LA# 8 - Stanhope chapters 7, 11, 18

Question 1

Which of the following practices applies to nursing care for clients with a foreign cultural background?a.Altering nonverbal behaviour to reflect the cultural norms the client is used tob.Keeping all behaviours culturally neutral to avoid misinterpretationc.Relying on friendly gestures to communicate a caring attituded.Avoiding showing prejudice by using the same behaviour with all clients

Answer 1

ACultural competence in community health nurses (CHNs) includes the adoption of culturally congruent behaviours. CHNs need to make sure their nonverbal communication techniques take into consideration the client’s use of eye contact, facial expressions, body language, touch, and space.

Question 2

A CHN often used to sit with his legs crossed at the knees when collecting a client’s history. However, he stopped doing this around his Iranian clients after being told that they were offended because this posture exposed the sole of his foot. In changing his behaviour, which culture-related response did the CHN exhibit?a.Cultural sensitivityb.Cultural awarenessc.Cultural knowledged.Cultural skill

Answer 2

DCultural skill refers to the effective integration of cultural awareness and cultural knowledge to obtain relevant cultural data and meet the needs of culturally diverse clients. The CHN’s use of cultural skill ensures that nonverbal communication techniques take into consideration the client’s use of eye contact, facial expressions, body language, touch, and space.

Question 3

A CHN states, “The best way to treat clients from other countries is to care for them the same way we would want to be cared for ourselves. After all, we are all human beings with the same expectations and needs.” Which culture-related response does this statement exemplify?a.Cultural awarenessb.Cultural blindnessc.Cultural knowledged.Cultural preservation

Answer 3

BCultural blindness is a denial of diversity and the inability to recognize the uniqueness of individual clients. An example is CHNs who, attempting to be culturally unbiased, treat all clients in the same manner by conducting their nursing assessments using the same questions, do not actively listen to the responses, and fail to modify their questioning to gain an understanding of client culture and client uniqueness.

Question 4

A CHN rearranges the room and moves the bed of a bedridden Muslim client so that the client is facing toward Mecca for his daily prayers. What does the CHN’s culture-related response exemplify?a.Cultural skillb.Cultural awarenessc.Cultural brokeringd.Cultural imposition

Answer 4

ACultural skill refers to the effective integration of cultural awareness and cultural knowledge to obtain relevant cultural data and meet the needs of clients from diverse cultural backgrounds. For this client, daily prayers in the tradition of Islam are important, possibly more important from the client’s perspective than medical treatment.

Question 5

Which one of the following is an example of “overt racism”?a.Using traditional food and traditional dressb.Restricting the burning of sweet grassc.Participating in hate crimesd.Making job positions available only to persons who are Canadian-born

Answer 5

COvert racism is an open demonstration by attitudes, actions, policies, and practices of a feeling of superiority over individuals or groups with the intent of harming or damaging. Hate crimes, for example, are considered to be one example of overt racism.

Question 6

A health care provider states, “I’m not going to change the way I practise medicine regardless of where the client is from, because research shows that Western medicine is the best.” Which of the following behaviours does this statement exemplify?a.Ethnocentrismb.Prejudicec.Racismd.Stereotyping

Answer 6

AEthnocentrism, a type of cultural prejudice at the cultural population level, is the belief that one’s own cultural group determines the standards of behaviour by which all other groups are to be judged. CHNs who assume that their way of providing nursing care is the only right way are ethnocentric.

Question 7

A health care worker tells the CHN, “It does no good to try to teach those Aboriginal clients about nutrition because they will just eat whatever they want to, no matter how much we teach them.” Which of the following behaviours does this statement exemplify?a.Cultural impositionb.Ethnocentrismc.Racismd.Stereotyping

Answer 7

DStereotyping occurs when generalizations are applied to an individual without exploring individual values, beliefs, and behaviours. In this instance, the health care worker makes the assumption that all Aboriginal people are not educable. The health care worker is also guilty of making assumptions about noncompliance among other Aboriginal people she has known; this noncompliance may have had to do with their inability to buy nutritious foods, which tend to be more expensive.

