NFDN 2006 Final Exam: Community Health Nursing Questions and Answers, Exams of Nursing

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NFDN 2006 FINAL EXAM LATEST

2024/25 UPDATED EXAM WITH

COMPLETE QUESTIONS AND VERIFIED

CORRECT ANSWERS/GRADED A+

What is community? - ANSWER - Defined as a specific population of people, or a place where people live and work. What principles make up the Canada Health Act? - ANSWER - Universality, Accessibility, Comprehensiveness of services, Portability, and Public Administration What are the 6 distinguishing features of culture? - ANSWER

• Learned
• Adaptive
• Dynamic
• Invisible
• Shared
• Selective What is Culture? - ANSWER - A term that applies to all groups of people where there are common values & ways of thinking and acting that differ from those of another group

What are the 2 principles of developing cultural competence? - ANSWER - Maintain a broad, objective, and open attitudes towards individuals and their cultures

• Avoid seeing all individuals as alike What are the 7 attributes of cultural competence? - ANSWER
• Cultural awareness
• Cultural knowledge
• Cultural understanding
• Cultural sensitivity
• Cultural skill
• Cultural proficiency
• Cultural interaction What is ethnocentrism? - ANSWER - Belief that one's own group determines the standard of behaviour for all other groups to be judged
• Owns culture is superior to others
• Discrimination is a subtle form What is cultural blindness? - ANSWER - Ignore differences between cultures
• Acts as though all people are the same What is culture shock? - ANSWER - Feeling of helplessness, discomfort and disorientation by individual in attempting to understand What is stereotyping? - ANSWER - Making generalizations about values, beliefs and behaviours of a group

What is prejudice? - ANSWER - Emotional manifestation of deeply held beliefs about other groups involving negative attitudes What is racism? - ANSWER - Prejudice based on belief that one's own culture is superior to other cultural groups What is overt racism? - ANSWER - Demonstration of attitudes, actions, policies openly illustrate feeling superiority over groups with intent of harming or damaging

• Obvious racism What is systemic racism? - ANSWER - Policies not equally applied to all persons Community as Client - ANSWER - Community assessment emphasizes the use of epidemiological data and disease occurrence to identify needs Community as a Partner - ANSWER - The CHN places emphasis on community strengths or assets to manage community identified health concerns
• Will utilize community capacity and community development to support the community to make change What are the 3 dimensions of community? - ANSWER 1. People

2. Place
3. Function

Types of community - ANSWER - Identifiable need, problem ecology (pollution), concern, special interest, viability, resource, solution, political jurisdiction, action capacity, face to face & neighbourhood Community Assessment Wheel - ANSWER - The core: represents the people who make up the community. Must be maintained to ensure the survival of the community

• 8 Subsystems; physical environment, health and social services, economics, safety and transportation, politics and government, communication, education and recreation Community Assessment Dats - ANSWER - Demographic characteristics; Age, sex, ethnic and racial groupings
• Geographic characteristics; Area boundaries, size of neighborhood, public spaces, roads
• Socioeconomic; Occupation, income, education, home rental/ownership
• Health, social resources & services; hospitals, clinics, etc. 3 Characteristics of Community Health - ANSWER 1. Status (physical, social, emotional) Primary & Secondary community level prevention

2. Structural (services and resources)
3. Process (effective community function) Comprehensive Community Assessment - ANSWER - Identify Community, Strengths and health concerns, plan, implement and evaluate

What is epidemiology? - ANSWER - The study of the distribution and factors that determine health of populations True or false: Prevalence rate is the number of total cases divided by total population at a specific time (x 1000 or

100000. • ANSWER True What is active immunity? - ANSWER - Immunity acquired through vaccinations Which term measures how accurately the test identifies those with the condition and represent true positives? - ANSWER - Sensitivity True or false: Aquiring antibodies from an immune serum medication is an example of active immunity - ANSWER False True or false: providing health across the lifespan includes health promotion, health protection and health maintenance

• ANSWER True When providing health promotion to children, what is the most important factor to consider? - ANSWER - Ensure family members/caregivers receive the health promotion education What is a priority nursing focus when providing health promotion to women? - ANSWER - Cardiovascular disease

What is an example of family demographics? - ANSWER - The number of family members The family is seen as the interactions between family members, these become the target for nursing interventions; what is this called? - ANSWER - Family as a system What is case management? - ANSWER - Advocacy, advice, coordinating/facilitating access to health care services What are components of the assessment of families? - ANSWER - biological risk assessment

