Download nursing 108 midterm exam questions with answers and more Exams Nursing in PDF only on Docsity!
nursing 108 midterm exam questions with
answers
1. what are the 2 types of community health nurses: 1) public health nurse
- home health nurse/clinic nurse
2. what do public health nurses do?: promote/protect the health of a specific population or the community as a
whole
3. what do home health/clinic nurses do?: focus on prevention, health restoration, health maintenance and palliative
care
4. what kind of patients did community health nurses first begin to work with?: -TB patients in 1905
-later began to work with children to promote hygiene and nutrition
5. what is the British North American Act? (1867): stated that the federal gov't funds quarantine and marine hospitals
but the provinces are in charge of everything else. Organized health care was provided at the local level through public welfare and charities.
6. what is the Medical Care Insurance Act? (1968): universal insurance for hos- pital and medical services
7. what is critical thinking?: ability to focus purposeful thinking to get required results in specific situations.
8. why is critical thinking important to nursing?: it produces a positive pa- tient/family outcome, helps with
patient safety and patient/family satisfaction
9. name some things that foster critical thinking: empathy, courage, humility, curiosity etc.
10. what are the 7 critical thinking skills?: 1) use of precise language
2) perceiving; recognizing differences
3) believing and knowing; don't jump to conclusions
4) clarifying; ask questions
5) comparing; notice similarities and differences
6) judging and evaluating; providing evidence
7) reasoning; distinguish b/w relevant vs irrelevant info
11. what are the 5 ways of acquiring nursing knowledge?: tradition, authority, trial and error, personal
experience, and role modelling
12. what is the nursing problem solving process?: a systemic, problem solving approach to identify, prevent and
treat actual or potential health problems and promote wellness. It's a 'thinking and doing' approach= a way of organizing your thoughts, then creating an action for it.
13. what are some benefits of the nursing problem solving process?: promotes collaboration, is efficient, increases
client participation, promotes individualized care, promotes continuing care and increases job satisfaction
14. what are the 5 steps of the nursing problem solving process cycle?: 1) assessment
2) nursing diagnosis
3) planning of care
4) implementation of care
5) evaluation
24. what is the importance of a nursing diagnosis?: it offers individualized care, describes an independent area of
nursing practice, promotes communication within teams and it helps to determine assessment and evaluation parameters. -it also focuses on the client's needs for nursing care rather than just medical care
25. what is a nursing diagnosis problem?: a statement of an actual or potential health problem that nurses can
identify and prescribe primary intervention for. It includes inference, problem solving and clinical decision making.
26. define health: it has many different definitions but in a nursing view it means quality of life and well being. It's a
state of complete physical, mental and social well being and not just the absence of disease.
27. define discourse: a patterned system of conversations (texts, dialogue, mes- sages) that can be identified in
communication and located in social structures. It plays a role in determining what is valued in society and it receives attention and resources
28. what are the 3 discourses on health?: medical model, systems view, and social determinants
29. what is the medical model of health?: it is the absence of disease
a problem focused approach that predicts and controls health and is the basis for health care funding, it's helpful when trying to cure/treat a medical disease
30. what is the systems view of health?: it is more than the absence of disease and is helpful during prevention
views health as being constructed through interrelatedness of physical, mental and social well being
31. what are the social determinant of health?: factors and conditions that influ- ence health over one's life and have
been identified as essential to promote the health of a population. Some ex: education, economic status, stress level, seasons, genetics, diet etc.