Question 8

Migrant workers tend to have high occupational mobility, are often poor, and have limited formal education. They may seek health care only when they are ill and unable to work. What does the CHN need to do whenever she has a chance to interact with migrant workers?a.Advocate for emergency health care.b.Teach prevention and health maintenance.c.Ensure funding is available for adequate nutrition.d.Contact the Workplace Safety and Insurance Board (WSIB).

Answer 8

BCHNs work with clients from diverse cultural backgrounds, and one example is migrant workers. Because migrant workers are highly mobile and tend to seek health care only when they are ill and unable to work, whenever a CHN interacts with these clients, it is important to teach them about disease prevention, health maintenance, health protection, and health promotion activities before the clients move on.

Question 9

A family from Mexico presents to the public health department. None of the family members speak English, and no one at the health department speaks Spanish. Which of the following will be the most appropriate action on the part of the CHN?a.Attempting communication using an English–Spanish phrase bookb.Calling the local hospital and arranging a referralc.Emphatically stating, “No hablo Español” (I don’t speak Spanish) and repeating as necessaryd.Finding an interpreter to translate

Answer 9

DCommunication with the client or family is required for a cultural assessment. When CHNs do not speak or understand the client’s language, they need to obtain an interpreter.

Question 10

A 40-year-old Bosnian Muslim woman who does not speak English presents to a community health centre in obvious pain and requests a female health care provider. She indicates through gestures that the pain originates in either the pelvic or the genital region. Assuming several people are available to interpret, which of the following persons would be the most appropriate choice of interpreter?a.A female who does not know the clientb.A female from the client’s communityc.A male who is certified as a medical interpreterd.The client’s 20-year-old daughter

Answer 10

AAlthough it is important to use an experienced medical interpreter, in many cultures, it is considered inappropriate to have a male interpreter for a female client. This client has specifically requested a female health care provider; therefore, one might anticipate that the client will prefer a female interpreter as well. In spite of a male interpreter’s certification and ability, he cannot be effective if the client is withholding information that she feels is not right to discuss in front of a man. This client may also consider it inappropriate to have her daughter interpret private matters (especially of a sexual nature or if they involve infidelity). Additionally, the CHN should not use an interpreter from the same community as the client, in order to avoid breach of confidentiality.

Question 11

At a local hospital, postpartum care policy requires that nurses observe the mother to assess her ability to care for the new baby and to promote bonding. A new immigrant mother says that, in her country, all infant care is provided by family members so that the mother can rest and recover. In her home country, it is believed that if the mother does not recover sufficiently, she will be unable to provide the best care. Which of the following actions will the culturally competent nurse take?a.Allow family members to provide care to the baby and assess the mother’s knowledge of child care through discussion.b.Explain the importance of bonding and how all good mothers gladly assume these responsibilities.c.Explain that the process of postpartum recovery does not require this much rest, but does require that she provide infant care.d.Explain that the mother must abide by hospital policy because documentation of this ability is required for discharge.

Answer 11

ACulturally competent nursing care is individualized for each client, reflecting the client’s beliefs and values, and is provided with sensitivity.

Question 12

The CHN who wishes to develop cultural competence can improve cultural awareness by doing which one of the following?a.Completing a survey of all the ethnic groups in the CHN’s communityb.Considering how the CHN’s personal beliefs and decisions are reflective of his or her culturec.Inviting a family from another cultural background to participate in an event with the CHNd.Studying the beliefs and traditions of persons coming from other cultures

Answer 12

BCultural awareness is self-examination and in-depth exploration of one’s own beliefs and values as they influence behaviour.

Question 13

The incidence of type 2 diabetes among Aboriginal peoples (First Nations, Inuit, and Métis) is three to five times higher than in the general population. When teaching a nutrition class to a group of students, of which a large percentage is Aboriginal, the CHN incorporates into the presentation such foods as bannock and other healthy dishes familiar to Aboriginal students. Which level of prevention does this culturally sensitive action represent?a.Primary preventionb.Secondary preventionc.Tertiary preventiond.Both primary and secondary prevention

Answer 13

APrimary prevention involves such activities as health teaching to prevent a problem from occurring.

