health nursing focuses on population health, emphasizing disease prevention, health promotion, and system-level interventions rather than just individual patient care. The correct answer (a) aligns with this because assessing healthcare services and their effectiveness is a public health function aimed at improving health outcomes on a broader scale.
How Public Health Nursing Differs from Individual Care
✔ Focuses on Communities and Systems:
• Public health nurses assess how well health services meet the needs of a population (e.g., school children).
✔ Emphasizes Prevention and Health Promotion:
• Evaluating a clinic’s effectiveness helps identify gaps in care, which can lead to policy changes and better access.
✔ Uses Data for Decision-Making:
• By assessing services, public health nurses generate evidence for improving resource allocation and program success.
Why the Other Options Are Incorrect:
• (b) Caring for patients after outpatient surgeries
• This is more aligned with clinical or acute care nursing rather than public health, which focuses on prevention and system-wide strategies.
• (c) Giving care to schoolchildren and their families at a clinic
• While this includes community care, it is still individualized treatment rather than a population-based, systemic assessment.
• (d) Treating pediatric patients at an outpatient clinic
• This represents direct clinical care, which is not the primary focus of public health nursing.
Final Takeaway:
Public health nursing is more than just providing care—it involves evaluating health systems, developing policies, and implementing interventions that improve overall population health. Assessing the effectiveness of a school health clinic directly aligns with these public health nursing principles, making (a) the best choice.
Which public health service best 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
c. Providing an influenza vaccination program in a community retirement village
Why is “Providing an Influenza Vaccination Program” Primary Prevention, but Not “Developing a Health Education Program”?
Primary prevention refers to interventions that prevent disease before it occurs by reducing risk factors and increasing resistance to illness. The correct answer (c: Providing an influenza vaccination program) is the best example of primary prevention because vaccines directly prevent infection by boosting immunity.
Why Not (a) “Developing a Health Education Program About Smoking”?
Although educating people about the dangers of smoking is an important health promotion strategy, it is not always considered purely primary prevention because:
✔ It does not directly prevent disease—it aims to modify behavior, but some people may still choose to smoke.
✔ Health education often overlaps with secondary prevention, especially when targeting individuals already exposed to risk factors (e.g., smokers learning about quitting).
Why (c) Vaccination is the Best Example of Primary Prevention:
✔ Direct disease prevention → Stops influenza before it occurs.
✔ Widely accepted as primary prevention → Immunization programs are public health staples for reducing disease burden.
✔ Proven effectiveness → Vaccines have a measurable impact on disease rates.
Final Takeaway:
While health education is important, vaccination is a more direct, effective, and universally recognized primary prevention strategy because it physically prevents the disease from occurring.
What term is used interchangeably with the term subpopulations?
a. Groups
b. Aggregates
c. Clients
d. Communities
b. Aggregates
Which public health service best 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
b. Initiating an infant car seat safety screening program for parents in low-income
housing
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
b. Upstream thinking
Upstream vs. Downstream Thinking in Health Care
Upstream thinking refers to a macroscopic, big-picture approach to health that focuses on preventing health issues before they occur by addressing the root causes. It contrasts with downstream thinking, which deals with the consequences of health problems rather than their causes.
Upstream Thinking (Big-Picture, Preventive Approach)
✔ Focuses on social determinants of health (e.g., poverty, education, environment, access to healthcare).
✔ Aims to prevent disease at a systemic level before it occurs.
✔ Looks beyond individual responsibility to address policy, societal, and structural factors influencing health.
✔ Emphasizes long-term change rather than short-term fixes.
🔹 Example:
Instead of treating people who develop Type 2 diabetes, upstream thinking improves access to healthy foods, promotes exercise programs, and enforces policies to reduce sugar consumption in communities.
Downstream Thinking (Reactive, Treatment-Based Approach)
✔ Focuses on managing health problems after they arise rather than preventing them.
✔ Centers on individuals rather than population-wide factors.
✔ More expensive over time due to repeated treatments instead of prevention.
✔ Emphasizes short-term solutions like medical treatment, rather than structural change.
🔹 Example:
A nurse working in an emergency room treating patients with heart disease caused by poor diet and lack of access to healthcare is using a downstream approach—addressing the immediate effects but not the root causes.
Comparison:
Thinking Approach Focus Example
Upstream Thinking Prevention & Systemic Change Improving food security, building more parks, creating policies for health equity.
Downstream Thinking Treatment & Individual Care Treating diabetes complications, prescribing medications, conducting surgeries.
Why “Upstream Thinking” is the Correct Answer:
The question asks about a macroscopic, big-picture population focus—which upstream thinking represents because it addresses the broader determinants of health rather than just responding to individual cases.
Would you like more examples of how upstream thinking is applied in different healthcare settings?
Which is a requirement for reaching the goal of “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
b. A system for health
Which 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.
b. It provides essential care that is universally accessible to persons in a community
and encourages self-management, self-reliance, and competence.
Which public health service best represents primary prevention?
a. Administering the influenza vaccine to a group 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 who reside in low-income
housing
d. Setting up a blood pressure screening clinic at the local mall
a. Administering the influenza vaccine to a group of seniors
