Community health nursing a canadian perspective 3rd edition lynnette leeseberg stamler test bank

Name: Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition What is the origin of Medicare? a The American health care system b Traditional Aboriginal healing practices c The religious orders that first provided health care d Canada's federal government Who was assigned the responsibility for health care in the 1867 Constitution Act (British North America Act)? a The provinces were responsible for public health care b First Nations communities were responsible for Aboriginal health care c The federal government was responsible for military health care d The provinces were responsible for health policy Where was North America's first universal health insurance program implemented? a Manitoba in 1957 b Canada in 1967 c Prince Edward Island in 1867 d Saskatchewan in 1947 What was the purpose of the Canada Health Act (1984)? a Provide the provinces with more legal authority b Ban extra billing and user fees c Establish a national drug plan d Increase Canadians' access to health care based on ability to pay What Act has as its cornerstones publicly administrated, comprehensive, universal, portable, and accessible? a Hospital Insurance and Diagnostic Services Act b Constitution Act c Canada Health Act d American Medicare Act What is one of the primary objectives of Canadian health care policy according to the Canada Health Act (1984)? a Facilitate reasonable access to hospital care b Protect the health care system from privatization c Restore stable health care funding to the provinces d Protect, promote, and restore the physical and mental well-being of Canadians How has the Canada Health Act (1984) been successful in ensuring all Canadians have access to the health care they need? a Creating specific mechanisms to ensure accountability and transparency b Establishing criteria and conditions for insured health care services that must be met before federal transfer payments are made c Penalizing provinces that not comply with the public health aspects of the Act d Determining the extent to which each province and territory has satisfied the criteria and conditions of the Act Copyright © 2012 Pearson Canada Inc Name: Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition Which model dominated public and political thinking about health during the time that the Canadian Medicare system was created in 1957? a Healthy lifestyle model b Socio-environmental model c Biomedical model d Health promotion model Who said, "The practice of health care has evolved And despite efforts to keep pace, Medicare has not"? a Monique Begin, Minister of Health b Ralph Klein, Premier of Alberta c Brian Mulroney, Prime Minister of Canada d Ray Romanow, Commissioner on the Future of Health Care 10 How does Canada rank in the world with respect to health care? a Canadian men and women outlive Americans b Canada spent 16% of the gross national product on health care in 2008 c The Canadian infant mortality rate is one of the best in the world d Canada has the highest cost per capita in health care expenditures 11 What are the four determinants of health identified by the Lalonde Report (1974)? a Socio-environmental, biomedical, disease prevention, and health promotion b Gender, culture, working conditions, and education c Biological, emotional, spiritual, and psychological d Environment, lifestyle, human biology, and the health care system 12 What provided the basis for the Ottawa Charter? a Alma Ata Declaration b Canada Health Act c National Forum on Health d Epp Framework 13 What is involved in a health care system that focuses on primary care? a People accessing health care services at the first point of contact b Health education, proper nutrition, and disease prevention c Disease prevention, health protection, and health promotion d Accessible, acceptable, and affordable health care 14 Recently, Family Health Teams have been set up to provide primary health care Where have these been established? a Ontario b Quebec c Nova Scotia d British Columbia 15 Who funds public health in Canada? a Provincial and/or municipal tax dollars b Municipalities c Federal government d Provinces and federal government Copyright © 2012 Pearson Canada Inc Name: Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition 16 What nursing sector is currently the fastest-growing area in Canada? a Public health b Acute care c Home care d Long-term care 17 Mr Jones lives in Ontario and requires home care nursing and support services Who would deliver these services? a Social services branch of the department of health b Local public health units c Agency contracted by the Local Health Integration Network d Local health authority 18 What is a common argument for the discontinuation of publicly funded, not-for-profit health care? a Shortage of health care workers b The aging Canadian population will escalate health care costs c Emerging diseases d Pressure from for-profit centres for federal funding 19 What statement is true about community health nurses in Canada? a They are slightly younger than hospital nurses b The proportion in leadership positions is increasing c They are more likely to have a