Question 14

A nurse practitioner (NP) has just found out that her immigrant client is not taking the penicillin prescribed because his illness is “hot” and he feels that penicillin, a “hot” medicine, will not provide balance. If the NP changes the penicillin to a different but equally effective antibiotic, which cultural attribute will the NP be demonstrating?a.Cultural awarenessb.Cultural brokeringc.Cultural knowledged.Cultural skill

Answer 14

DCultural skill refers to the effective integration of cultural awareness and cultural knowledge to obtain relevant cultural data and meet the needs of culturally diverse clients. Cultural skill involves providing care that is beneficial, safe, and satisfying to the client.

Question 15

Which one of the following is the designation given to groups at high risk of having poor health outcomes?a.Cumulative risk groupsb.Health disparity groupsc.Resilient populationsd.Vulnerable populations

Answer 15

DSpecific populations who are more vulnerable—that is, at-risk populations who are more susceptible to poor health because of socioenvironmental factors—are often referred to as vulnerable populations.

Question 16

Which one of the following is the best intervention a community health nurse (CHN) can initiate to increase lasting resilience among new immigrants?a.Directing clients to English-as-a-second-language coursesb.Giving immigrant clients money to help them get settledc.Identifying areas in the city where housing is less expensived.Soliciting donations for food, clothing, and other needs

Answer 16

AResilience refers to the ability of the client to successfully cope when faced with a threat or hardship. Individuals with low resilience are more inclined to have feelings of hopelessness and may choose suicide as a method to resolve these feelings. Support needs to be provided to those with decreased resilience in order to enhance problem-solving skills and give a greater sense of personal autonomy. When the CHN places emphasis on client strengths and assets rather than client deficits and susceptibility, resilience is more likely to increase.

Question 17

Which of the following interventions by the CHN would best serve a vulnerable population?a.Addressing multiple health concerns, including preventive education, when clients present for treatment of an illnessb.Establishing a system of networks so that clients may be referred to different services such as preventive care, acute illness care, and chronic treatmentc.Providing acute care services that focus on the client’s main health concern and setting up appointments at discharge for other concernsd.Referring clients to specialists to address specific health concerns

Answer 17

AWhen working with vulnerable populations, it is a good idea to arrange to have as many services as possible available in a single location and at convenient times. This “one-stop shopping” approach to care delivery is helpful for populations experiencing multiple social, economic, and health-related stresses. This becomes especially important if clients have problems accessing health care services.

Question 18

Which definition accurately reflects the meaning of the term health inequities?a.Health inequities are the accumulation of multiple factors that lead to poor health.b.Health inequities occur when people are more inclined to become ill and usually do not seek appropriate care.c.Health inequities are unfair differences in health that could be avoided with reasonable action.d.Health inequities are wide variations in health status and services among certain population groups.

Answer 18

CHealth inequities refers to differences in health that could be avoided if reasonable action was taken, and therefore these differences are considered to be unfair and socially unjust.

Question 19

Which of the following is a primary cause of vulnerability?a.Breakdown of family structuresb.Povertyc.Prejudiced.Social isolation

Answer 19

BPoverty is a primary cause of vulnerability. The lack of financial resources may cause some people to not seek preventive health services. This leaves them vulnerable and with increased risk of experiencing the effects of preventable illnesses.

Question 20

Which level of prevention is a CHN practising when she offers homeless clients yearly tuberculosis (TB) screening and free treatment for those who test positive?a.Primary preventionb.Secondary preventionc.Tertiary preventiond.Secondary and tertiary prevention

Answer 20

BScreening homeless persons for TB and providing medications to those who test positive are examples of secondary prevention. The TB screening identifies the disease in its early stages. Medications work to prevent further development of the disease.

Question 21

A CHN is orienting a new recruit to a health clinic that primarily serves vulnerable populations. Which of the following statements by the CHN indicates a need for additional information?a.“If a client who does not speak English comes in, you must obtain an interpreter right away.”b.“We try to take care of as many problems as possible in one visit, so when you check the client in, ask about additional concerns.”c.“You will like working with Filipino immigrants because they have close-knit family structures.”d.“You will need to assist the client by scheduling any referral or follow-up appointments.”

Answer 21

CAssumptions are not helpful. Each person and family should be assessed individually. No two people or groups are alike. Both good and bad stereotyping can create problems. For example, even though Filipino families are generally close knit, by assuming that all Filipino families are this way, clinic care providers will likely miss recognizing such issues as family violence.