• environmental risk assessment
• behavioural risk assessment Forming partnerships, promoting capacity building, empowering families and advocating for families is an example of... - ANSWER - Intervention phase of the CHN family nursing process What determinant of health is the most significant predictor of health? - ANSWER - Income/Poverty When assessing for the presence of factors that increase the likelihood of an illness or adverse event, the CHN is - ANSWER - Completing a health risk appraisal

What communication technique is used to help a CHN to understand how illness is affecting the family - ANSWER - encouraging narratives What best describes comprehensive services - ANSWER - Focusing on more than one health concern What would be a sign of caregiver stress? - ANSWER - Reports of headaches, depression, and loss of hope What is a greater than normally expected occurrence of disease in a community region called? - ANSWER - Epidemic What is a principle of environmental health? - ANSWER - "Todays solution may be tomorrows problem" CHN role in environment health does not include... - ANSWER - Supervising a chemical spill clean up

• CHNs role is to do risk assessments, Risk communication and epidemiological investigations and policy development A solid line in a genome represents what? - ANSWER - An intact relationship Phases of Disaster Management - ANSWER 1. Eradicating the risk of injury, death.

2. Ready to respond to and manage a disaster situation and it's consequences

3. Activities that are carried out by emergency response teams
4. Includes clean up, repair and rebuilding What falls under environmental risk assessment in family nursing? - ANSWER - Ecomap What is a strategy to bring health care services to homeless clients? - ANSWER - mobile health service van What are 2 main factors that predispose people to vulnerability? - ANSWER - Employment and social supports What are two health challenges presented by homeless pregnant women? - ANSWER - Less access to prenatal care, and Increased risk of incompletion/interrupted education program What is a nursing action essential for the CHN planning and implementing care for vulnerable populations? - ANSWER - Create a trusting environment What is an elderly Inuit woman in a remote village and with HTN, IDDM and no doctor at greatest risk for? - ANSWER - Health disparities You are assigned as a case manager to a homeless client to teach about wound care. Your first priority is to establish what? - ANSWER - Trust and Rappor

What situation is more prevalent in poor neighbourhoods? - ANSWER - single parent families Which steps towards decolonization would be important for the CHN to take in a community development activity? - ANSWER - Committing to collective action in solidarity with the community In what activity is the CHN practicing trauma informed care?

• ANSWER - by understanding the role of history of violence when providing support What is an example of a proximal determinant of health? - ANSWER - Graduation from an Indigenous law program What community experiences support distal determinants of health? - ANSWER - Rural representation on economic and resource development committees The LPN asks her client about how her illness has affected her family. This is an example of which approach? - ANSWER
• Family as the client Why is it important to understand family demographics? - ANSWER - It helps the CHN forecast stresses and developmental changes for the family A CHN creates a diagram for the family that displays the family unit across generations, what is this called? - ANSWER - A genogram

Using the family systems theory, which interventions would help a family with coping with illness of one of its members?

• ANSWER - Discuss a method for contacting family to share information regularly
• Discuss ways to provide for everyday functioning during an illness
• Teach the family about expected growth and development By encouraging clients to ask for help from extended family, this is a form of family empowerment which reflects... - ANSWER - The ability to communicate and obtain needed resources The term eradication means? - ANSWER - permanent removal of a disease worldwide True or false: Contact tracing violated patient confidentiality
• ANSWER - False True or false: Virulence is the ability to produce severe disease or reaction in the body - ANSWER - True What is an example of vertical transmission? - ANSWER - Infection is passed to the infant via breast milk What is the Lalonde Report (1974)? - ANSWER - It initiated health promotion movement in Canada.

• This was the first development of the determinants of health. What is the Alma Ata Declaration? - ANSWER - Declaration for primary health care, promoting the health of all.
• First time primary care and addressing social determinants was identified as the key to achieving widespread health.
• Addressed the need for health promotion approach within primary care. What did the Epp report identify? - ANSWER - Reducing inequities, increasing prevention, and enhancing coping skills as specific challenges to achieving health; these challenges are also recognized as the determinants of health. What is community health nursing? - ANSWER - Promotes and protects the health of individuals, families, groups, communities and populations.
• Involves coordinating care and planning services, programs, and policies by collaborating with individuals, caregivers, families, other disciplines, communities and governments. Community Health Nursing... - ANSWER - Works IN the community; focus on health promotion and disease prevention, provides health care to individuals and families, and uses community as a resource.
• Works WITH community as a client; focus is the health of the community, community development, and community itself is the client.