university degree d About 75% work full time in the community 20 In 2002, Romanow recommended a shift to health promotion and disease prevention What is a barrier to achieving this goal? a Competing care challenges b Lack of stable long-term funding c Number of people requiring home care d Shortage of health care professionals 21 Role clarity has been identified as an issue for community health nurses in the 2010 Synthesis of Canadian Community Health Nursing Reports What is a component of role clarity? a Understanding the role of other health care professionals b Common language to describe the role c Access to specialized expertise d Leadership development 22 What factor has the greatest impact on community health nurses' ability to practice to their full scope? a Staffing shortages b Funding c Leadership d Being valued for their services Copyright © 2012 Pearson Canada Inc Name: Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition 23 What organizational supports would encourage the professional development of community health nurses? a Regular performance feedback b Formalized communication mechanisms c Formalized student preceptor programs d Articulation of the vision 24 In 1989 the Treasury Board approved the transfer of Indian health services Which statement is true about this transfer? a Transferred responsibility to the provinces b Unspent monies were to be returned c Requires certain programs to be offered d Optional to all First Nation and Inuit communities 25 What health care service accounts for the smallest percentage of health care dollars? a Physicians b Hospitals c Drugs d Home care 26 The Best Practice Guidelines on Nursing Leadership (RNAO, 2006) outlined attributes for effective nurse leaders What is one of those attributes? a Avoiding risk taking b Organizational ability c Social awareness d Comfort with routines 27 Contrast the terms primary care and primary health care and give an example for each related to community health nursing practice 28 Summarize two federal initiatives in the development of health promotion and give one rationale for each that illustrates their importance on an international level 29 Give an example of where the Canada Health Act (1984) has been successful Provide a rationale and an example of where its success has been more limited 30 Describe the importance of three historical milestones in the development of the Canadian health care system 31 Discuss three Canadian values that are reflected in the current Medicare system 32 Name three of the five principles of the Canada Health Act (1984) and give an example for each Copyright © 2012 Pearson Canada Inc Name: Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition Activity Name: Chapter 02 c The religious orders that first provided health care Learning Objective: Chapter Multiple Choice Questions Feedback: Correct: The idea of Medicare evolved from the traditions of religious orders Incorrect: The American health care system did not influence Medicare Incorrect: Aboriginal healing practices did not contribute to the evolution of Medicare Incorrect: Canada's federal government enacted legislation for universal Medicare, but the idea originated with the early religious orders Hints: c The federal government was responsible for military health care Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: The BNA did not assign the responsibility for health policy to either the federal or provincial governments Incorrect: Public health care was not assigned to either level of government Incorrect: Aboriginal health care was the responsibility of the federal government Correct: The BNA assigned health care services for veterans and the military to the federal government Hints: d Saskatchewan in 1947 Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: This was the start of the universal health insurance program in Canada, but Canada followed Saskatchewan Incorrect: The first universal health insurance program was introduced in Saskatchewan Correct: Saskatchewan introduced the first universal health insurance program under Tommy Douglas Incorrect: P.E.I did not introduce the first universal health insurance program Hints: b Ban extra billing and user fees Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: The Bill C-3 was introduced to control extra fees being charged by provinces and physicians Incorrect: The Canada Health Act did not establish a national drug plan Correct: Extra billings and user fees were escalating and threatening the universal health care program Incorrect: The Act was to prevent access based on ability to pay Hints: Copyright © 2012 Pearson Canada Inc Name: Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition c Canada Health Act Learning Objective: Chapter Multiple Choice Questions Feedback: Correct: These are the cornerstones of the Canada Health Act Incorrect: These are not cornerstones of the American Medicare Act Incorrect: This Act introduced universal health care in Canada Incorrect: The Constitution Act created Canada as a dominion Hints: d Protect, promote, and restore the physical and mental well-being of Canadians Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: It is to facilitate reasonable access