Question 22

While screening for diabetes at a community clinic, a CHN found out that a new client had type 2 diabetes. The CHN then provided counselling, referred the client to an endocrinologist for initial assessment and treatment, helped with arrangements for financial assistance, arranged transportation, and booked a follow-up appointment. What role is this type of service most representative of?a.Case managementb.Client advocacyc.Holistic cared.Wrap-around services

Answer 22

ACase management involves linking clients with services and providing direct community health nursing services, including teaching, counselling, screening, and immunizing. Linking health services is accomplished by making appropriate referrals and by following up with clients to ensure that the desired outcomes from the referral were achieved.

Question 23

CHNs at a clinic for homeless persons are concerned that clients rarely return for follow-up after their TB skin (Mantoux) tests. Which policy would be the most appropriate one for addressing this situation?a.Call all homeless clients 48 hours after testing to remind them to return to the clinic for follow-up.b.Have the homeless persons read the test result themselves and then mail in the results on a postage-paid card coded to protect privacy.c.Readminister the test if the client returns later than scheduled for follow-up.d.Routinely refer all homeless clients for chest X-rays.

Answer 23

BSecondary preventive activities are aimed at reducing the prevalence or pathological nature of a condition. They involve early diagnosis, prompt treatment, and the limitation of disability. CHNs can work with homeless and near-homeless aggregates to provide education about existing services and strategies for influencing public policy that will provide more comprehensive services for homeless and near-homeless persons. If necessary, CHNs should develop a method for homeless individuals to read the reaction to the TB skin test themselves and send the results to the facility where the skin test was administered.

Question 24

Which of the following actions should a CHN take when using the case management approach with vulnerable populations?a.Be willing to enter into a long-term relationship with families.b.Direct and control the client’s care because the CHN knows what is most needed.c.Encourage families to become self-sufficient and less dependent on nursing personnel for advice and referrals.d.Rotate assignments periodically, to prevent attachment and codependency.

Answer 24

ACase management is a process that enhances continuity and appropriateness of care. When using case management with vulnerable populations, the CHN can offer the greatest benefit when she or he is willing to develop long-term relationships with the families served. Long-term relationships create trust and ensure continuity of care. Care involves a partnership between the CHN and the client. CHNs who direct and control the client’s care cannot establish a trusting relationship and may inadvertently foster a cycle of dependency and lack of personal health control measures.

Question 25

Which one of the following is an example of tertiary prevention by a CHN?a.Administering the Mantoux (skin) test to identify persons with TBb.Assessing for signs and symptoms of active TBc.Directly observing clients with active TB as they take their antituberculosis medicationsd.Interpreting TB skin test results

Answer 25

CTertiary prevention is implemented when CHNs provide directly observed therapy (DOT) to those with active TB.

Question 26

Which one of the following is the cause of the greatest overall costs to the community for providing health care to the homeless?a.The need for increased preventive services to address the health conditions of the homeless populationb.The need for more frequent clinic visits by homeless clients for multiple health problemsc.The spread of contagious diseases by homeless people to those they pass on the streetd.The fact that most of the care for homeless people takes place in hospital emergency departments

Answer 26

DHomeless persons encounter the same problems accessing health care (e.g., lack of money, lack of housing, lack of transportation) that others do in impoverished conditions. Therefore, health care of homeless persons tends to be crisis oriented and sought in emergency departments. Low-income Canadians have the highest mortality rates and the highest rates of hospitalizations and emergency visits.

Question 27

A CHN presents a proposal for a program for preventing teen pregnancy to a group of parents. In the discussion that follows the presentation, which of the following responses by a parent indicates the need for additional teaching by the CHN?a.“I do not know if my son is sexually active; however, I have decided that I am going to talk to him about birth control, just in case.”b.“I have found that being very strict and checking on my daughter whenever she is out are the best ways to prevent trouble.”c.“I plan to sit down with my daughter and have an honest talk about sexuality and potential risks.”d.“I will start spending more time with my teens when I get home from work.”

Answer 27

BParents who are extremely demanding and controlling or neglectful, and who have low expectations, are the least successful in instilling good values in their children. Children of parents who are neglectful are the most sexually active, followed by children of parents who are very strict. Furthermore, parents who discuss birth control, sexuality, and pregnancy with their children can positively influence delaying initiation of sexual activity and use of effective birth control. Parents who do not talk about sexuality with their teens may find them more at risk for sexual permissiveness and unwanted pregnancies.

