shit Flashcards

1
Q

What 7 activities can community health be considered as?

A

o Education concerning prevailing health problems and the methods of preventing and controlling them

o Promotion of food supply and proper nutrition

o Provision of an adequate supply of safe water and basic sanitation

o Provision of maternal and child healthcare; including
o Immunisation against the major infectious diseases

o Appropriate control of locally endemic diseases

o Provision of essential drugs

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2
Q

What did the nightingale model focus on?

when was it introduced to Australia?

A

sanitation
hygiene
client education
benevolent support of the client

1868

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3
Q

When did community nursing start in Australia?

A

1885 with the start of the Melbourne district nursing service

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4
Q

What model will the community nurse use for post acute and subacute?

A

Disease - Recovery

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5
Q

What does primary health care focus on?

A

Early intervention to prevent exacerbation

Health education, disease prevention and health promotion focus

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6
Q

What is the psychological approach?

A

considers the multiple effect and interrelatedness of social and environmental factors as they determine health

o Addresses issues, locates the most effective way to encourage healthy behaviour within the individual, the person and their environment and within levels of government (policies, resources)

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7
Q

What is the social gradient?

A

Effect of relative and absolute income on an individual’s health

o ‘poor’ people have poor health outcomes and visa versa

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8
Q

What is the social gradient influenced by?

A

♣ Social status and position
♣ Emotional environment in early childhood
♣ Psychosocial disadvantage
♣ Levels of access to services
♣ Comparative vs complete lack of resources
♣ The capacity for power and control of one’s situation
♣ Opportunities for social inclusion and participation

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9
Q

What is the primary care of a person?

A

the initial medical care given has an illness focus

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10
Q

What are the 4 A’s of primary health care?

A

Accessible, Affordable, Acceptable and Available

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11
Q

What does a community health nurse do?

A
  • work using a primary health care focus of health promotion and disease prevention
  • target at risk groups
  • health promotion, education, screening, early detection
  • work in community health care nursing, organisation, institutions eg prison nursing, infant and child welfare nursing, drug and alcohol, mental health
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12
Q

What does a community based nurse do?

A
♣	Hospital in the home 
♣	Rehabilitation nursing 
♣	Royal flying doctor service 
♣	Palliative care nursing 
♣	Home based chemotherapy
♣     home dialysis

Aims to provide healthcare, disease management and care coordination to individuals and localised groups across the lifespan; aiming to promote health, prevent complications, manage conditions and enable self-care within a community context

observes client in personal environment

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13
Q

What are the values of a primary health care approach?

A
  • Equity
  • Social Justice
  • Empowerment
  • Self-determination
  • Culturally appropriate services
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14
Q

What are the social determinants of health?

name 4

A

Represent the conditions in which people live and work, which affects personal ability to be healthy

  • Social Gradient
  • Stress
  • Early life – developmental stages, childhood illness…
  • Social exclusion – racism, discrimination, stigmatisation, hostility, unemployment
  • Work/Unemployment
  • Social support
  • Addiction
  • Food
  • Transport
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15
Q

Approaches to primary health care

explain the social model of health

A

this approach attempts to address the broader influences on health (social, cultural, environmental and economic factors) rather than disease and injury.

It is a community approach to prevent diseases and illnesses with the focus on policies, education and health promotion

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16
Q

Approaches to primary health care

explain public health

A

focus on health of entire population and includes disease surveillance and prevention, health education, sanitation and environmental safety

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17
Q

Approaches to primary health care

explain community health

A

seeks to identify the health needs of community and develop program to meet needs through empowering of people to promote prevention

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18
Q

Approaches to primary health care

explain web of causion

A

allows an epidemiologist to map the interrelationships among factors that contribute to the development and/or prevention of a particular health condition. It identifies the influence of multiple direct and indirect factors on the development of specific health conditions

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19
Q

Approaches to primary health care

explain the new public health movement?

A

challenges the prevailing focus on finding a cure and argues for a focus on anticipating and preventing health problems

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20
Q

Approaches to primary health care

explain the epidemiological triad

A

the traditional model of infectious disease causation and has three factors; an agent (a perpetrator), the host (the at-risk population), and the environment which work together to contribute to disease

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21
Q

What are the components of the community assessment wheel and the core subsystems

A
  • community in the middle
  • physical environment
  • education
  • safety and transportation
  • politics and government
  • health and social services
  • communication
  • economics
  • recreation
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22
Q

The community assessment wheel and the core subsystems

Explain the community core

A
  • The core of the community is its people, history, values characteristics and beliefs
  • Describes the people and boundaries of your community
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23
Q

The community assessment wheel and the core subsystems

Explain the subsystem of the physical envionment

A
  • The physical assessment of a community is accomplished through careful observation using all the senses. Take a walk and/or drive through the community and see what you notice.
  • Includes the boundaries of the community, climate, housing, water and air quality, and solid waste disposal
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24
Q

The community assessment wheel and the core subsystems

Explain the subsystem of education

A
  • The general education status describes the adequacy of education for the needs of the community
  • Institutions, vocational skill needs
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25
Q

The community assessment wheel and the core subsystems

Explain the subsystem of safety and transport

A
  • Describes how the population moves in, out and within the boundaries, as well as safety issues for the population
  • Includes protective services (fire, police and sanitation) and private and public transport
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26
Q

The community assessment wheel and the core subsystems

Explain the subsystem of politics and government

A
  • Control, guidance, rules and regulations are the cornerstones of a civilised community. These components bring structure, coordinated organisation, economic balance and safety to a community
  • Sources of funding, leadership, organising structure
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27
Q

The community assessment wheel and the core subsystems

Explain the subsystem of health and social sciences

A
•	Contains largest amount of data that health professionals desire. 
•	Health services
o	Physical 
o	Spiritual
o	Mental 
•	Social services
o	Economic 
o	Housing 
o	Support groups
•	Consider the structure (what types of services) and the process (how accessible)
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28
Q

The community assessment wheel and the core subsystems

Explain the subsystem of communication

A
  • May be formal or informal. Formal communication including newspaper, radio, and television often originates outside the community. Informal communication (such as those conversations occurring over coffee in churches and restaurants) almost always originates and is disseminated within the community
  • Patterns of communication and efficacy
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29
Q

The community assessment wheel and the core subsystems

Explain the subsystem of economics

A
  • The goods and services in the community as well as economic data
  • May include household income levels, major employers, and rate of employment
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30
Q

The community assessment wheel and the core subsystems

Explain the subsystem of recreation

A
  • Provide activities to help the members of a community maintain or increase their mental, social and physical health needs
  • Sites of recreation, acceptability to wide array of ages, unmet needs
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31
Q

Describe the community as a partner model

A
  • The partnership approach provides a framework for planning health promotion programs with local communities
  • Help guide public health nurses in their practice
  • Underlying philosophy is primary health care with an emphasis on community empowerment
  • A systems perspective that gives direction to types of community systems that need to be assessed
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32
Q

Explain the differences of the biomedical model and the social model in reference to:

their focus

A

Biomed model:

  • acute treatment of individuals
  • clinical services, health education, immunisation

social model:

  • societal focus - living and working conditions that affect health
  • public health infrastructure and legislation, social services, community action, equity/access issues
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33
Q

Explain the differences of the biomedical model and the social model in reference to:

Key indicators of illness

A

Biomed model:

  • individual pathology
  • hereditary factors, sex, age
  • risk taking factors

Social model:

  • social inequity
  • social groups, class, race, age, ethnicity, gender, occupation, unemployment
  • risk-imposing factors
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34
Q

Explain the differences of the biomedical model and the social model in reference to:

Goals

A

Biomed:
- cure disease, limit disability and reduce risk factors to prevent disease in individuals

social model:
- prevention of illness and reduction of health inequities to aim for equality of health outcomes

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35
Q

Explain the differences of the biomedical model and the social model in reference to:

Benefits

A

Biomed:
- adressess disease and disability of individuals

Social model:
- addresses social determinants of health and illness

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36
Q

Explain the differences of the biomedical model and the social model in reference to:

Causes of illness

A

Biomed model:

  • gene defecits and micro-organisms (viruses, bacteria)
  • trauma
  • behaviour/lifestyle

Social model:

  • political economic factors
  • employment and education factors
  • cultural and structural factors
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37
Q

Explain the differences of the biomedical model and the social model in reference to:

Interventions

A

Biomed model:

  • surgery and pharmaceuticals
  • behaviour modification
  • health education and immunisaiton

Social Model:

  • Public policy
  • State intervention to alleviate health and social inequities
  • community participation, advocacy and political lobbying
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38
Q

What are the critisisms of the Biomedical model?

A

Disease focus - lack of preventative measures
ignores the complexity of health and illness
fails to take into account social origins of health and illness
medical opinions can reniforce victim-blaming

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39
Q

What are the critisisms of the social model?