to health services, not hospital care Correct: This is one of the primary objectives Incorrect: This was not one of the primary objectives Incorrect: Funding was limited to medically necessary physician and hospital services Hints: b Establishing criteria and conditions for insured health care services that must be met before federal transfer payments are made Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: The provinces needed to meet the criteria and conditions or lose funding Incorrect: Public authority is accountable to the government but does not ensure access Correct: This is the way in which the federal government ensured access to health care across Canada It prevented the use of user fees and extra billing Incorrect: Access would be ensured if the provinces met the criteria, not by penalizing them Hints: c Biomedical model Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: The biomedical approach was popular at that time Incorrect: The healthy lifestyle model began in the 1970s Incorrect: The health promotion model began in the 1970s Correct: The biomedical model to health was common during this period Hints: Copyright © 2012 Pearson Canada Inc Name: Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition d Ray Romanow, Commissioner on the Future of Health Care Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: This statement was not made by Ralph Klein Correct: Ray Romanow made this statement Incorrect: Brian Mulroney did not make this comment Incorrect: This comment was made after Monique Begin was Minister of Health Hints: 10 a Canadian men and women outlive Americans Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: The United States has a higher cost than Canada Correct: Canadian women live three years longer and men two years longer than Americans Incorrect: A number of developed countries have lower infant mortality rates than Canada Incorrect: Canada spent only 10.4% of the GNP Hints: 11 d Environment, lifestyle, human biology, and the health care system Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: These are the approaches to health enhancement Incorrect: These are not the four determinants identified by Lalonde Correct: Lalonde identified environment, lifestyle, human biology, and the health care system as the four determinants of health Incorrect: These determinants of health were added to refine and add to the original four determinants Hints: 12 d Epp Framework Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: The Alma Ata Declaration was signed by Canada at an international conference that focused on the protection and promotion of health for all people Correct: The Epp Framework introduced health promotion, which became the basis for the Ottawa Charter Incorrect: The Canada Health Act is federal legislation that outlines the criteria and conditions provinces must meet to get federal funding for health care Incorrect: The National Forum on Health is an advisory body to the prime minister on ways to improve the health care system and the health of Canadians Hints: Copyright © 2012 Pearson Canada Inc Name: Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition 13 a People accessing health care services at the first point of contact Learning Objective: Chapter Multiple Choice Questions Feedback: Correct: Primary care occurs when people are able to access their family physician or nurse practitioner as the first point of contact Incorrect: These are some of the criteria that the provinces must meet to receive federal money for health care Incorrect: Primary health care refers to first point of contact Incorrect: These are some of the roles of public health Hints: 14 a Ontario Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: They were not set up in Nova Scotia Correct: Ontario recently set up Family Health Teams in communities to provide health care Incorrect: Quebec set up the first primary health units with salaried employees They were based on Centres Locaux de Service Communautaires Incorrect: British Columbia's walk-in clinics are not called Family Health Teams Hints: 15 a Provincial and/or municipal tax dollars Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: The federal government does not fund public health Correct: Public health funding comes from provincial and municipal tax dollars Incorrect: The provincial government assists the municipal governments in funding public health Incorrect: The federal government does not fund public health Hints: 16 c Home care Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: Public health is not growing as quickly as home care Incorrect: Acute care nursing is not growing as quickly as home care Correct: The increasing growth in home care is due to the belief that care in the home will be less costly Incorrect: Home care is the fastest-growing sector Hints: Copyright © 2012 Pearson Canada Inc Name: Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition 17 c Agency contracted by the Local Health Integration Network Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: Public health units not offer home care services in Ontario Incorrect: In the Yukon a social services branch of the department of health offers home care Correct: In Ontario services are contracted by one of 14 Local Health Integration Networks Incorrect: Most provinces have home care offered through local health authorities Hints: 18 b The aging Canadian population will escalate health care costs Learning Objective: Chapter Multiple Choice Questions Feedback: Correct: The aging population is predicted to escalate health care costs Incorrect: There is no evidence that this is escalating costs at the same rate as the aging population Incorrect: Some for-profit clinics currently access provincial funding Incorrect: Although there is a shortage of health care workers, this is not related to escalating costs Hints: 19 c They are more likely to have a university degree Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: Nurses working in community health are older than nurses in hospitals Incorrect: Only 54% work full time in the community Correct: This is true Incorrect: The proportion in leadership has decreased Hints: 20 b Lack of stable long-term funding Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: Funding, not staff shortages, is a major barrier Correct: Lack of stable long-term funding is the major barrier The funding that currently exists is being threatened Incorrect: Funding is the major barrier Incorrect: Funding, not care challenges, is the major barrier Hints: Copyright © 2012 Pearson Canada Inc Name: Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition 21 b Common language to describe the role Learning Objective: Chapter Multiple Choice Questions Feedback: Correct: This is one of the components of role clarity Incorrect: The community health nurses' role is not understood by other health care professionals Incorrect: This was not a component of role clarity Incorrect: This was not a component of role clarity Hints: 22 c Leadership Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: Community health nurses are not currently valued for their services Role clarity will assist with this Incorrect: Although funding is an issue, leadership was identified as having the greatest impact Correct: Leadership, especially front-line managers, has the greatest impact on community health nurses being able to work to their full scope Incorrect: Shortages of nurses may be a factor in having the capacity to give care, but leadership is the greatest factor in a nurse's ability to work to full scope Hints: 23 a Regular performance feedback Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: This strategy will improve the infrastructure Incorrect: This strategy will improve the workplace but not necessarily develop the nurse professionally Incorrect: This is an infrastructure strategy, not a support aimed at professional development Correct: Providing community health nurses with regular performance feedback from a variety of sources allows the nurses to develop Hints: 24 c Requires certain programs to be offered Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: The transfer was to those First Nation and Inuit communities who wished to assume authority for their health care Incorrect: This transfer of authority was optional for communities south of the 60th parallel Correct: Those communities that accepted the authority were required to ensure that certain public health and treatment programs were available Incorrect: The community had flexibility in how money was spent, but they were allowed to keep unspent funds Hints: Copyright © 2012 Pearson Canada Inc 10 Name: Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition 25 d Home care Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: Physician services are not the smallest percentage Incorrect: Hospitals and physician services account for over 50% of the spending Correct: Despite the growth in home care services, it accounts for less than 5% of the money spent on health care Incorrect: The percentage of health care dollars spent on drugs is increasing and is greater that money spent on home care Hints: 26 c Social awareness Learning Objective: Chapter Multiple Choice Questions Feedback: Incorrect: This was not one of the attributes identified Incorrect: Willingness to take risks was an attribute that was identified Incorrect: Comfort with ambiguity was identified as an attribute Correct: Self-confidence, self-awareness, and social awareness were identified as attributes of an effective leader Hints: 27 Primary Care: a person's first point of contact with the health care system Primary care services are dominated by medicine and have focused mainly on acute care and treatment of disease The largest group of primary care providers in Canada is physicians Other primary care providers are nurse practitioners, dentists, chiropractors, pharmacists, dieticians, midwives, optometrists and to some extent PHNs Most Canadians access primary care though a family or general practitioner who is reimbursed on a fee-for-service basis Only a few Canadians receive primary care services through a CHC, walk-in clinics, or emergency rooms Example related to CHN practice: A family who a PHN visits in the postpartum period may also see the primary care provider, most likely a GP, around the same time, increasing the need for interprofessional communication