Question 28

By which of the following actions can the CHN best ensure long-term positive health outcomes in pregnant teens from low-income groups and their children?a.Help teen mothers learn about body changes during pregnancy.b.Develop programs that enable teen mothers to complete their education.c.Offer courses in proper care of babies.d.Monitor pregnant teens for early detection of problems in pregnancy.

Answer 28

BPrograms that enable the teen mother to complete her education increase her chances for a better future and improved health care over the long term, across the lifespan. Issues to discuss include education and career plans, family finances and qualifications for outside assistance, and personal values about pregnancy and parenting at this time in her life.

Question 29

A CHN who works at a clinic for homeless persons wants to institute a more efficient treatment for chronic wounds. Which of the following actions offers the best way to improve outcomes for these clients?a.Administer antibiotics to all homeless persons with chronic, nonhealing wounds.b.Facilitate daily access to a room with soap, water, and bandages.c.Provide free bandaging supplies to clients at each clinic visit.d.Regularly monitor the wound condition of clients.

Answer 29

BHealth problems faced by homeless people often are related directly to poor access to preventive health care services. The CHN can implement tertiary prevention by designating a wound room in which clients can carry out wound care activities taught during clinic visits. Only infected wounds would need treatment with antibiotics, not all wounds. Free bandaging only addresses one part of the problem and monitoring does not improve outcomes; only treatment does.

Question 30

What information is most important to keep in mind when caring for a pregnant teen?a.All teen pregnancies are considered high risk.b.Limited knowledge can lead to pregnancy complications.c.Pregnant teens are less likely to focus on proper prenatal nutrition.d.Pregnant teens who are poor are more likely to have poorer health outcomes.

Answer 30

CThe nutritional needs of a pregnant teenager are especially important. The CHN needs to assess the pregnant teenager’s current eating pattern and provide creative guidance to address the issue of the demands of pregnancy on a normally changing teenager’s body and a teenager’s usual nutritional habits of fast foods and snacking.

Question 31

Which of the following actions is a way in which the CHN can help prevent depression in older adults who are at high risk for it?a.Encourage them to move to a nursing home where they will have the company of others in the same age group.b.Monitor for signs and symptoms of depression.c.Organize a health promotion program for older adults at the local centre.d.Encourage older adult clients to focus on their strengths rather than their weaknesses.

Answer 31

CIt is important for CHNs to recognize that older adults who are depressed usually have a clinically different presentation from that of clients in other age groups. Older adults who are depressed tend to present with many bodily complaints, such as chronic pain, nausea and vomiting, and insomnia, and usually do not express feelings of sadness, guilt, or worthlessness. The depression rate among older adults is half that among younger people, but the presence of a physical or chronic illness increases rates of depression. Activities to improve the mental health status of older adults include public education programs, prevention approaches, and the provision of mental health services in primary care. Depression rates for older adults in nursing homes range from 15% to 25%, and thus this would not be a good place to recommend for social networking. Encouraging older clients to focus on their strengths rather than their weaknesses can sound insensitive if (1) the weaknesses are, indeed, profound, and (2) the necessary tools for coping are not provided along with the advice. Monitoring for signs and symptoms of depression only monitors health issues, rather than preventing them.

Question 32

A CHN is concerned about caregiver stress in the children of older clients with health concerns. Which of the following secondary prevention strategies can the CHN implement to limit caregiver stress?a.Asking caregivers how they are coping with their roleb.Encouraging caregivers to periodically take a few hours away from their dutiesc.Establishing support groups for caregivers of older adult parentsd.Referring some caregiving responsibilities to home health nurses (HHNs) or professional caregivers

Answer 32

ASecondary prevention includes screening that allows for early recognition of health concerns so that prompt interventions can prevent long-term disabilities. By asking caregivers how they are coping (thus screening), the CHN can identify problems early so that interventions can be made to limit the extent of stress, thus paving the way for improving the situation. The other options are either primary or tertiary activities, depending on whether the intervention takes place before or after development of caregiver stress.