A

equity goal leads to unfeasible expectations of change
over emphasis on harmful side effects of biomedicine
solutions are complex and difficult to implement in the sort term

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40
Q

Prior to technological developments such as the microscope enabling the discovery of micro-organisms, people believed that disease was the result of

a. Retribution for being a bad person
b. Maisma, which is bad or foul air
c. Exposure from bathing to often
d. Sloth from not working hard enough

A

b. Maisma, which is bad or foul air

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41
Q

Equity means

a. People who have the greatest needs receive the most assistance
b. All people are treated exactly the same
c. People who have a good income will get the best service
d. Making sure those who complain the loudest get taken care of first

A

a. People who have the greatest needs receive the most assistance

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42
Q

What is the social gradient?

a. The line that separates the rich and the poor
b. An indication of how popular a person is
c. An imaginary inclined line representing on a continuum the relationship between income and health status
d. A line that shows the wealthier a person is the more friends they have

A

c. An imaginary inclined line representing on a continuum the relationship between income and health status

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43
Q

The role of a community health nurse focuses on

a. Providing clinical care to maintain health and prevent the onset, progress or complications from disease
b. Health promotion and disease prevention activities aimed at groups
c. Chatting to members of the community regularly
d. Visiting people in their homes to see if the needs to go to hospital

A

b. Health promotion and disease prevention activities aimed at groups

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44
Q

The role of a community based nurse focuses on

a. Providing clinical care to maintain health and prevent the onset, progress or complications from disease
b. Visiting people in their homes to see if they need to go to hospital
c. Working with local governments to plan healthy environments
d. Chatting to members of the community regularly

A

a. Providing clinical care to maintain health and prevent the onset, progress or complications from disease

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45
Q

Which of these roles would NOT be done by a community nurse?

a. Working at the blood bank for the Red Cross
b. Working in a public health unit
c. Working as a district nurse from a rural hospital
d. Working as a school nurse at the local secondary school

A

a. Working at the blood bank for the Red Cross

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46
Q

What is meant by scope of practice?

a. The nurses check the environment for signs of danger before they do any work
b. The nurses can undertake any kind of work they are asked to perform
c. That nurses can experiment with ideas they think work in the care of their clients
d. That nurses must work within the boundaries of what they have been educated, authorised and deemed competent to perform

A

d. That nurses must work within the boundaries of what they have been educated, authorised and deemed competent to perform

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47
Q

What is a nurse practitioner?

a. A student nurse who is still practicing new skills and knowledge
b. A registered nurse who has recently graduated and is practicing skills and knowledge to consolidate their professional practice
c. A registered nurse who has undertaken advanced education and is authorised to request appropriate tests, medications and manage of their client in a specialised area of healthcare
d. A registered nurse who works in a GP or medical specialists practice

A

c. A registered nurse who has undertaken advanced education and is authorised to request appropriate tests, medications and manage of their client in a specialised area of healthcare

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48
Q

What is a nurse specialist?

a. A nurse who works in a GP or medical specialists practice
b. A nurse who has high level skills and knowledge in a specific area of nursing, or a defined population or health related activity
c. A nurse who is really interested in a particular area or type of nursing
d. A nurse who is recognised by their peers as being an excellent colleague

A

b. A nurse who has high level skills and knowledge in a specific area of nursing, or a defined population or health related activity

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49
Q

What does it mean to work in an advanced practice role?

a. This is a nursing role where there is greater complexity, usually requiring further education, experience, competence development, clinical leadership and more autonomy with clinical judgement
b. This is a role which involves lobbying governments to recognise the need to broaden the scope of practice for nurses and advance the practice of the nursing profession
c. This refers to any nurse who has been doing the same job for more than 5 years
d. This is a nursing role which involves planning in advance the type of care a client might need

A

a. This is a nursing role where there is greater complexity, usually requiring further education, experience, competence development, clinical leadership and more autonomy with clinical judgement

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50
Q

Why are good client assessments important in community nursing practice?

a. As community nurses frequently work alone, there is no one else who will check that they haven’t missed anything
b. As the client is not in hospital there is not a lot of equipment close by if the nurse needs to do anything specific for the client
c. Colleagues who also see the client might need to know if there any risks when seeing the client, such as aggressive dogs, firearms in the house or domestic violence issues
d. A good client assessment enables the signs of complications to be detected early, so that the intervention and referrals can occur as quickly as possible

A

d. A good client assessment enables the signs of complications to be detected early, so that the intervention and referrals can occur as quickly as possible

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51
Q

The arrangement where different health professionals work together as a team and take on overlapping professional action is called

a. Multidisciplinary practice
b. Collegial practice
c. Interdisciplinary practice
d. Transdisciplinary practice

A

d. Transdisciplinary practice

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52
Q

Which of the following proposed financial arrangements may contribute to shaping future community practice?

a. Financial incentives to treat people in community based primary care services rather than hospitals
b. Individualised funding where consumers will take a more active role in selecting the services they wish to receive
c. Government proposals for a more integrated model of health funding
d. All of the above

A

d. All of the above

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53
Q

Shorter hospital stays and early discharge practices has meant that community based nurses

a. Have to work harder
b. Need to understand treatment protocols, processes and how a range of devices work because of greater technological care in the home
c. Losing practical skills due to the change in environment and practice setting
d. All of the above

A

b. Need to understand treatment protocols, processes and how a range of devices work because of greater technological care in the home

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54
Q

Evidence based practice for community nurses means

a. Information used is current and the appropriate research has proved that it is the best way to practice
b. Doing things the way they have always been done
c. Providing care for the client in the way the clients wants it to be done
d. Following the instructions given in the discharge plan

A

a. Information used is current and the appropriate research has proved that it is the best way to practice

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55
Q

Health coaching is

a. Getting people more active and involved in sports
b. Taking a tram approach in managing a person’s health care
c. Assisting the client to better manage their chronic health issue using education and promoting healthy behavioural changes
d. Teaching carers how to best look after the person in their care

A

c. Assisting the client to better manage their chronic health issue using education and promoting healthy behavioural changes

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56
Q

What does the term ‘carer’ mean?

a. Any person who is concerned about the wellbeing of another
b. A person employed to provide assistance and support to a person with health issues
c. A health specialist responsible for organising the care provided for a person with health issues
d. An unpaid worker, often a family member, who looks after another person with a health problem for which they require assistance and support

A

d. An unpaid worker, often a family member, who looks after another person with a health problem for which they require assistance and support

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57
Q

What is meant by the term ‘worker’?

a. Any health care professional who is not a doctor, nurse or pharmacist
b. A person employed to provide assistance and support to a person with health issues and is not bound by any professional regulations
c. A health specialist responsible for coordinating the work involved in providing care for a person with health issues
d. An unpaid workers, often a family member, who looks after another person with a health problem for which they require assistance and support

A

b. A person employed to provide assistance and support to a person with health issues and is not bound by any professional regulations

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58
Q

What historical challenges for rural nurses still exist to this day?

a. Difficulties in recruitment
b. The blurring of personal and professional boundaries
c. Lack of privacy
d. All of the above

A

d. All of the above

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59
Q

What is the definition of ADVANCE PRACTICE ROLE

A

– A nursing role that is characterised by greater complexity

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60
Q

What is the definition of MIASMA

A

– Means polluted and is used to describe noxious, foul-smelling forms of bad air

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61
Q

explain the qualities of a community assessment

A
  • reflect the aim of the planned initiatives
  • composition of community, community resources, key people in community, the strengths, weaknesses, opportunities and threats to community
  • include epidemiological and demographic data, stakeholder information, information from service providers and service user reports
  • A needs analysis may need to be completed to identify felt, normative, expressed and comparative needs in the community
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62
Q

Community Definition:

A

A group of people with diverse characteristics who are linked by social ties, share common perspectives and engage in joint action in geographical locations or settings

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63
Q

explain how to build a community profile

A
  • understanding of a population, including its morbidity and mortality trends, community infrastructure and referral pathways
  • Community profile assists nurse to establish baseline data to inform policy, planning and practice
  • Step 1 is to use pre-existing knowledge to describe the community Step 2 is to research and gather information about community
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64
Q

Describe the nurse’s role in providing education to individuals and communities

A
  • Is to provide capacity building and empowerment opportunities to the community and its people
  • The aim of education is to assist people to make informed choices about lifestyle decisions, to take control of and participate in health and lifestyle decisions
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65
Q

What is the Adult Learning Theory?

A

a tool to assist nurses to provide education to adults that reflects their health needs and learning styles

  • Theory assists the nurse to empower people through education
  • Assumes adults are self-directed learners who are motivated to learn, are problem focused, bring valuable life experience to the education process and are able to collaborate in setting education and evaluation goals.
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66
Q

What is health literacy?