32. what are the 6 shifts in focus towards health care/promotion in canada?: 1) Lalonde Report (1974)
2) Ottawa Charter for Health Promotion (1986)
3) Epp Report, Achieving Health for All (1984/86)
4) Population Health (1994)
5) Canadian Nurses Association (1995)
6) Healthy Productive Canada (2009)
33. explain the Lalonde report.: -Was the first time the gov't supported health promotion. Represents a turning point
in thinking about health promotion. Found that lifestyle and environment were key determinants of health. Involves the integration of the health care system with prevention and health promotion. -Views health as not just freedom of disease but a state of well being
34. what are the 4 key health determinants that the Lalonde report focused on?: human biology, lifestyles,
environment and access to health care systems
35. what are the 5 strategies for promoting health outlined in the Ottawa Charter for Health
Promotion?: 1) building healthy public policy
2) creating supportive environments
3) strengthening community action
-Health determinants: physiological risk factors. -Strategies: disease screening, immunizations etc. -Goal: decrease morbidity and mortality rates
41. what is the behavioural/lifestyle approach to health promotion?: -focus on prevention of disease in people at
risk due to their individual lifestyle choices. -Health: is the physical-functional ability like physical and emotional well being. -Health determinants: behavioral risk factors (like smoking, eating poorly, drinking etc.) -Strategies: health education, social marketing and behavior modification -Goal: decrease risk factors, improve lifestyles and provide policies
42. what is the socio-environmental approach to health promotion?: -key for CHN
-Health: goes beyond the physical-emotional well being and includes social well being at individual and community levels -Health determinants: psychosocial and socio-environmental risks -Strategies: Ottawa Charter strategies and empowerment strategies -Goal: improve personal health perception through social networks, community group actions and to form health public policies
43. what are the difference between behavioural approach and socio-environ- mental approach?: behavioural
approach focuses on promoting a healthy lifestyle and changes in behaviour ex; diet/exercise socio-environmental approach focuses on education, helping someone deal with a disease and getting to the root of the problem ex; "looking upstream"
44. what was so important about the 1980s?: involved new ways of thinking about health promotion. Introduced
social justice and equity and the common good for needs of many. Social changes occurred rather than individual behaviour as a goal of health promotion which caused socio-ecological perspective to evolve and new epidemiology
evidence.
45. what are WHO's 5 key principles of health promotion ?: -address social and environmental determinants
1) population as a whole (not just those at risk)
2) action on causes of health
3) diverse, complementary methods
4) effective public participation
5) health professionals must enable promotion
46. What are the Toronto Charter 2002 social determinants?: early childhood development, education,
employment/working conditions, food security, health care services, housing shortages, income, social exclusion and social safety nets.
47. what are the 4 predictors of individual health?: Poverty, Income, Residence, Education
-if you can control these 4 things, its easier to make healthier life choices
48. what are the lay perspectives of health?: diverse, difficult to define, dynamic, perceptions are individual
49. what are the roles of a CHN?: identifying problems, intervene to control the cause, build trusting relationships,
collaborate with clients to address issues, advo- cate patient strengths and provide health related education
50. which province did universal health care start in?: Saskatchewan in 1947
51. what does the federal gov't fund?: healthcare, welfare and post-secondary education
52. what does the provincial gov't fund?: public health
61. what are the 5 primary healthcare principles?: 1) accessibility for all
2) health promotion and disease prevention
3) public participation
4) intersectoral collaboration
5) appropriate use of health care resources
62. what are some primary health care essential elements?: education, food supply/proper nutrition, safe
water/sanitation, maternal/child/family planning care, immunizations, prevention/control of diseases and provision of essential drugs
63. what does WHO stand for?: World Health Organization (report in 2008)
64. what is WHO concerned with?: -stress has caused health care systems to not work up to their potential and people
are becoming impatient with the system. health care systems need to respond faster and better, PHC can change this.
65. what is epidemiology?: pattern of disease. How often diseases occur in differ- ent groups of people and why. This
info is used to plan and evaluate illness prevention and to help patient's with those diseases.
