Chapter 3 Flashcards
Which statement 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
a. A population health approach designed to prevent disease, promote health, and protect populations
Public health isn’t about treating one sick person at a time. It’s about going full Oprah:
“You get prevention! You get education! Everybody gets a vaccine!”
It’s the big-picture strategy:
• Prevent illness before it happens
• Promote health with policies, education, and access
• Protect communities (think water sanitation, vaccinations, seatbelts—not just stethoscopes and band-aids)
The increasing complexity of societal needs and rapid changes in public health no longer allow for adequate time for on-the-job training and education. As a result, what is the current minimum level of educational preparation for a public health 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
c. A baccalaureate degree in nursing
What is a core competency required of public health nurses (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
d. Skill in developing policy and planning programs to improve health.
The correct answer is d. Skill in developing policy and planning programs to improve health because public health nurses (PHNs) focus on population health rather than individual acute care. Their role involves assessing community needs, advocating for health policies, designing preventative programs, and addressing social determinants of health. Unlike hospital-based nurses who work with critically ill patients or advanced medical technology, PHNs use policy development, education, and health promotion strategies to create long-term health improvements at the community level.
A health centre administrator is in the process of hiring a new community health nurse (CHN). Which statement 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.”
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.”
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 schoolteachers 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)
b. Partnering with schoolteachers to teach handwashing to elementary school children and observe their techniques
Yes, there are three levels of prevention in public health:
- Primary Prevention (Prevention Before Disease Occurs)
• Goal: Stop disease from occurring in the first place.
• Examples:
• Health education (e.g., teaching handwashing, safe sex practices).
• Vaccination programs to prevent infections.
• Environmental sanitation (e.g., clean water supply, air quality control).
• Legislation and policies (e.g., seat belt laws, smoking bans). - Secondary Prevention (Early Detection & Intervention)
• Goal: Detect and treat diseases early to prevent complications.
• Examples:
• Screening programs (e.g., mammograms for breast cancer, STI testing).
• Early treatment of infections to prevent spread.
• Contact tracing for communicable diseases. - Tertiary Prevention (Managing Existing Disease & Reducing Impact)
• Goal: Prevent worsening, disability, or complications in people with existing diseases.
• Examples:
• Rehabilitation programs (e.g., stroke rehab, physical therapy).
• Directly observed therapy (DOT) for TB patients.
• Support groups for chronic disease management (e.g., diabetes, heart disease).
For your question, teaching handwashing in schools is primary prevention because it helps prevent infections before they occur. Secondary prevention would involve identifying and treating an infection early, while tertiary prevention focuses on managing disease after diagnosis to prevent further complications.
What activity is the public health nurse (PHN) participating in when tracing the sexual contacts of clients with sexually transmitted infections (STIs) for potential screening purposes?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Secondary and tertiary prevention
b. Secondary prevention
Secondary prevention is the correct answer because tracing sexual contacts for STI screening aims to detect and treat infections early, preventing complications and further transmission.
• Primary prevention focuses on stopping disease before it occurs (e.g., STI education, condom distribution, vaccination for HPV).
• Tertiary prevention involves managing long-term effects of disease (e.g., treatment for HIV/AIDS to prevent complications).
Since contact tracing and screening help identify infections early for treatment, it falls under secondary prevention—which is about early detection and intervention to reduce disease impact.
Which community health nursing activity demonstrates tertiary prevention related to mental health?
a. Disseminating information about mental health to community organizations
b. Partnering with public health nurses (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
c. Providing case management services that link clients with serious mental illnesses to mental health and community support services
It’s tertiary prevention because it focuses on managing serious mental illness by connecting clients to treatment and support services. Tertiary prevention helps individuals live with and manage their condition to prevent worsening or complications.
Which of the following represents the main 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
a. Affiliation with a church or congregation
What is the central 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 client’s environment.
c. Reimbursement for home health care is different from that of care provided in
institutions.
d. Home health care focuses on community health.
b. Home health care is provided in the client’s environment.