A

cognitive and social skills which determine motivation and ability of individuals to gain access to, understand and use information in ways to promote and maintain good health

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67
Q

Activities that optimise health by reducing societal inequity, promoting actions that are predicted to increase positive health impacts and reducing actions that have negative health impacts are classified as

a. Health education
b. Health promotion
c. Community development
d. Capacity building

A

b. Health promotion

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68
Q

Evaluating and establishing a defined population’s resources, strengths and assests, and needs and issues, and then partnering with the community to plan, locate and provide services to meet identified needs is known as

a. A community needs assessment
b. Public health assessment
c. Community profiling
d. Community development

A

a. A community needs assessment

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69
Q

Inappropriate responses from health professionals may result from unhelpful negative stereotyping

a. A comparative need assessment is used
b. They have preconceived ideas about the community they are working with
c. The profile of a whole community is applied to an individual
d. Normative need assessment is applied

A

c. The profile of a whole community is applied to an individual

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70
Q
  1. A need defined by an expert is referred to as

a. A felt need
b. Comparative need
c. Normative need
d. Expressed need

A

c. Normative need

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71
Q

A need identified by the community or services within the community as what they want is a

a. Felt need
b. Comparative need
c. Normative need
d. Expressed need

A

a. Felt need

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72
Q

Why should a community needs assessment be done?

a. To justify the existence of an organisation or program
b. To ensure sound public policy and to develop appropriate health promotion programs
c. To assess the need for nurses in particular community
d. All of the options listed

A

b. To ensure sound public policy and to develop appropriate health promotion programs

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73
Q

The sociocultural determinants that impact on health and wellbeing cannot be identified using

a. Qualitative data collection
b. Consultations with community members or community service providers
c. Epidemiological data of the distribution and determinants of disease
d. A community needs assessment

A

c. Epidemiological data of the distribution and determinants of disease

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74
Q

Establishing the makeup of the community, how things work in the community, what resources the community has at its disposal and who are they key stakeholders in the community is included in

a. A community needs assessment
b. Program planning
c. Developing public policy
d. All of the above

A

a. A community needs assessment

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75
Q

A simple and quick framework that can be used to identify the strengths, weaknesses, opportunities and threats of a situations refers to

a. A SWOT analysis
b. Community needs assessment
c. Community profile
d. A swift analysis

A

a. A SWOT analysis

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76
Q

Equity and access and health literacy impact upon

a. Health care provision
b. Health service funding
c. Health education
d. Health statistics

A

c. Health education

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77
Q

Language spoken, educational level, economic circumstances, employment and family and community membership are

a. Issues that need to be overcome when working with clients
b. Social determinants identified by a community needs assessment
c. Health limiting factors
d. Client characteristics accommodated for quality health education

A

d. Client characteristics accommodated for quality health education

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78
Q

Readiness to learn may be affected by

a. Motivation
b. Physical and psychological capacity
c. The environment
d. All of the options listed

A

d. All of the options listed

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79
Q

What type of environmental factors may affect the learning of participants?

a. Temperature of a room, noise, ventilation and lighting
b. Timing of the education and transportation to the venue where it is being held
c. The choice of font, its size and colour in printed materials
d. The provision of breaks and refreshments

A

a. Temperature of a room, noise, ventilation and lighting

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80
Q

Accessing, utilising and understanding health information demonstrates

a. Educational achievement
b. Professionalism
c. Health literacy
d. Sound public health policy

A

c. Health literacy

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81
Q

Planning, resourcing, implementation and evaluation are

a. The process required to develop health literacy
b. The steps required in undertaking health education
c. The stages of group formation
d. The steps involve in developing public health policy

A

b. The steps required in undertaking health education

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82
Q

Printed material is most common resource used in health education sessions, these need to be

a. As detailed as possible and use the correct medical terminology
b. Colourful at attract the reader’s attention
c. Provided in the everyday language of the reader with clear illustrations
d. Provide only enough detail to ensure the reader will enlist the services of a healthcare professional

A

c. Provided in the everyday language of the reader with clear illustrations

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83
Q

A group with fixed specific goal or purpose is known as

a. A supportive/therapeutic group
b. A teaching group
c. A social group
d. A task / action group

A

d. A task / action group

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84
Q

A group which aims to assist individual growth and problem solving is referred to as

a. A supportive / therapeutic group
b. A teaching group
c. A social group
d. A task/action group

A

a. A supportive / therapeutic group

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85
Q

Closed groups

a. Have no structure
b. Require membership to be static, or if members leave it decline as no new members are added
c. Are usually run by volunteers
d. Allow movement of membership, with new member joining all the time and old members leaving when they wish to

A

b. Require membership to be static, or if members leave it decline as no new members are added

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86
Q

What are the two usual elements of health promotion?

a. Overcoming current health issues and revering the effects of these
b. Applying strategies to prevent the development of health issues and overcoming current health issues
c. Overcoming current health issues and improving health literacy
d. Applying strategies to prevent the development of health issues and promoting positive health behaviours

A

b. Applying strategies to prevent the development of health issues and overcoming current health issues

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87
Q

Explain Social Inclusion

A

– assumes that each person needs to have access to particular resources and structures within society to have health, achieve successfully in life and participate fully in society

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88
Q

Explain Social Exclusion

A

– is the outcome of multiple deprivations (unemployment, discrimination, inadequate skills, low incomes, poor housing, high crime, family breakdown) that prevent individuals or groups from participating fully in the economic, social and political life of the society in which they live.

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89
Q

What is Social Capital and the 3 types?

A
  • Social Capital concerns the extent of trust, reciprocity and mutual cooperation that are available to individuals and communities
  • Community nurses who employ a social capital approach to working with their communities, seek to build lasting, cohesive and cooperative bonds between all stakeholders

bonding
bridging
linking

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90
Q

3 types of social capital

Explain bonding social capital

A

occurs within tightly connected groups such as families, groups that share a common purpose or social identity, where one can gain strong emotional and social support. This SC helps people get by

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91
Q

3 types of social capital

Explain Bridging social capital

A

happens between individuals that are not part of the same group but share a sense of respect and reciprocity. This SC helps people get ahead

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92
Q

3 types of social capital

Explain Linking social capital

A

occurs between individuals and organisations in a more vertical manner. There is usually a formal power differential in these – relationship between lecturer and student. This SC helps people get ahead

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93
Q

What is Social Capacity?

A

The ability to produce an enabling environment that fosters open and inclusive relationships between people that are characterised by qualities such as trust, cooperation, justice and equity, from which a cohesive, relational and tolerant society can develop.

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94
Q

What is globalisation

A

a process that marks the diffusion of commodities, ideas and economic activity around the world

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95
Q

What is the impact of globalisation on health?

A

• People traveling around the world contributes to the distribution of disease and disease transmission rates and consequently to the management of diseases
• Increased movement of goods, services, trade, investment, money, knowledge, ideas, technology, culture and people between countries to create a more borderless world
• Poverty in developed countries is decreasing and the global health initiative to eradicate it is working
• Examples:
o The advertising and marketing of tobacco, fast food and consumer goods known to be associated with disease, death and lifestyle disorders
o The spread or threat of spread of epidemic and pandemic infections diseases such as TB, H1N1-swine and H5N1-avian influenza, HIV/AIDS, the plague, continue to be a concern with the movement of people, hosts and vector organisms
o The increase in modern technology to enable a rapid response to pandemic emergencies and health conditions

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96
Q

What are the 8 Millennium development goals?

A

o Eradicate extreme poverty and hunger
o Achieve universal primary education
o Promote gender equality and empower women
o Reduce child mortality
o Improve maternal health
o Combat HIV/AIDS, malaria and other diseases
o Ensure environmental sustainability
o Develop a global partnership for development

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97
Q

What are the four levels of community engagement?

A

o 1. Provide information to individuals or community about decisions and activities underway. Involves use of factsheets, websites, information kits

o 2. To consult with individuals and community and get feedback on activities. Involves communication in the form of focused groups, comments and surveys

o 3. Involvement by working with community to explore issues. Involves working groups, committees and workshops involving community members

o 4. Collaborate and engage so the community can define their own goals and contribute to decision making to address a collective health issue

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98
Q

What are the 2 components of medicare?

A

federal and state funded Australian Healthcare Agreements for public hospital services

National Medical Benefits Scheme.

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99
Q

Where does funding for health come from ?

A

medicare
not for profit organisations
regional health services
contracts with public hospitals

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100
Q

What is the Integrated Community Care for Older People (ICCOP) program and what are some of the benefits of this program?

A
  • for older people with chronic conditions
  • goal is to promote self care and reduce escalation of condition
  • risk assess
  • promote early intervention
  • designed to link clients to their community
  • helping keep them in their own home
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101
Q

What does the Home and Community Care (HACC) Program include?