66. what are the goals of epidemiology?: -find origin and risk factors of disease
-determine disease strength and how it progressed -evaluate current and new measures of prevention -collect data on how to improve things -provide evidence to develop public policies
67. who is Hippocrates?: first person to observe and record relationship b/w the environment and disease of people
68. who is John Graunt?: man who studied the statistics available on births and deaths
69. who is William Farr?: found death rates based on occupation or imprisonment
70. who is John Snow?: involved in research of the cholera epidemic in England and SOHO. By observing he found
the link b/w contaminated water and disease
71. who is Florence Nightingale?: she recorded deaths and their causes during the Crimean War and promoted
infection control processes
72. what is susceptibility/risk for disease dependent on?: the host, agent and environment
73. what are the 3 assessment variables (related to disease risk)?: person= age, ethnicity, gender, class, lifestyle
place= region, urban/rural, geographical location time= cyclic or seasonal (flu) or following specific events (post partum depression)
74. what are the 2 modes of disease transmission? explain.: Direct= involves contact with a person with a disease
Indirect= when the disease is spread by 'vehicle' that moves the disease to a new host
75. what is the web of causation?: a map of what might cause a specific disease and what could happen to a person
based on their symptoms=all are interrelated
76. what are the three stages of prevention and explain?: Primary= preexpo- sure/preclinical stage ex; you may
have been exposed to HIV so you get tested Second= clinical stage ex; you have HIV, nurses help a manage the disease at that time Tertiary= resolution stage ex; nurse knows what will happen in the long run so they help you prepare for it
77. what is prevalence rate?: how often something occurs within a population at a CERTAIN time
formula= # of disease occurrences in pop. divided by total population X100, 1000, 10000 etc -only tells you whats happening at a certain pt in time
3) retrospective cohort: go back in time, collect past info
85. what is the United Nations health for all movement of 2000?: offers an equal opportunity to a healthy life and
accessibility to health care, does not mean free of disease ex; canada is currently free of polio since 1994 but outbreaks occur in Syria still b/w they don't have equal access to health care for all
86. what is global health?: the optimal well being of all humans. Achieved through access to adequate income, food,
shelter, education, stable ecosystems, community resources, peace, social justice and equity that is experienced by all
87. what are the 6 points of the global health framework?: 1) elimination of poverty, social and economic
disparities
2) sustainable and environmentally responsible economic development
3) creation of public health policies
4) protection of human rights
5) rights recognition of women, youth and communities
6) accessible, affordable and culturally sensitive healthcare services
88. what is social justice?: the fair distribution of society's benefits, responsibilities and consequences. (decrease
oppression, racism etc.)
89. what is equity?: everyone should have fair opportunity to attain his/her full health potential and no one should
be disadvantaged (based on where they live, who they are etc.)
90. what's the main belief of postcolonial feminism?: that there's no 'right way' to health, everybody is different
91. what is globalization?: notion that nations, business and people are becoming more connected and interdependent
via increased economic integration, commu- nication exchange and cultural diffusion. ex; medical discoveries can be shared throughout work in short amount of time due to flight access and technology of Internet
92. does global warming impact global health?: yes, ex; by decreasing quality of vegetation
93. what health problem does extreme high heat from global warming cause?-
: cardio and respiratory complications such as heat stroke
94. what health problems do natural disasters and rainfalls cause?: asthma attacks and lack of medicine
95. how has lack of water supplies effected our health?: increase rates of malaria
96. what health problems does a lengthened/change in season cause?: trans- mission time of infections lengthens
ex; malaria
97. what is culture?: how we identify ourselves through beliefs and values. It is constantly changing and shapes what
we do. It can pose as a determinant of health.
98. what is ethnocentrism?: belief that one's own culture is the best. Poses as a barrier to both nurses and patients.
99. what is cultural diversity?: variation of cultural factors b/w and within groups. This can be beneficial to health
care professionals b/c it leads to adaptation, creativity and innovation
100. what is multiculturalism?: the integration of practices of diversity, tolerance and respect for multiple ways of
knowing and being with issues of equity and social justice.
101. what is ethnicity?: a way of describing social identity with a group that is based on a shared history and social
structure.
102. what is the top country that people are immigrating from into Canada?: -
china
106. what is cultural competence?: application of knowledge and skills that are required by nurses to maximize
respectful relationships with diverse openness. Nurses must examine their own values, beliefs and assumptions in order to support competence.
107. what is culturally-sensitive care?: ability to provide care with a client-cen- tered orientation. Avoid making
assumptions about a person's values and beliefs based on their culture.