Question 33

Which of the following actions can a CHN take to potentially increase accessibility to health care services for mentally ill homeless clients?a.Apply for a grant to fund a mobile clinic to take health care to the clients.b.Distribute flyers to homeless persons that detail the location of various healthcare services.c.Refer homeless clients to temporary housing facilities.d.Solicit donations for food and clothing to be distributed to the homeless.

Answer 33

AAccessibility refers to the ability of clients to access needed health care services. While all of the options listed lead to opportunities for achieving better health outcomes, either directly or indirectly, only a mobile health clinic can potentially improve accessibility to health care. Neighbourhood clinics, mobile vans, and home visits can bring health care to people unable to access health care units. Coordinating health care services from a central location often improves client compliance because it reduces the stress of getting to multiple places.

Question 34

A CHN suspects that an elementary school student is being physically abused. Which action would be the most appropriate one for the CHN to take?a.Ask the student about the abuse.b.Document findings in the student’s school record.c.Discuss the suspicions of abuse with the student’s teachers or the family’s spiritual leader.d.Notify legal authorities.

Answer 34

DAll individuals in Canada who suspect child abuse are required to report it to the proper child protection agencies, as mandated by law. First Nations peoples have their own child protection agencies.

Question 35

Which of the following actions by a case manager would be classified as primary prevention?a.Advocating for the client whose values conflict with those of the medical service providerb.Collaborating between nursing and occupational health personnelc.Educating a group regarding community services that are available if they are ever neededd.Resolving conflict between a primary care clinic and a tertiary care facility

Answer 35

CPrimary prevention involves the use of the information exchange process to increase the client’s understanding of the health care system. Remember that primary prevention occurs at a point before an illness or a problem occurs. In all of the other options, the client’s health concern already exists and interventions have been employed.

Question 36

A client reports that the narcotic she took for pain on a regular basis made her feel bad and that when she tried an alternative analgesic, she experienced withdrawal symptoms. What is this client suffering from?a.Drug abuseb.Drug addictionc.Drug dependenced.Substance abuse

Answer 36

CThe terms drug dependence and drug addiction often are used interchangeably, but they are not synonymous. Drug dependence is a state of neuroadaptation caused by the chronic, regular use of a drug. People who are dependent on drugs must continue using them to prevent withdrawal symptoms. Drug addiction, in contrast, is a pattern of abuse characterized by an overwhelming preoccupation with the use (compulsive use) of a drug and securing its supply, and a high tendency to relapse if the drug is removed.

Question 37

A CHN is asked by a parent group to explain the risk factors for alcoholism. Which of the following statements should the CHN include in the explanation?a.Alcoholism is determined solely by environment.b.Alcoholism is determined partly by genes.c.Alcoholism is higher in women.d.Persons born with fetal alcohol syndrome are alcoholics from birth.

Answer 37

BResearch has shown conclusively that alcoholism is, at least in part, genetic and not just the result of family environment.

Question 38

At a district board meeting, the CHN requests funding for an after-school recreation program that promotes healthy, fun activities in an effort to decrease drug abuse. Which level of prevention does this exemplify?a.Primary preventionb.Secondary preventionc.Tertiary preventiond.Primary and secondary prevention

Answer 38

APrimary prevention includes the promotion of healthy lifestyles and resiliency factors. The harm reduction approach to the issue of substance abuse focuses on health promotion and disease prevention.

Question 39

An intravenous (IV) drug abuser admits to the CHN that he has no desire to give up his addiction, so the CHN counsels him on the importance of sterilizing his needles to prevent infection and transmission of blood-borne diseases. Which level of prevention does this action represent?a.Primary preventionb.Secondary preventionc.Tertiary preventiond.Primary and tertiary prevention

Answer 39

CTertiary prevention is implemented in people who already have a health concern or problem (in this instance, someone who is already addicted) to prevent complications (harm reduction). In this instance, because the client does not plan to stop the drug abuse, the CHN is trying to prevent complications arising from use of contaminated needles. Emphasis is placed on reducing the transmission of blood-borne diseases through contaminated needles. Giving up the addiction is the best solution but unrealistic for many addicts. Using the harm reduction model, the CHN should provide education on cleaning needles with bleach between uses and about needle exchange programs to decrease the spread of blood-borne pathogens.