A

o Personal care and support
o Home cleaning and maintenance
o Meals on Wheels
o Respite care services
o Assistance with local transport, shopping
o Health and wellbeing programs
o Community nursing services – changing dressings, administration of medication

102
Q

What does ACAT do?

A

The Aged Care Program heavily subsidises residential aged care, community aged care and community respite care for people determined as eligible

They assess the person and give them an acat score

103
Q

What are Community Aged Care Packages (CACPs) for?

A

low-care needs – personal care and assistance with ADLs but no nursing care

104
Q

What is Extended Aged Care at Home (EACH) for?

A

• for high-care needs including nursing cares

o Funding is for an approved number of eligible people only

105
Q

What type of things do community nurses see?

A

o Stressful family dynamics
o The effects of being a continuous carer
o The isolation of having a disability and limited mobility
o Diminished self-confidence
o The discomfort of incontinence
o The shrinking ability of an elderly person with confusion to deal with basic tasks

106
Q

What is absolute poverty

A

♣ It is the extreme kind of poverty involving the chronic lack of basic food, clean water, health and housing. People in absolute poverty tend to struggle to live and experience a lot of child deaths from preventable diseases like malaria, cholera and water-contamination related diseases. This type is usually long term in nature, and often handed to them by generations before them. This kind of poverty is usually not common in the developed world.

107
Q

What is relative poverty?

A

♣ This kind is usually in relation to other members and families in the society. For example, a family can be considered poor if it cannot afford vacations, or cannot buy presents for children at Christmas, or cannot send its young to the university. Even though they have access to government support for food, water, medicine and free housing, they are considered poor because the rest of the community have access to superior services and amenities.

108
Q

What is situational poverty?

A

♣ People or families can be poor because of some adversities like earthquakes, floods or a serious illness. Sometimes, people can help themselves out of this situation quickly if they are given a bit of assistance, as the cause of their situations was just one unfortunate event.

109
Q

What is generational or chronic poverty?

A

♣ This is when poverty is handed over to individuals and families from generations before them. In this type, there is usually no escape from it, as people are trapped in its causes and have no access to tools that will help them get out of it.

110
Q

What are the 4 types of poverty?

A

absolute
relative
situational
gernerational/chronic

111
Q

Poverty

What is the impact of hunger, health and deaths?

A
  • extreme hunger, starvation and malnutrition
  • more vulnerable to preventable diseases
  • no access to healthcare
  • engaging in risky behaviours
  • living on unhealthy foods
112
Q

Poverty

What is the social and political impact?

A
  • indulging in risk taking behaviours or crime to meet immediate needs
  • rebel leaders may take advantage of young people in return for basic needs
113
Q

How are people affected by poverty economically?

A
  • cannot afford food, water or shelter
  • not heathy enough to undertake economic activity
  • cannot send kids to school
  • economic breakdown of community
  • forced to migrate to where there is better opportunity
114
Q

What is the poverty cycle?

A

poor house hold
little food, unclean water, no school
diseases, infections, no energy and skills to work
low productivity
low or no income
low self esteem, no personal control
high child births, sick, elderly, more dependants

115
Q

Give some strategies to break the poverty cycle

A

o Provide some kind of assistance; health, feeding, shelter and basic education
o Provide economic activity to bring income to those who need it
o Education – empowers people to identify and take advantage of opportunities and learn life skills. Training teachers, building schools, providing education materials and breaking down the cycle improve outcomes.
o Health and income redistribution to ensure equitable access, availability and is affordable
o Removing social and legal barriers to income growth among the poor
o Many programs aim at feeding kids at school and providing health services as well. This encourages parents to send the children to school and keep them there

116
Q

Globalisation can be defined as

a. A free market trade company
b. A process that marks the diffusion of commodities, ideas and economic activity around the world
c. The increase in multinational companies
d. The ease of international travel

A

b. A process that marks the diffusion of commodities, ideas and economic activity around the world

117
Q

What modern phenomenon contributes to the increase in global distribution of disease and disease transmission rates?

a. The large numbers of refugees worldwide
b. The ease of international travel
c. The importation of foods from other countries
d. Reduced immunisation rates

A

b. The ease of international travel

118
Q

Smallpox is

a. The major cause of death in developing countries
b. Often misdiagnosed as chickenpox
c. A highly infectious disease which was eradicated through a global effort
d. A common cause of disfigurement if left untreated

A

c. A highly infectious disease which was eradicated through a global effort

119
Q

The integration of world economics is commonly referred to as

a. Globalisation
b. The World Financial Crisis
c. Balance of Trade
d. The European Union

A

a. Globalisation

120
Q

The immigration of health workers from poorer developing world countries to more developed countries to meet the health workforce shortage in more developed countries is said to be the result of

a. Global warming
b. World Financial Crisis
c. The ease of international travel
d. Globalisation

A

d. Globalisation

121
Q

The advertising and marketing of tobacco, fast food and consumer goods known to be associated with disease, death and ‘lifestyle disorders’ are identified as

a. A worldwide phenomena
b. A significant health impact of globalisation
c. Sign of economic development
d. A consequence of the ease of international travel

A

b. A significant health impact of globalisation

122
Q

The reduction in child mortality and to achieve universal primary education are two of the stated goals included in

a. The declaration of Alma Ata Goals
b. Health for All Goals
c. The Millennium Development Goals
d. The Goals of the Ottawa Charter

A

c. The Millennium Development Goals

123
Q

Housing, education, gender equality, opportunities for income generation, maternal and child health services, access to safe drinking water and adequate food supplies are recognised as

a. Unlikely to ever to universally achievable
b. The criteria to be considered a developed country
c. Achieved through globalisation
d. Basic health determinants that all members of the global community need

A

d. Basic health determinants that all members of the global community need

124
Q

Individuals and communities who demonstrate respect, trust and cooperate with one another demonstrate

a. Social capital
b. Social inclusion
c. Social capacity
d. Community spirit

A

a. Social capital

125
Q

Policies that promote social inclusion and try to reduce inequality and inequity are those that

a. Develop community spirit
b. Reduce racial tension
c. Facilitate social capital
d. Promote civic pride

A

c. Facilitate social capital

126
Q

What groups that share a common purpose or social identity help each other out when needed, this is referred to as

a. Bridging social capital
b. Bonding social capital
c. Linking social capital
d. Social inclusion

A

b. Bonding social capital

127
Q

The belief that people require particular resources and structures to participate fully in society, achieve successfully in life and have is known as

a. Bridging social capital
b. Bonding social capital
c. Social capital
d. Social inclusion

A

d. Social inclusion

128
Q

The vertical connection between people and organisations or institutions is known as

a. Bridging social capital
b. Bonding social capital
c. Linking social capital
d. Social inclusion

A

c. Linking social capital

129
Q

The connections people make with others outside their social group, with whom they share a sense of respect and reciprocity refers to

a. Bridging social capital
b. Bonding social capital
c. Linking social capital
d. Social inclusion

A

a. Bridging social capital

130
Q

The absence of multiple resources and structures which prevents people who may want to participate from being involved in the economic, social and political life of the society in which they live is known as

a. Racism
b. Social exclusion
c. Being underprivileged
d. Poverty

A

b. Social exclusion

131
Q

Building ongoing cohesion and cooperation between all the stakeholders with whom they work is a way that community nurses can

a. Use a social capital approach in their work
b. Prevent social exclusion
c. Promote participation
d. Encourage social inclusion

A

a. Use a social capital approach in their work

132
Q

Creating the right circumstances for a person or people to live together cooperatively and respectfully means

a. Ensures social inclusion
b. Prevents social excludes
c. Reduces racism
d. Develops social capacity

A

d. Develops social capacity

133
Q

Demonstrating that community health problems achieved the purpose for which they were funded is done through

a. Report writing
b. Epidemiological data
c. Evaluation
d. Anecdotal evidence

A

c. Evaluation

134
Q

A World Health Organisation movement that states governments at all levels have the responsibility to provide public policies that enable the basic conditions for healthy living of all their citizens, is known as?

a. The Public Health Movement
b. The Healthy Cities initiative
c. Political lobbying
d. The Health for All Goals

A

b. The Healthy Cities initiative

135
Q

Community nurses need to understand how to obtain meaningful community participation, which is achieved through

a. Consultation and the provision of information
b. Consumer representation on advisory groups
c. Public meetings and focus groups
d. Partnerships, delegation of power and full citizen control

A

d. Partnerships, delegation of power and full citizen control

136
Q

What is the DISABILITY-ADJUSTED LIFE YEAR?

A

The sum of years of potential life lost due to premature mortality and the years of productive life lost due to disability

137
Q

What is the HEALTHY CITIES INITIATIVE ?

A

A world health organisation movement that states governments at all levels have the responsibility to provide public policies that enable the basic conditions for healthy living of all their citizens

138
Q

What are the various types of nursing positions available in the community?

A
  • Outback Nursing
  • Nurses who work and live on mine sites
  • Working with the homeless in shelters and on the streets
  • Parish Nurses who service those who are homeless, uninsured, healthcare screening and answering questions as resources and providers of community services
  • Nurses who work in GP clinics
  • Palliative Care in the home
  • Wound Care Nurses
  • Diabetes Educator/Nurse
  • Youth/School Health Nurse
  • Maternity, Women and Children’s Health
  • Rehab Programs
139
Q

What are some traditional nursing settings?

A

• – care is delivered in corresponding structured settings
o Intensive Acute Care in an ICU hospital ward
o Generalist Acute Care in hospital
o Rehabilitation in hospital wards
o Primary Care in GP clinics and health centres
o Mental Health
o School Health

140
Q

What are some contemporary nursing settings?

A

• – care not restricted to location
o Intensive Acute Care that is delivered in the home of a person with a complex disability
o Generalist Acute Care such as Hospital-at-Home services and services at aged-care facilities
o Rehabilitation at home including transitional care
o Primary Care that is delivered at a person’s home, workplace, park or shelter, church
o Maternal and Child health that is delivered in kindergartens and childcare centres by visiting nurses

141
Q

What are the key behaviours and practices that facilitate client care in the community?

A
  • working under the patient centred care approach
  • Ensure equity and access to services is maintained and offered to the client
  • gain and ensure trust is created and maintained
  • working in partnership with the client
  • client empowerment
  • work in teams and independently
  • utilise reflective practice
  • clinically confident
  • deliver health education, promotion and primary intervention/prevention
  • ensure continuity of care and therapeutic relationship
  • know how to prioritise
142
Q

What assessments do community nurses need to be able to perform?

A
o	Comprehensive Clinical Assessment 
o	Cognitive Assessment 
o	Social Assessment
o	ADL Assessment
o	Mental Health Assessment 
o	Nutritional Assessment 
o	Pain Assessment 
o	Accumulating assessment data and developing a Care Plan
143
Q

What are the key principles for effective discharge planning?

A
  • Assess clinical areas eg; pharmacy, GP contact, physio, social worker and right through to the transport services
  • crucial for continuity of care
  • start planning before or on admission
  • identify wether the client has simple or complex needs
  • communicate with mdt
  • set discharge date
  • review clinical management plan daily
  • invove patients and carers
  • ensure patients understand their diagnosis
  • ensure patients understand wound care
  • ensure patients understand medications
144
Q

Sub-acute care refers to

a. Non-emergency care
b. Care that does not require life support
c. Care that is provided to people who are medically stable, but who have not returned to their pre-morbid condition
d. Care which provides assistance with activities for daily living

A

c. Care that is provided to people who are medically stable, but who have not returned to their pre-morbid condition

145
Q

Cognitive capacity refers to

a. A person’s ability to learn
b. A person’s ability to construct thoughts and to recognise, image, reason, judge, evaluate and solve problems
c. Person’s ability to speak and communicate
d. A person’s ability to remember

A

b. A person’s ability to construct thoughts and to recognise, image, reason, judge, evaluate and solve problems

146
Q

What does virtual health information refer to ?

a. Health information that provides the most essential details only
b. Health information that is embedded in an activity (e.g. games, stories)
c. Health information that is provided in a virtual setting (e.g. the internet, over videophone or using a computer-based interactive software)
d. Health information that is presented in the simplest way

A

c. Health information that is provided in a virtual setting (e.g. the internet, over videophone or using a computer-based interactive software)

147
Q
  1. What is one of the early signs of poor health in an older person?
    a. Neglect of their personal surroundings
    b. Physical neglect
    c. Deterioration of their self-care
    d. All of the above
A

d. All of the above

148
Q

When a nurse discussed a client with other health care providers such as allied health professionals or the client’s GP

a. Communication must be undertaken with the client’s informed consent
b. Written permission needs to be obtained first
c. Family members should be notified
d. All of the above

A

a. Communication must be undertaken with the client’s informed consen

149
Q

To work with individuals in a non-judgemental way means that community nurses must

a. Try to monitor the language they use so it does not sound like they are disapproving of the client
b. Try to avoid disagreeing with the client
c. Try to see the world from the client’s perspective
d. Try to ignore any behaviours of the client which they disapprove

A

c. Try to see the world from the client’s perspective

150
Q

It has been suggested that to facilitate self-care, nurses need to

a. Move from feeling responsible for the clients, to feeling responsible to the clients
b. Provide better health education
c. Coordinate health care service provision
d. All of the above

A

a. Move from feeling responsible for the clients, to feeling responsible to the clients

151
Q

It is said that general observation is one of the community nurse’s best practice tools. What observations should be made?

a. Signs of normal activity e.g. dishes in the sink, cup of tea on the table
b. Smell and light
c. Order and cleanliness
d. All the above

A

d. All the above

152
Q

Visiting guidelines for community nurses include

a. Make conversation that focuses on the client’s health condition and raise questions that provide insight into the clients orientation to time, person and place
b. Refrain from commenting on personal items, unless the client brings them up first
c. Always knock and wait to be invited into a client’s home, regardless of how many times you have previously visited
d. All of the above

A

d. All of the above

153
Q

What new technologies can assist in people retaining their independence without over intrusion?

a. Safe return bracelets for those who have a tendency to wander
b. Telehealth
c. Monitored dosage systems for medication
d. All of the above

A

d. All of the above

154
Q

In holistic care, nursing theory defines the whole

a. In terms of its component dimensions
b. In terms of its component dimensions, but adds that the whole is greater that the sum of its parts, or alternatively as one irreducible unit
c. As greater than the sum of its parts
d. As one irreducible unit

A

b. In terms of its component dimensions, but adds that the whole is greater that the sum of its parts, or alternatively as one irreducible unit

155
Q

In an effort to ensure that the client remains connected with their family and social support system what does a nurse in the community need to ensure its integrated within the care they provide?

a. Self-care management and self-responsibility
b. Self-responsibility and self-assurance
c. Self-esteem and self-confidence
d. Self-assurance and self-efficacy

A

a. Self-care management and self-responsibility

156
Q

Nurses who work with clients who have dementia try to get to know and understand a person’s history, life experiences, culture and personal values, personality and possible reactions to their environment as their cognition deteriorates, this is referred to as

a. Individualised care
b. Holistic care
c. Coordinated care
d. Person-centred care

A

d. Person-centred care

157
Q

With clients who have dementia, why is maintaining their care within the home environment a key health objective?

a. Prevents bed blocking in acute care settings
b. Dementia clients are too difficult to manage in a busy hospital setting
c. A client with dementia deteriorates within a hospital setting
d. Dementia clients cannot be given the level of care they require in a busy hospital setting

A

c. A client with dementia deteriorates within a hospital setting

158
Q

Why is it important that information about risk factors such as loose pavers in a front path, a protective animal or poor lighting is documented

a. So that these risks are on record and if any of them contribute to a worker being injured they can sue the client
b. So other workers are aware of the issues and can take note of them when they are planning their work schedule
c. So that these risks are on record and if any of them contribute to a worker being injured they can make a Work Cover (Workers compensation)
d. So that these risks can be attended by the employing agency because of they have a duty of care to provide a safe working environment

A

b. So other workers are aware of the issues and can take note of them when they are planning their work schedule

159
Q

What percentages of injuries in Australia occur outside, but within the environs of the home?

a. 25%
b. 30%
c. 35%
d. 55%

A

a. 25%

160
Q

When is the Case management care model used?

A

♣ Used for waiting lists, referral criteria, funding of services
♣ Consists of an assessment of the individual’s needs, the coordination of services between the agencies and the client’s home and regular reviews and monitoring of the client

161
Q

People with a well controlled chronic disease report…

A

o Better mental health
o Greater stability in life allowing them to participate in community
o More consistent employment
o Reduced personal and community costs of healthcare

162
Q

What can be stressors of caregivers?

A

o Financial concerns
o Health of carer
o Emotional distress

163
Q

What is wagners chronic care model?

A

provides a framework that helps to identify the systems changes that are required to improve the coordination of care

164
Q

What are the 6 components of wagners chronic care model?

A
  1. Community
    – resources and programs provide ongoing support for people
  2. Health System
    – supports prepared and proactive practice and provides incentives for care providers
  3. Self-Management Support
    – empowers and prepares clients to self-manage their health with resources, training and psychosocial support
  4. Delivery System Design
    – interdisciplinary teams deliver systematic, effective and efficient clinical care and self management support, incorporating consultations and follow-ups in their practice
  5. Decision Support
    – ensuring clinical care is consistent with Evidence Based guidelines
  6. Clinical Information Systems
    – data systems provide information about the client and at-risk groups, give reminders for reviews and follow-ups and monitor performance of care teams
165
Q

The Australian Bureau of Statistics Year Book Australia (2007) reports that

a. 21% of children under 15 years and 50% of people aged 65 years and over have at least one chronic health condition
b. 41% of children under 15 and nearly all people aged 65 years and over have at least one chronic health condition
c. 50% of children under 15 and nearly 75% of people aged 65 years and over have at least one chronic condition
d. 10% of children under 15 and 41% of people aged 65 years and over have at least one chronic health condition

A

b. 41% of children under 15 and nearly all people aged 65 years and over have at least one chronic health condition

166
Q

Health coaching requires knowledge and skill in

a. Conflict resolution and problem solving
b. Problem solving and transition theory
c. Motivational interviewing and transition theory
d. Motivational interviewing and conflict resolution

A

c. Motivational interviewing and transition theory

167
Q

Approximately 20% of all Indigenous Australian deaths are associated with

a. Poor diet and physical inactivity
b. Poverty and lack of education
c. Alcohol
d. Smoking

A

d. Smoking

168
Q

Self-care refers to

a. What a person does on a day-to-day basis to maintain their quality of life and prevent the development of health conditions
b. What a person with health conditions does to maintain their quality of life and meet their needs on a day-to-day basis
c. What a person with health conditions does on a day-to-day basis
d. What a person does to meet their needs on a day-to-day basis

A

b. What a person with health conditions does to maintain their quality of life and meet their needs on a day-to-day basis

169
Q

Case management usually occurs when

a. A person has a condition that requires assessment
b. A person has a complex condition
c. A person has a condition that requires multiple services to be used from multiple providers
d. A person has a complex condition that requires multiple services

A

d. A person has a complex condition that requires multiple services

170
Q

The WHO asserts that healthcare systems need to move towards models of care that prevent or manage long term conditions. What is NOT an outcome of this

a. This is a step towards long-term, integrated, planned care models
b. This is a step towards a total redevelopment of healthcare services
c. This is a step away from traditional acute sector models that focus on single, episodic-based care
d. None of the above

A

b. This is a step towards a total redevelopment of healthcare services

171
Q

A person’s belief about their ability and capacity to achieve tasks and to meet challenges in life is known as

a. Self-efficacy
b. Self-confidence
c. Self-esteem
d. Self-assurance

A

a. Self-efficacy

172
Q
  1. Identifying the type of healthcare workers who are required to meet a client’s needs is known as
    a. Individualised care
    b. Interdisciplinary are
    c. Coordinated care
    d. The skill mix
A

d. The skill mix

173
Q

A major stumbling block for autonomous practice in caring for Australians out of the Acute care setting was overcome when

a. Interdisciplinary care was introduced
b. Practice nurse roles evolved
c. Qualified, eligible nurse practitioners and midwives were given the legal right to prescribe certain medications under the PBS
d. Electronic health records were developed

A

c. Qualified, eligible nurse practitioners and midwives were given the legal right to prescribe certain medications under the PBS

174
Q

What is a genogram?

A

• A display of a person’s family relationships and medical history

175
Q

What are the 8 key areas to assess families as found in the Australian Family Strengths Nursing Assessment?

A
o	Togetherness
o	Sharing of activities
o	Affection 
o	Support 
o	Communication 
o	Acceptance 
o	Commitment 
o	Resilience
176
Q

What are some assessments that the child health nurse does?

name 5

A

o Growth and physical check
o Vision surveillance and screening
o Promoting, protecting and supporting breastfeeding
o Promoting responsive settling and facilitating safe sleep
o Early childhood oral health
o Body mass index (BMI)
o Promotion of immunisation
o Development screening tools: parents evaluation of developmental status, ages and stages questionnaire, ages and stages questionnaire: social emotional
o Identifying and responding to risk of harm of infant/child
o Supporting the healthy parent child relationship
o Infant mental health
o Routine screening for domestic violence
o Suicide risk assessment and safety management
o Identifying and responding to drug and alcohol issues

177
Q

What are some protective factors for families and children?

A

Child protective factors
parent and family protective factors
social and environmental protective factors

178
Q

What do school nurses do?

A
  • individual consults
  • plan, implement and evaluate school policies
  • health promotion activities
  • advice about health
  • provision of services for challenging and vulnerable groups
  • referrals
  • counceling
  • advocacy
  • immunisation programs
  • sexual health education
  • use of alcohol and drugs
  • exercise
  • mental health
179
Q

What are the 6 guideline areas for a health promoting school? (HPS)

A

♣ The physical environment of the school
♣ The health policy of the school
♣ The social environment of the school
♣ Community relationships
♣ Personal health skills
♣ Relationships with other health services

180
Q

Tools such as genograms and ecograms encompass can help the nurse to

a. Identify deficits in parenting skills
b. Help the nurse understand the family boundaries, organisation and structure
c. Provide frameworks for structural, developmental and functioning assessments
d. Initiate a conversation with a family

A

b. Help the nurse understand the family boundaries, organisation and structure

181
Q

Solution-focused and strengths-based approaches are

a. Former approaches used within nursing when working with families
b. The current trend in the approach to working with families within nursing
c. Health promotion campaigns targeting families
d. Used with problem-based approaches when working with families

A

b. The current trend in the approach to working with families within nursing

182
Q

Attributes that are associated with an increased probability of health and wellbeing are referred to as

a. Risk factors
b. Social factors
c. Protective factors
d. Genetic factors

A

c. Protective factors

183
Q

Midwives who visit newly discharged mothers and infants in their homes once they leave hospital to provide a range of midwifery services are called

a. Domiciliary midwives
b. Family nurses
c. Maternal and child health nurses
d. Domiciliary nurses

A

a. Domiciliary midwives

184
Q

How can maternal and child health nurses assist in providing support for new parents geographically isolated from their extended family?

a. By encouraging mothers to attend a first time mothers group
b. Through providing babysitting services
c. By facilitating contact with extended family
d. Through taking on maternal role with new parents

A

a. By encouraging mothers to attend a first time mothers group

185
Q

Providing information to a client or their family prior to an anticipated age or stage describes

a. Health promotion
b. Health education
c. Anticipatory education
d. Anticipatory guidance

A

d. Anticipatory guidance

186
Q

What is anticipatory guidance?

A

– Involves providing information to a client or their family prior to an anticipated age and stage

187
Q

Define cultural competency

A

implies understanding and sensitivity of different cultural beliefs and practices

188
Q

Define cultural safety

A

encompasses a holistic reflection of the person within family and community contexts and the customs, attitudes, beliefs and preferred ways of doing things that comprise this system

189
Q

What are the challenges rural and remote nurses face in the community?

A

poor access to services eg transport, specialist appointments
primary manager of all care
first point of call for trauma and community disaster
developing community partnerships
higher violence levels

190
Q

What are some strategies for working with our indigenous community?

A

o Recognise their spirituality and holistic views regarding health
o Empathise with them regarding past trauma and loss
o Respect diversity
o Understand the narrative construction of identity in their culture
o Understand decision making within their culture – they cant always make their own decisions
o Understand the range of perspectives and values regarding family

191
Q

What document established a common framework for enhancing global health status through the adoption of a PHC philosophy

a. The Kyoto Protocols
b. The Ottawa charters
c. The Alma-Ata declaration
d. The Jakarta Declaration

A

c. The Alma-Ata declaration

192
Q

What documented outlined the World Health Organisation’s international strategy for implementing a PHC approach to achieve ‘health for all’ in the world

a. The Kyoto Protocols
b. The Ottawa charters
c. The Declaration of Alma-Ata
d. The Jakarta Declaration

A

b. The Ottawa charters

193
Q

What document which identifies the priorities for health promotion for the 21st century

a. The Kyoto protocols
b. The Ottawa charters
c. The declaration of Alma-Ata
d. The Jakarta Declaration

A

d. The Jakarta Declaration

194
Q

Caring for individuals from initial contact with health providers through recovery and health sustainability is referred to as

a. The continuum of care
b. Health care packages
c. Continuous care
d. Duty of care

A

a. The continuum of care

195
Q

What type of information do nurses need to assist them to recognise potential health and social issues that may impact on groups and individuals, and can plan activities to promote wellness?

a. Hospital admission data, medical practitioner numbers and dental services
b. Population size and composition; local resources including health services, education, transport, communications systems, employment rates and the strength of the local economy
c. The number of recreation grounds, sporting clubs and swimming pools
d. Home and care ownership data

A

b. Population size and composition; local resources including health services, education, transport, communications systems, employment rates and the strength of the local economy

196
Q

A community needs assessment combines community profile data with

a. Population information
b. Transportation and employment data
c. Hospital admission data
d. Population information and a range of other data, including environmental, climatic, social, economic, geographic and educational data

A

d. Population information and a range of other data, including environmental, climatic, social, economic, geographic and educational data

197
Q

As the health issues and life opportunities of Indigenous Australians are consequence of the past and present socioeconomic and sociocultural status within Australian society, it is important that

a. Health professionals acknowledge by the ‘country’ of their indigenous Australian clients
b. Health professionals to have knowledge of and understand Indigenous history
c. The government provides housing for indigenous Australians
d. Indigenous Australians work harder to achieve equity

A

b. Health professionals to have knowledge of and understand Indigenous history

198
Q

When nurses travel as part of their work what personal safety precautions should they put in place?

a. Letting someone know what time they expect to return
b. Letting someone know when and where they are going, their expected time of return and carrying some form of communication such as a phone or radio
c. Ringing ahead to the client to check that they are home and it is safe to visit
d. Asking if there are guns in the home of clients they intend to visit

A

b. Letting someone know when and where they are going, their expected time of return and carrying some form of communication such as a phone or radio

199
Q

What are some adverse life events that disrupt one’s personal sense of self?