Primary Health Care: a philosophy or approach to care that involves the principles set forth at Alma Ata in 1978: health care that is accessible, affordable, and acceptable; uses appropriate technology; promotes health; and recognizes intersectoral and interdisciplinary approaches Examples related to CHN practice: a multidisciplinary community health council with several CHNs as members collaborates with a community to develop a network of safe bike and walking trails through residential and industrial neighbourhoods Learning Objective: Chapter Essay Questions Feedback: Hints: Copyright © 2012 Pearson Canada Inc 11 Name: 28 Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition - Lalonde Report (1974): acknowledged the limitations of the funded medical/treatment system Presented a vision for health promotion Identified four determinants of health, with an emphasis on lifestyle and the environment Led to a global reconceptualization of health promotion - Epp Report (1986): expanded the definition of health promotion, incorporated some of the tenets of primary health care, and emphasized social/environmental/political dimensions of health Formed the basis for the Ottawa Charter of Health Promotion - Ottawa Charter of Health Promotion (1986): International document identifying the prerequisites for health, strategies for promoting health, and outcomes of the strategies Acknowledges that caring for one's self and others is conducive to health Identifies caring, holism, and ecology as essential concepts in health promotion - Population Health Template and Population Health Promotion Model (2001 and 1996): resources developed to put population health and health promotion into action Used nationally and internationally in program planning, community development, and resource allocation Learning Objective: Chapter Essay Questions Feedback: Hints: 29 - Successful: in abolishing user fees and extra billing Provinces were penalized for allowing user fees and extra billing through the federal transfer payment plan - Less successful: violations of portability criterion between provinces, and suspected violations of comprehensiveness and accessibility The federal government does not collect enough information on compliance with criteria and does not impose penalties outside of extra billing and user fees Learning Objective: Chapter Essay Questions Feedback: Hints: 30 1867-1867—Constitution Act (BNA Act) assigned responsibility for hospitals to provinces Did not explicitly assign responsibility for health policy to either federal or provincial government 1919—national health insurance on the Liberal Party platform 1947—Saskatchewan gets Medicare under Tommy Douglas 1957—national Hospital Insurance and Diagnostic Services Act (HIDS) provides financial incentives to the provinces to build hospitals through 50/50 grants if provinces meet five key principles 1962—Saskatchewan gets universal, publicly funded medical insurance 1966—federal Medicare including physicians' services; if provinces meet same principles as HIDS, feds pay 50% of costs 1971—all provinces participate 1977—Established Programs Financing Act changes federal share of health costs to a per capita block grant 1996—Canada Health and Social Transfer (CHST) payments include federal transfer payments for health, postsecondary education, and welfare Learning Objective: Chapter Essay Questions Feedback: Hints: Copyright © 2012 Pearson Canada Inc 12 Name: 31 Date: Course: Stamler/Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition - Social justice: All members of society, including the most vulnerable, are entitled to free health care in Canada - Equity: All Canadians are viewed equally and without discrimination in terms of universal health care coverage - Community: All members of society contribute through taxation to provide everyone in the community with access to health care regardless of ability to pay Learning Objective: Chapter Essay Questions Feedback: Hints: 32 - Publicly administered: Health care funds are administered by a local elected regional health authority under the direction of the provincial health department - Portable: A person from Saskatchewan can receive insured health care in Ontario - Accessible: Families across Alberta have access to pediatric health care in their own communities or in communities within their health region without additional user fees - Universal: All residents of British Columbia are covered by B.C health care - Comprehensive: In-hospital health care, such as medically necessary surgery, is covered in the province of Newfoundland Learning Objective: Chapter Essay Questions Feedback: Hints: Copyright © 2012 Pearson Canada Inc 13 ... 2012 Pearson Canada Inc Name: Date: Course: Stamler/ Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition 13 a People accessing health care services at the... 2012 Pearson Canada Inc Name: Date: Course: Stamler/ Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition 23 What organizational supports would encourage... an example for each Copyright © 2012 Pearson Canada Inc Name: Date: Course: Stamler/ Yiu: Test: Chapter 02 Community Health Nursing: A Canadian Perspective, Third Canadian Edition Activity Name: