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NURS 2000 Questions with Complete Solutions
Stigma Correct Answer-Stigma is the negative stereotype and ... discrimination is the behaviour that results from this negative stereotype Tobacco and Alcohol Correct Answer-The economic cost of substance use in Canada in 2014 was $38.4 billion, or about $1,100 for every Canadian, and came with a staggering toll of 67,515 deaths, says a report released Tuesday. The Canadian Centre on Substance Use and Addiction partnered with the Canadian Institute for Substance Use Research to examine the data and estimate the harms of substance use based on health, justice, lost productivity and other costs. While researchers acknowledged that Canada is in the middle of a crisis because of illicit opioid overdose deaths, their study concluded that two- thirds of substance use costs are associated with alcohol and tobacco. It found the four substances related to the largest costs are alcohol at $14.6 billion, tobacco at $12 billion, opioids at $3.5 billion and marijuana at $2.8 billion. Tobacco
Costs Correct Answer-Approximately 45,500 deaths were attributable to smoking in Canada in 2012. This translates to about 125 deaths each day in Canada—more than the total number of deaths due to car collisions, accidental injuries, and assaults. The total costs of tobacco use in Canada were $16.2 billion in 2012. Health care costs attributable to smoking in Canada were estimated to be more than $6.5 billion in 2012. Indirect costs due to lost production amounted to $9.5 billion. Think about all the supports we offer to people to help them quit smoking. Think about all the resources that have been put in to reducing smoking over the past four decades through regulatory changes, personal supports, limiting where you can smoke, increasing taxes on cigarettes, cracking down on sales to minors, changes in packaging, etc, etc. Tobacco has no nutritive value and is designed only to deliver a drug, nicotine. WHY IS IT STILL LEGAL? The current opioid crisis is a result of multiple complex factors that include: Correct Answer-A misunderstanding of the addictive risk of prescription opioids; Frequent opioid prescribing and high amounts being prescribed for pain relief
"People...who use opioids every day - and people... whose drug use is intermittent, deserve to live and be well. People who are dependent on opioids and other substances have a health problem - often described as addiction. Addiction is not a crime. It is not a moral failing. It is a health problem. The drivers of problematic substance use are well known. They include: Correct Answer-Stigma and discrimination Poverty and the absence of social supports Isolation, rejection, abandonment Abuse, conflict Mental illness chart (4 things) Correct Answer-- prevention -harmreduction
- community safety
- Treatment and recovery Dr. Gabor MatÉ Correct Answer-"If a cure is possible and probable without doing greater harm, then cure is the objective. When it isn't - and in most chronic medical conditions cure is not the expected outcome
- the physician's role is to help the patient with the symptoms and to mitigate the harm done by the disease process" Harm reduction Correct Answer-is a neutral, non judgmental, low threshold approach, geared towards individuals as well as to address social factors of behaviour and potential risk for harm.
Language sets the tone
- Words stigmatize
- try instead Correct Answer-1. Addict Alcoholic Drug/alcohol abuse Crack head Drug seeker Clean/dirty War on drugs
- Substance use Drug use Alcohol use Prescription misuse Someone with substance use concerns Abstinent
appropriate screening tool to determine the level of support required. V Recommendation 1.3: Conduct a comprehensive assessment with all clients who screen positive for substance use, as appropriate based on the nurses' knowledge, skill, time, setting and resources. V
Planning Recommendation 2.1: Build collaborative relationships with clients through the use of motivational interviewing techniques to develop the plan of care. Ia
Implementation Recommendation 3.1: Use brief intervention to collaborate with clients identified as at risk for or experiencing a substance use disorder.
Ia Recommendation 3.2: Advocate for and support access to combined pharmacological and psychosocial interventions, as appropriate, and promote the appropriate use of combined interventions to improve well-being and health outcomes. Ia Recommendation 3.3: Engage youth and adolescents at risk for or experiencing a substance use disorder using family-based therapies until recovery, as appropriate. Ia
Evaluation Recommendation 4.1: Reassess the effectiveness of the plan of care until the client's goals are met. Levels of evidence:
considering change.
- PREPARATION Client makes commitment and plans for change by seeking support.
- ACTION Client has initiated change.
- MAINTENANCE Client is adjusting to change and is practicing new skills and behaviors to sustain change. ---> client leaves treatment RELAPSE Client has relapsed
to drug use. Harm Reduction Correct Answer-Harm reductionG refers to practices, programs, and policies that aim to reduce the adverse health, social, and economic consequences of substance use without requiring individuals to abstain from substance use (CNA, 2011; Rassool, 2010). Harm reduction: ■ Is an alternative to the disease causation model of substance use; ■ Accepts that at any given time some people are not ready to choose abstinence; ■ Accepts that substance use occurs in society and works to minimize its harmful effects; ■ Accepts that people who are substance-dependent should have a voice in the creation of programs and policies designed to serve them; ■ Values patient autonomy; and ■ Does not exclude abstinence as an option (Beirness, Jesseman, Notarandrea, & Perron, 2008; CNA, 2011) GOALS OF HARM REDUCTION
- PRACTICAL LEVEL
- • Needle exchange
- Methadone maintenance
- Outreach
- Law-enforcement cooperation
- Illicit drug prescription
- Tolerance zones
- Alcohol server intervention
- Smoking contro WEEK 10 Correct Answer-Communicable Disease and Emergency Preparedness Estimated top 5 causes of death, females, aged 10-14 and 15-19 years in 2016 Correct Answer-Leading causes of adolescent girls' deaths in 2016 were maternal conditions, self-harm and road injury. Estimated top 5 causes of death, males, aged 10-14 and 15-19 years in 2016 Correct Answer-Road injury is by far the leading cause of adolescent boys' mortality, with about a quarter of all deaths in male adolescents aged 15-19 yeas due to road injury. All-cause mortality among adolescents aged 10-14 and 15-19 years, by sex and modified WHO region in 2016 Correct Answer-Death rates in African low and middle-income countries are nearly 13 times as high as
those in high-income countries in adolescents aged 10-14 years, and over 7 times in adolescents aged 15-19 years. Emergency Preparedness Correct Answer-Emergency preparedness includes all activities, such as plans, procedures, contact lists and exercises, undertaken in anticipation of a likely emergency. " (Government of Canada, 2017) Natural disasters (floods, snowstorms, ice storms, forest fires) Public health emergencies (pandemic flu) Explosions (chemical and fuel spills) Communicable diseases Correct Answer-"illness caused by specific infectious agents or its toxic products that arise through transmission of that agent or its products from an infected person, animal or reservoir to a susceptible host" Communicable disease overview Classification of communicable disease SDH related to communicable disease Interventions for communicable disease: Nurses Emergency and disaster planning Epidemiological Triad Correct Answer-environment agent
Young and healthy
- 284,000 worldwide 80% < 65 years old 51% Africa and South East Asia Canada- mortality 1.3/100, Highest hospitalization rate children < Present
- Ebola Virus Correct Answer-1.2014-2016 28,610 cases Deaths 11,308 (WHO, 2018) What has changed? Correct Answer-Sanitation Vaccines Antibiotics Infection control Communication and knowledge Global travel Scope of practice of a Nurses What has not changed? Correct Answer-SDOH
Pathophysiology Critical Social Justice Lens Correct Answer-Who is most vulnerable? Who is protected? Who is included? Who is excluded? What systems support these differences?
- Case:
- Index case:
- Outbreak:
- Endemic:
- Epidemic:
- Pandemic:
- Syndemic(s):
- Colonization means germs are on the body but do not make you sick. People who are colonized will have no signs or symptoms. Syndemic Correct Answer-disparity conditons that promote disease clustering Disease 1 + disease 2 meet in middle to form adverse interactions --> enhanced disease Communicable Disease Classifications Correct Answer-•Vaccine preventable disease •STI and blood borne •Respiratory •Enteric, food and waterborne •Healthcare acquired •Zoonatic and vector borne Eradication Goal ... Smallpox Correct Answer-Agent: variola virus Transmission: direct contact, saliva 30% fatality Known for 3000 years SEP: Smallpox Eradication Program
Last case: Somalia 1977 Declared eradicated by WHO 1980 Polio Correct Answer-Agent: poliovirus Transmission: fecal-oral Poliomyelitis: 90% asymptomatic Fever, fatigue, pain in limbs 1/200 acute flaccid paralysis Bulbar polio: CNS involvement, requires ventilation Post polio syndrome No cure Multiple vaccinations required Polioeradication.org What are current challenges for nurses Correct Answer-•Complacency •Mis-information •Non-proven but popular alternative ideas STI's and Blood Borne Infections Correct Answer-Chlamydia Gonorrhea Syphilis HPV HIV Trichomoniasis