108. what are the 2 barriers to providing culturally-sensitive care?: lack of experience and fear
109. what are the 4 elements of providing culturally-sensitive care?: 1) self reflection (know own
beliefs/values/biases)
2) acquiring cultural knowledge (know how to ask Qs)
3) facilitating client choice (help client meet own goals)
4) communication (open/close ended Qs, verbal vs non verbal approaches and working with interpreters)
110. what are the 7 core principles of culturally-appropriate care?: 1) everyone has a culture
2) culture is individual
3) culture is influenced by many factors
4) culture is dynamic (changing)
5) it influences nurse-client relationships
6) a nurse's culture is influenced by personal belief and nursing professional values
7) nurse is responsible for assessing/responding appropriately to the client's cultural expectations/needs
111. what are the 3 competencies of the Community Health Nurses Associa- tion of Canada?: 1) recognize how
the determinants of health influence the health of populations
2) address population diversity when planning and implementing public health policies
3) apply culturally relevant approaches to people who have diverse cultures, educa- tional backgrounds etc.
112. what is nursing knowledge?: research conducted provides evidence that can be used to improve patient outcomes
113. what are the 4 things that nursing students must acquire?: 1) basics for scientific enquiry (research
theory/method)
2) capacity for critical thought and analytical skills
3) skills to access relevant research and evidence
4) ability to read and critically appraise research
114. how is evidence based practice (EBP) achieved?: 1) find evidence (search literature)
2) understand evidence (critically appraise literature and understand it)
3) apply the evidence
115. how is evidence found?: through primary studies, systemic reviews of studies and clinical practice guidelines
116. what is a systemic review?: a formal way of locating, evaluating, selecting, assembling, synthesizing,
analyzing and interpreting a body of research.
117. how is a systemic review conducted?: through meta-analysis (combining quantitative data) and meta-
125. what were the 2 problems with Bill 46?: 1) the development of improvement plans only focused on patient
safety
- once reported to the government, data was lost
126. what is safety? (patient): the prevention of harm to patients. It is freedom from accidental or preventable injuries
produced by medical error.
127. List important dates of the history of quality movement in the US.: 1980: Institute for Healthcare
Improvement 1995: Harvard Medical Practice Study results published 2000: To Err is Human 2001: Crossing the Quality Chasm 2003: CPSI 2004: The Canadian Adverse Events Study 2012: The Canadian Pediatric Adverse Events Study 2013: The Relationship b/w the Nursing Work Environment and the Occurrence of Reported Pediatric Medication Administration Errors
128. what is an error?: planned sequences of mental/physical activities that fail to achieve their intended outcomes
when cannot be attributed to chance.
129. how do errors occur?: by doing the wrong thing (commission) or by failing to do the right thing (omission)
130. what 2 elements are involved in errors?: 1) latent conditions; also known as hazards. involve poor decisions,
designs, supervision and inadequate tools and equipment
- active failures; person making error is in direct contact with another person, equipment or system.results are immediate adverse effects.
131. why do errors occur?: because of system issues, problems in communication b/w areas, reporting issues and a
lack of research.
132. what is systems thinking?: using what is known about how systems work to improve performance.
133. what is a positive work environment?: a quality work environment in which there is an emphasis placed on
workplace safety, personal satisfaction and support, teamwork, a reasonable workload and adequate physical surroundings.
134. how do you make complex systems fail?: through normalizing deviance= little problems that com up in daily
routine become so familiar that staff start to assume they're normal, and begin to ignore them.
135. Why is health education important to nurses?: -so we can educate others (to help prevent illness and so they
can help themselves) -reduce health care costs -help prevent serious outbreaks -it would allow us to see more acute cases rather than chronic that could be treated at home. This allows for more diversity in what you see
136. what are health promotion activities?: help people modify their lifestyles, help people achieve their health
potentials and personal goals.= this is achieved through health education and teaching conducted by nurses
137. what factors affect health?: lifestyle choices, coping skills and preventive health behaviours.
138. what is the purpose of health education? (4): 1) wellness promotion
2) disease prevention
3) restoration of health
4) promoting coping
139. what is health education/teaching?: it's a focused and creative interpersonal nursing intervention where the