What is a population? - ANSWER - A collection of people who share one or more personal or environmental characteristics. What is an aggregate? - ANSWER - Subpopulation, groups within a population. What are the health status indicators? - ANSWER - Well being, life expectancy, incidence and prevalence rate, mortality rate, burden of illness How do we determine the health of a population? - ANSWER

• Using measurements of health: the determinants of health and health status indicators. What is primary disease prevention? - ANSWER - Seeks to prevent disease from the beginning (e.g. education) What is secondary disease prevention? - ANSWER - Seeks to detect disease early in its progression in order to make early diagnosis and begin treatment. (e.g. screening, mammogram) What is tertiary disease prevention? - ANSWER - Begins once disease has become obvious; aims to interrupt the course of the disease. (e.g. diabetes care, taking care of symptoms) What is downstream thinking? - ANSWER - Taking a microscopic look at individual health concerns and

treatments, but does not consider sociopolitical, economic, and environmental variables.

• Looking only at the individual
• E.g. acute care nurses, stabilize, treatment What is upstream thinking? - ANSWER - Taking a macroscopic look, population health approach
• Primary prevention perspective
• Considers determinants of health and other economic, political and environmental factors
• e.g. community health nurses, proper nutrition, how could this be prevented? What are the 6 basic principles for collaboration? - ANSWER
• Client focus, population health approach, quality care and services, access, trust/respect, communication What is Health Canada? - ANSWER - Federal department responsible for helping Canadians maintain and improve their healt.
• Safegaurds the population health by surveillance, prevention, legislation, and research What are the determinants of health? - ANSWER - Factors that influence an individual's or population's health
• Income and social justice, social support network, education, employment, physical and social environments, healthy childhood development, culture, gender, health services

What are the social determinants of health? - ANSWER - The economic and social conditions that shape the health of individuals, communities and jurisdiction as a whole. What are the 5 principles of primary health care? - ANSWER

1. Equitable distribution
2. appropriate technology
3. a focus on health promotion and disease prevention.
4. community participation
5. a multisectoral approach What is public health nursing? - ANSWER - Includes the study of epidemiology, stats and assessment.

• Functions: protection, promotion, assessment, surveillance, and injury/disease prevention Ethical Issues - ANSWER - An identifiable problem, situation, or opportunity requiring a choice among several actions that must be evaluated as right or wrong, ethical or unethical Ethical Dilemma - ANSWER - A decision that involves a conflict of values; every potential course of action has some significant negative consequences Morals - ANSWER the rules people develop as a result of cultural values and norms What is health promotion? - ANSWER - The process of enabling people to increase control over, and to improve, their health

What was health defined as early on? - ANSWER - Absence of disease What is harm reduction? - ANSWER - Policies or programs that decrease substance use

• e.g. needle exchange program for IV drug users According to LaLonde, what we're the determinants of health? - ANSWER - Biology, environment, and lifestyle What are the 3 major approaches to health promotion? - ANSWER 1. Biomedical; focuses on treatment and prevention of disease.

2. Behavioural; came out of Lalonde Report. Focus is on lifestyle changes to promote health.
3. Socio environmental; came out of Alma Alta. Community participation and collaboration to address population health. Health is seen as a resource. Health promotion strategies - ANSWER - Advocating, enabling, mediating to help communities, groups, and individuals to reach optimal health Ottawa Charter: 5 Action Areas for Promoting Health: - ANSWER 1. Healthy public policy (mandatory seat belts)
4. Supportive Environments (smoke free workplace)
5. Strengthening Community action (funding for health initiatives such as heart health and healthy food choices in restaurants)

4. Developing personal skills (adult literacy program)
5. Reorienting health services (creating interdisciplinary community centres) What is risk reduction? - ANSWER - A disease prevention strategy

• Reduces or alters health concerns
• Most often used with clients with substance use What is the health promotion model? - ANSWER - Used by CHN's to help plan change with individuals, families, groups and communities.
• Explains the relationship between population health and health promotion
• WHAT should we take action on? WITH WHOM should we act? And HOW should we take action 8 Key elements of population health approach model: - ANSWER 1. Focus on the health of population

2. Address determinants of health and their interactions
3. Base decisions on evidence
4. Increase upstream investments
5. Apply multiple interventions and strategies
6. Collaborate across sectors and levels
7. Employ mechanisms for public involvement
8. Demonstrate accountability for health outcomes What are the 2 types of diversity? - ANSWER 1. Visible; age, physical appearance and gender; greater risk of

experiencing discrimination, stereotyping and marginalization

2. Invisible; religion, national origin, occupation and sexual orientation; inconspicuous attributes may not be acknowledged True or false: The flu is considered endemic at present - ANSWER - True