A community health nurse (CHN) is part of a palliative consultation team that provides
care for people living on the streets, in parks, or in shelters or who are unwilling or unable
to come to the clinic, hospital, or hospice to receive end of life care. How can this type of
nursing service be best classified?
a. Community-oriented nursing
b. Home health nursing
c. Outpost nursing
d. Private duty nursing
b. Home health nursing
It is classified as home health nursing rather than community-oriented nursing because the focus is on providing direct, individualized care to people where they live (even if that is on the streets or in shelters). Home health nursing involves delivering medical care, symptom management, and palliative support outside of hospitals or clinics, which aligns with the scenario described.
Community-oriented nursing, on the other hand, focuses on broader public health initiatives, such as disease prevention, health promotion, and policy development, rather than direct one-on-one clinical care.
Which of the following is the best way for a home health nurse (HHN) to 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
c. Teaching self-care to the client
The correct answer is c. Teaching self-care to the client because the goal of home health nursing is to promote independence and enhance the client’s ability to manage their own care. Teaching self-care empowers the client to perform daily activities as much as possible despite their right-sided paresis (weakness).
Options a, b, and d focus on providing assistance or relying on others, which does not promote long-term independence. The nurse’s role is to help the client adapt, regain function, and use assistive techniques to maximize their ability to perform activities of daily living (ADLs) autonomously.
A home health nurse (HHN) in training states, “I don’t understand why we have to collaborate with so many other disciplines. Doesn’t this conflict with the concept of holistic nursing practice?” What 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.”
a. “The nurse still functions holistically; however, interdisciplinary collaboration is necessary to prevent fragmentation of care.”
A family member asks a home health nurse (HHN) to explain the concept of hospice care. Which action 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 client’s living will is honoured
c. Placing experts in the position of power of attorney
d. Providing respite and comfort measures before death
d. Providing respite and comfort measures before death
In an effort to prevent drug abuse among junior high–school students, a public health nurse (PHN) has enlisted the assistance of high-school role models in the areas of both sports and scholarship for an antidrug presentation. What is the level of prevention represented by this activity?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Both primary and secondary prevention
a. Primary prevention
The community health nurse (CHN) has arranged for students in all classes at the local school to receive visual acuity testing to determine if they need glasses. What is the level of prevention represented by this activity?
a. Primary
b. Secondary
c. Tertiary
d. Both primary and secondary
b. Secondary
A community health nurse (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. What is the level of prevention represented by this activity?
a. Primary
b. Secondary
c. Tertiary
d. Both primary and secondary
c. Tertiary
What practice is being implemented by the occupational health nurse (OHN) who removes
a foreign body from a client’s eye?
a. Primary care
b. Primary prevention
c. Secondary prevention
d. Tertiary prevention
a. Primary care
What practice is being implemented by the occupational health nurse (OHN) who periodically conducts spirometry testing of employees working with hazardous gases?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Tertiary care
b. Secondary prevention
An employee in a laboratory drops a flask, resulting in the chemical splashing into her eyes. What is the agent in this scenario?
a. Chemical
b. Employee
c. Flask
d. Laboratory
a. Chemical
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, what is considered to be the host?
a. Each sick nurse
b. The communicable disease
c. The hospital
d. The client
a. Each sick nurse
*** client is the source - not the host *
What hazard tends to particularly affect employees who work in two-week shifts?
a. Biological hazards
b. Environmental hazards
c. Physical hazards
d. Psychosocial hazards
d. Psychosocial hazards
What 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
c. Sexual assault nurse examiner (SANE)
From which health care professional is a rural resident with asthma more likely to receive health care services?
a. Allergist
b. Nurse practitioner
c. Pediatrician
d. Pulmonologist
b. Nurse practitioner
In addition to the common barriers faced by most rural residents, what 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
a. Absence of culturally appropriate care