A
♣	Disability 
♣	Separation and divorce
♣	Redundancy
♣	Child sexual abuse, family violence
♣	Death
200
Q

What is transition?

A

a process people employ to move through a period of time where they must negotiate their sense of self within an altered social landscape

201
Q

What are the 4 phases of the transition model?

A

Familiar life
An ending
Limbo
Becoming ordinary

202
Q

Transition Model

Explain phase 1 Familiar life

A

life is predictable and familiar. Roles, status, location, health and relationships are known and understood. A firm sense of identify is held

203
Q

Transition Model

Explain phase 2 An ending

A

a change or experience causes disruption. The old ways of responding no longer work. The disruption ends the known way of living and forces the person to change connections. The person cannot go back to familiar life instead must try and locate sense of self within new environment

204
Q

Transition Model

Explain phase 3 Limbo

A

person is not familiar and has yet to incorporate changes required to move into new life phase. The person is trying to make sense of changed life and may feel they are a victim of their circumstances and don’t know how to make sense of such new life. They may feel powerless, disorientated, alone, overwhelmed.

  • commence sense making processes
  • acknowledge a change needs to occur
205
Q

Transition Model

Explain phase 4 Becoming ordinary

A
  1. changes are integrated and the person lives and functions with a sense of continuous self. As people master new life skills, their coping strategies improve and they develop a more flexible perspective about who they are in new situations. A stronger sense of self is paired with resilience and their capacity to overcome adversity, build confidence and establish social markers
206
Q

What is the look think act process?

A
  • Look, Think, Act is a tool that helps a person work out what is happening in their life and focuses on changing thinking so future behaviours and response can be anticipated and different outcomes under similar circumstances can be obtained
  • Nurses can facilitate transition using the Look, Think, Act process when dealing with vulnerable people by increasing self awareness and understanding of a situation
207
Q

‘Look, Think, Act’ process

Explain the look phase

A

o The phase where the person tries to locate what the person can or wants to do about the situation.
o The nurse can discuss and work with the person to think about possible ways these issues may be handled. Ask questions such as; what have you done in the past, what would you like to do about?
o This process helps to build the person’s capacity to problem solve in the future

208
Q

‘Look, Think, Act’ process

Explain the act phase

A

o This phase is what is required to help and assist the person in implementing actions
o The nurse should validate the person’s feelings and capacity to deal with the issue. They should continue asking questions that lead to the person identifying possible solutions and a plan of action that considers likely outcomes of the intended actions
o The purpose of action is to put together practical solutions that facilitate the reshaping of a person’s future
o Actions that achieve an anticipated outcome become internal motivators that empower the person to continue with further action. Continued success encourages the person’s confidence, courage and motivation to grow

209
Q

‘Look, Think, Act’ process

Explain the Think phase

A

o The phase where the person tries to locate what the person can or wants to do about the situation.
o The nurse can discuss and work with the person to think about possible ways these issues may be handled. Ask questions such as; what have you done in the past, what would you like to do about?
o This process helps to build the person’s capacity to problem solve in the future

210
Q

What are some vulnerable groups?

A
  • very young
  • very old
  • different genders
  • pregnant women
  • low socioeconomic status
  • limited education
  • rural and remote
  • disability
  • chronic illness
  • mental illness
  • homeless
  • addiction
  • abuse
  • racial and ethnic minorities
211
Q

What are some common forms of dialogue to use when communicating with vulnerable groups?

A

o Conversation to build social and relational connectedness
o Knowledge Sharing so informed decisions can be made
o Sharing Options, Discussing Choices and Planning Actions
o Translating and Paraphrasing information so knowledge is received and understood
o Questioning to obtain information and ensure clarity and perspective of the issue
o Reassuring and Encouraging the person so they feel valued, understood, acknowledged
o Advocating access to the health system

212
Q

Discuss migrants

A
  • Choose to leave their homeland and settle in a country of their choice.
  • Arrange the most suitable method to travel and pack the possessions they wish to take.
  • Are usually well prepared and well motivated to settle in a new country.
  • Many will have found out about schools, employment and local conditions before the left their homeland.
  • Migrants take with them their travel documents, passports and other documentation; educational qualifications
213
Q

Discuss refugees

A
  • Do not choose to leave their homeland, they flee in response to a crisis and have little choice about where they go and by what means they will travel.
  • Have no time to pack or to distribute possessions so almost everything is left behind.
  • Are unprepared emotionally for leaving.
  • Refugees arrive in their new country ill prepared and often traumatised. They have little in the way of possessions and financial resources. They are often debilitated by a pervading sense of loss, grief, worry and guilt about the family left behind
214
Q

Familiar life is when

a. life is predictable; there is certainty in every day routines, social roles and social status –enabling a firm sense of identity
b. A person’s normal patterns of living and being in the world are interrupted, and that challenges their sense of identity
c. Life routines are re-established and coherent sense of self is reaffirmed following a life changing event
d. A person’s sense of self is not the same as it had been previously, and they have not made the adjustments that foster a continuous sense of self

A

a. life is predictable; there is certainty in every day routines, social roles and social status –enabling a firm sense of identity

215
Q

What is the term used to describe the third phase of the process triggered by a disruptive change event?

a. Limber
b. Limited
c. Lost
d. Limbo

A

d. Limbo

216
Q

Vulnerable populations are those that

a. Are multicultural populations which results in identity loss or threat
b. Are comprised of people with a predisposition to develop certain illnesses
c. Are those which lack of bio-diversity
d. Are more likely to experience poor health due to the presence of multiple risk factors at both the individual and ecological levels

A

d. Are more likely to experience poor health due to the presence of multiple risk factors at both the individual and ecological levels

217
Q

Why is the approach a nurse takes with vulnerable clients significant?

a. It has an effect on client outcomes
b. It determines the tone for the ongoing nurse – client relationship
c. It motivates the client through the nurse’s confidence and enthusiasm
d. It establishes rapport and support from the client’s family

A

a. It has an effect on client outcomes

218
Q

What steps need to be undertaken to create the foundation for a therapeutic relationship?

a. The nurse needs to be knowledgeable as possible about the specifics of the clients condition and its management
b. The nurse needs to know their own views and then seek to understand the other person’s perspective
c. The nurse must establish a sense of trust and confidence in their professional abilities
d. The nurse needs to accurately assess the client’s capacity to understand treatment options

A

b. The nurse needs to know their own views and then seek to understand the other person’s perspective

219
Q

What proportion of Australians are currently estimated will have a mental illness at some time in their life?

a. One in ten
b. One in five
c. One in three
d. One in seven

A

b. One in five

220
Q

How can the onset of dementia or a mental illness be differentiated?

a. Through a CT scan of the brain
b. Through a thorough Mental Status Examination
c. By a thorough investigation of the client’s cognitive function
d. By an Electro Encephalogram (EEG)

A

c. By a thorough investigation of the client’s cognitive function

221
Q

The term affect is used to described

a. The way a person behaves
b. The manner in which a person explains how they are feeling
c. The emotion that colours a person’s perception of the world
d. The visible expression of emotions

A

d. The visible expression of emotions

222
Q

What are licit drugs?

a. Legal drugs
b. Medications
c. Illegal drugs
d. Drugs only available with a prescription

A

a. Legal drugs

223
Q

The Australian Guidelines to Reduce Health Risks from Drinking Alcohol state that

a. For people aged 15-17 years, the safest option is to delay the initiation of drinking for as long as possible
b. Children under 15 years are the greatest risk of harm from drinking, and not drinking alcohol is especially important for this group
c. For children and young people less than 18 years of age, not drinking is the safest option
d. All of the above

A

d. All of the above

224
Q

The systematic approach to maintain and improving the quality of patient care within a healthcare system is known as?

a. Clinical Governance
b. Clinical Supervision
c. Clinical audit
d. Clinical strategies