Question 40

A CHN suspects that a new client may be a drug addict. When getting the health history of the client, the CHN needs to keep in mind that the client may not admit to drug use. Which one of the following is a primary symptom of addiction?a.Confusionb.Denialc.Forgetfulnessd.Mental status changes

Answer 40

BA primary symptom of addiction involves a refusal to acknowledge that a drug use or substance use problem exists.

Question 41

Which one of the following actions is the best example of enabling in a family with an alcoholic father?a.The father asks the CHN to explain why his continued drinking is dangerous.b.The son threatens to leave the home because he finds his father’s behaviour embarrassing.c.The teenage daughter turns to a favourite teacher for support.d.The wife tells her husband’s boss that her husband is sick when he is actually inebriated.

Answer 41

DEnabling is the act of shielding or preventing the addict from experiencing the consequences of his or her addiction.

Question 42

Which of the following statements made by a parent indicates a need for more education about child abuse?a.“I have stopped slapping my child, and I am learning to count to 10 before reacting.”b.“I never spank or hit my children; I yell at them to stop being stupid and if they don’t, I tell them that the boogeyman will steal them away at night if they don’t obey.”c.“I use ‘time out’ when my child acts out or is naughty. Sometimes, my child doesn’t cope well with this, but I am persistent.”d.“When my child misbehaves, I distract him and try to focus his attention on other things. If he throws a tantrum, I just pick him up and leave the store or show or wherever we may be.”

Answer 42

BEmotional abuse involves extreme debasement of feelings and may result in the child feeling inadequate, inept, uncared for, and worthless. A parent is emotionally abusing the children by yelling at them (“to stop being stupid”) and frightening them (“boogeyman stealing them away at night”).

Question 43

During a group counselling session for perpetrators of intimate partner violence, which of the following statements made by one of the clients indicates a lack of insight into his violent behaviour?a.“I have been taking out my frustrations about work on my girlfriend.”b.“I love my girlfriend and didn’t want to hurt her; it was an accident.”c.“It might be a good idea for me to temporarily leave the house when I feel I am getting angry.”d.“When I drink alcohol, I become more abusive toward my girlfriend.”

Answer 43

BViolence is defined as those nonaccidental acts that result in physical or psychological injury. Although the client may now be feeling remorse, at the time that the violent act was committed against the girlfriend, his intent was to inflict harm.

Question 44

A mother confides to the CHN that her live-in boyfriend pushed her 2-year-old child because he was crying too much. She begs the CHN not to tell anyone because her boyfriend has agreed to take anger management classes. What should the CHN do?a.Abide by the mother’s wishes because this information was provided in confidence.b.Arrange for the earliest available counselling for the boyfriend.c.Advise the mother to take the child away from the boyfriend and find alternate housing right away.d.Report the incident to the child protection agency.

Answer 44

DAll individuals in Canada who suspect child abuse are required to report it to the proper child protection agencies as mandated by law. First Nations peoples have their own child protection agencies. All of the other options put the child’s welfare at risk.

Question 45

Which one of the following characteristics observed in a teenage boy should always alert the CHN to the possibility of suicide?a.Age between 15 and 19 yearsb.A homosexual orientation and history of depressionc.Threatening to cause harm to peersd.A history of torturing and abusing animals

Answer 45

BDepression and homosexuality are two of the leading risk factors for adolescent suicide. Those who threaten peers or torture and abuse animals are more likely to cause harm to others than to themselves.

Question 46

Which of the following represents a challenge when gathering background statistical population-based information on specific minority aggregates?a.Cultural bias is always present.b.There are many social and political impacts of colonization.c.It is difficult to find comparative health information for small communities.d.Statistics Canada does not collect data on specific minority aggregates.

Answer 46

CIn the Chapter 18 case scenario regarding the community of “Northern,” the public health manager explained that it was difficult to find comparative health information on small communities. For example, while several First Nations communities across the country have participated in regional health surveys, access to that data is restricted to the participating community. Cultural bias should not be considered in the gathering of data for a background assessment. The social and political impacts of colonization need to be reversed to improve health, but they do not present a challenge in collecting background information. Statistics Canada does collect specific aggregate data, as indicated in the textbook. For example, according to Statistics Canada, the profile of the urban community showed that 10,055, or 8.3% of the population, self-identified as Aboriginal in 2006 in the Community profile and Aboriginal population profile for the Census Metropolitan Area (CMA) and public health unit. This is more than double the proportion of Aboriginal peoples (3.8%) in the Canadian population.

Question 47

Which one of the following groups has the highest life expectancy?a.Inuit malesb.Inuit femalesc.Registered Indian malesd.Registered Indian females

Answer 47

DThe life expectancy for Registered Indian men is 70.4 years, compared with 64.4 years for Inuit men. The life expectancy for Registered Indian women is 75.5 years, compared with 69.8 for Inuit women, and 82 years for non-Aboriginal women and 77 years for non-Aboriginal men.

Question 48

Which of the following demonstrates the second phase of application of the community health nursing process?a.Assessing the cultural normsb.Determining the needs of the communityc.Developing a 6-week wellness programd.Supervising a fitness class at the local YWCA or YMCA

Answer 48

DSection A of Chapter 18 in your textbook provides some background information on this community and the health issue, which is part of assessment (the first step) of the community health nursing process, followed by planning, action, and evaluation. Assessing cultural norms and determining the needs of the community are parts of the first phase (assessment); actually participating in an intervention for wellness demonstrates the third phase (action).

Question 49

Which of the following demonstrates the first phase of application of the community health nursing process?a.Participating in a health promotion lectureb.Determining the needs of the communityc.Developing a 6-week wellness programd.Supervising a fitness class at the local YWCA or YMCA.

Answer 49

BSection A of Chapter 18 in your textbook provides some background information on this community and the health issue, which is part of assessment (the first step) of the community health nursing process, followed by planning, action, and evaluation. Determining the needs of the community is part of the first phase (assessment). Development of a program occurs in the second (planning) phase, and actually participating in an intervention for wellness or participating in a health promotion lecture demonstrates the third phase (action).

Question 50

Which of the following demonstrates the third phase of application of the community health nursing process?a.Assessing the cultural normsb.Determining the needs of the communityc.Developing a 6-week wellness programd.Supervising a fitness class at the local YWCA or YMCA

Answer 50

DSection A of Chapter 18 in your textbook provides some background information on this community and the health issue, which is part of assessment (the first step) of the community health nursing process, followed by planning, action, and evaluation. Actually participating in an intervention for wellness (e.g., supervising a fitness class at the local YWCA or YMCA) demonstrates the third phase (action). Assessing cultural norms and determining the needs of the community demonstrates the first phase (assessment), and development of a wellness program demonstrates the second (planning) phase.

Question 51

Which of the following demonstrates the final phase of application of the community health nursing process?a.Presenting feedback about a 6-week fitness classb.Determining the needs of the communityc.Developing a 6-week wellness programd.Supervising a fitness class at the local YWCA or YMCA

Answer 51

ASection A of Chapter 18 in your textbook provides some background information on this community and the health issue, which is part of assessment (the first step) of the community health nursing process, followed by planning, action, and evaluation. Presentations related to feedback on actions demonstrate the fourth phase of the application of the community health nursing process, which is evaluation. Actually participating in an intervention for wellness (e.g., supervising a fitness class at the local YWCA or YMCA) demonstrates the third phase (action). Determining the needs of the community demonstrates the first phase (assessment), and developing a wellness program demonstrates the second (planning) phase.

Question 52

Whenever possible, population-based practice focuses on which level of prevention?a.Primary preventionb.Secondary preventionc.Tertiary preventiond.Individual prevention

Answer 52

AWhenever possible, population-based practice focuses on primary prevention.

Question 53

Which one of the following is a feature of community capacity building?a.Asking whyb.Assessing the status quoc.Obtaining sustainable financial resourcesd.Ensuring government is involved at all levels of planning

Answer 53

AAsking why is a feature of community capacity building. In the case scenario in Chapter 18 of your textbook, after briefly looking through the rest of the Community Capacity Building Tool, the group gets into a discussion about the feature “Asking Why,” which recommends using a community process to uncover the root causes of community issues.

Question 54

Developing a communication strategy to keep community members informed is an example of which of the following components of community capacity building?a.Skill developmentb.Partnership buildingc.Documentation of progressd.Establishing a planning team group

Answer 54

BDeveloping a communication strategy to keep community members informed is an example of partnership building.