A

a. Clinical Governance

225
Q

What should be the focus of an organisation’s quality and safety system?

a. The monitoring of critical incidents
b. The measurement of client and staff satisfaction
c. The measurement of the quality and safety of client outcomes and the interrelationship of the components of the strategic and infrastructure arrangements
d. Staff professional development

A

c. The measurement of the quality and safety of client outcomes and the interrelationship of the components of the strategic and infrastructure arrangements

226
Q

What are some of the ways that community nurses contribute to effective integrated risk management strategies?

a. Using sharps containers and standard precautions when dealing with clients
b. Through internal and external scanning of factors that influence safety and quality and the reporting of risks
c. Participating in staff surveys
d. Being familiar with the procedure manual

A

b. Through internal and external scanning of factors that influence safety and quality and the reporting of risks

227
Q
  1. What is a healthcare acquired infection also known as?

a. Idiopathic infection
b. Nomadic infection
c. Nosocomial infection
d. Iatrogenic infection

A

c. Nosocomial infection

228
Q

What are infections that occur as a result of healthcare interventions known as?

a. Idiopathic infection
b. Nomadic infection
c. Nosocomial infection
d. Iatrogenic infection

A

d. Iatrogenic infection

229
Q

Which of these is not a cost contributed to healthcare acquired infections?

a. Unnecessary pain and suffering for patients
b. Research and development of new generation antibiotics
c. Additional diagnostic and therapeutic interventions
d. Increasing length of stay resulting in bed block

A

b. Research and development of new generation antibiotics

230
Q

Microorganisms are responsible for

a. All blood borne diseases
b. All disease
c. Infectious diseases
d. Infiltrating diseases

A

c. Infectious diseases

231
Q

The sustained presence of replicating infectious agents on or in the body, without the production of an immune response or disease is termed

a. Colonisation
b. Transmission
c. Occupancy
d. Invasion

A

a. Colonisation

232
Q

The document which provides a six-character code to classify diseases and includes information such as the clinical features and causes of injuries and diseases is commonly known as

a. The Merck Manual
b. The Mims Guide
c. The Australian Diseases Classification Manual
d. The International Classification of Diseases

A

d. The International Classification of Diseases

233
Q

What is the main problem associated with retrospective collection and data aggregation in healthcare?

a. It results in homogenised data which is not useful when working within a specific community
b. As the data drawn from multiple sources the quality of data is inconsistent
c. It results in a reactive healthcare system which has difficulty responding to rapid changes in health needs in a timely manner
d. It does have the capacity to measure and identify the success of health promotion activities

A

c. It results in a reactive healthcare system which has difficulty responding to rapid changes in health needs in a timely manner

234
Q

When the findings of research projects can be applied more or less directly into the clinical context, and utilised to improve outcomes of care for clients, this is referred to as

a. Applied research
b. Clinical research
c. Ethical research
d. Experimental research

A

a. Applied research

235
Q

Qualitative community nursing research is more likely to have wider acceptance and funding as

a. The medical model and scientific research is limited in application
b. Community nursing is focused on developing understanding
c. Qualitative research is being accepted more as real research
d. The social health model will be accepted as the norm in the future

A

d. The social health model will be accepted as the norm in the future

236
Q

The nursing role which focuses on health promotion and disease prevention activities aimed at groups is usually undertaken by

a. a district nurse.
b. a nurse unit manager.
c. a community based nurse.
d. a community health nurse.

A

d. a community health nurse.

237
Q

Assisting a person to better manage their chronic health issue using education and promoting healthy behavioural changes is known as

a. health care.
b. health promotion.
c. health coaching.
d. health assistance.

A

c. health coaching.

238
Q

Reducing the difference in health outcomes between different groups of people using health promotion principles is the aim of

a. the social gradient.
b. the new public health movement.
c. the social determinants of health.
d. the biomedical model of health.

A

b. the new public health movement.

239
Q

The philosophy underpinning the Millennium Development Goals is that all members of the global community need to have

a. respect of cultural diversity.
b. transportation, airport security and a stable currency.
c. adequate immunisations and a passport.
d. opportunities to generate an income, housing and gender equality.

A

d. opportunities to generate an income, housing and gender equality.

240
Q

Bonding social capital refers to

a. the bond between people who see each other regularly when using public facilities.
b. groups that share a common purpose or social identity that help each other out when needed.
c. the connections people make with others outside their social group, with whom they share a sense of respect and reciprocity.
d. the connection between people and organisations or institutions.

A

b. groups that share a common purpose or social identity that help each other out when needed.

241
Q

What are the main causes of funding pressures facing community nursing?

a. Competition for funds between community health nursing and community based nursing organisations.
b. Funding is sourced from various levels of government and is allocated for specific types of care.
c. Health care is underfunded.
d. The aging population means more people need more care.

A

b. Funding is sourced from various levels of government and is allocated for specific types of care.

242
Q

What is meant by the term continuum of care?

a. Care for individuals from initial contact with health providers through to recovery and health sustainability
b. All the healthcare needs of an individual are met by one healthcare provider
c. One healthcare provider is responsible for the healthcare of an individual all their life
d. Ongoing care of a client in palliative care

A

a. Care for individuals from initial contact with health providers through to recovery and health sustainability

243
Q

What is meant by the term community development?

a. When new industries move into the community creating opportunity for employment
b. An increase in the number of new homes and other infrastructure being constructed
c. Individuals and groups identify their own, group and community goals, then plan and implement strategies to achieve the goals
d. The provision of grant money from government to a community for a purpose specified by the government

A

c. Individuals and groups identify their own, group and community goals, then plan and implement strategies to achieve the goals

244
Q

When life is predictable: there is certainty in every day routines, social roles and social status – enabling a firm sense of identity, this is referred to as –

a. Familiar life
b. Regular life
c. Normal life
d. Routine life

A

a. Familiar life

245
Q

A semi-structured interview to assess a person’s current neurological and psychological status is known as –

a. An Abbreviated Standard Mental Health Assessment (ASMHA)
b. A Mini Mental Status Examination (MMSE)
c. A Standard Mental Health Assessment (SMHA)
d. A Mental Status Examination (MSE)

A

d. A Mental Status Examination (MSE)

246
Q

What is not a common reason a person would seek help for their alcohol use?

a. Criminal charges
b. Alcohol-related illness
c. Work environment
d. Concerns expressed by loved ones

A

c. Work environment

247
Q

A felt need is

a. identified by the community or services within the community as what they want.
b. a need found by comparing similar populations or groups.
c. a need defined by an expert.
d. a need that has been identified and demonstrated by community action

A

a. identified by the community or services within the community as what they want.

248
Q

Self-care management and self-responsibility needs to be integrated into community nursing practice in an effort to -

a. Ensure that the individual remains connected with their family and social support system.
b. ensure that services are not over utilized for extensive periods of time.
c. ensure that the individual makes appropriate healthcare decisions.
d. All of the options listed

A

a. Ensure that the individual remains connected with their family and social support system.

249
Q

Explain PHC and the sociological approach to health.

A

Primary health care and the sociological approach recognise that health is dependent on more than biological processes and a number of social and environmental factors contribute to good or poor health. Nurses who work with a PHC philosophy are engaged in activities aimed towards creating equity, empowerment and social justice, particularly focusing on issues such as employment, education, access to appropriate health services or housing to name a few.

250
Q

Social capital relates to the value of social connections for the person and the community. Identify the three forms of social capital and explain each of these.

A

Bonding social capital occurs within tightly connected groups, such as families, kinship networks, neighborhood groups, work colleagues and groups that share a common purpose or social identity. Bridging social capital occurs between individuals that are not part of the same group, but which share a sense of respect and reciprocity. Linking social capital occurs between individuals and organizations or institutions in a more vertical manner

251
Q

Explain what is meant by the nursing person-centered approach or perspective.

A

A person-centered approach to care requires nurses to consider their ‘ways of doing’ with and for the client – to ensure their planning, implementing, monitoring and evaluating tasks are completed in such a way that the person feels understood, valued and considered. Here the woman/person is central to professional relationship

252
Q

Explain adult learning theory and the attributes of adult learners

A

In order to provide educational material that answers the needs of adults, adult learning theory and processes need to be used. Knowles (1975) theorised that all adults are self-learners and are capable of being autonomous and independent. The teachers’ role is to help the students acquire self-directed learning skills, so that adults can set about addressing their own learning needs. Knowles advised that particular attributes of adult learners need to be taken into account when planning educational material for adult learners. He suggests the application of the following key assumptions: 1. Adults are self- directed learners; 2. Adults are goal-directed in their learning approach; 3. Adults have a wealth of past experience; 4. Adults are motivated by an immediate need; 5. Adult learning is problem-centered rather than content-oriented; 6. Adults should be respected and considered as equals in the teaching-learning; 7. Adults are expected to contribute to the learning process.