Test Bank for Canadian Fundamentals of Nursing, 6th Edition

Chapter 02: The Canadian Health Care Delivery System Potter et al: Canadian Fundamentals of Nursing, 6th Edition MULTIPLE CHOICE 1. What is the fastest growing component of the health care system? a. Primary care. b. Respite care. c. Home care. d. Palliative care. ANS: C Canadian health care is shifting from an institution-based system to one in which community care is playing a greater role. Home care is one of the fastest growing components of the health care system, partly because patients are sent home from hospital sooner than they used to be. Primary care, respite care, and palliative care are not the fastest growing components of the health care system. DIF: Apply REF: 27 OBJ: Describe five levels of health care and associated types of services. TOP: Assessment MSC: CPNRE: Foundations of Practice 2. Which of the following is a contributing factor to the shortage of nurses in Canada? a. Increased birth rate, which creates a greater demand for nursing services. b. New technology, which replaces nurses at the bedside. c. Fewer people wishing to practise as nurses because health trends are focusing on natural and alternative therapies. d. Retirement of a large percentage of nurses. ANS: D The nursing workforce is currently challenged by the aging of workers, high retirement rates, ethical problems in international recruitment, and lack of full-time positions. The average age of RNs in Canada is 44.6 years; for LPNs, it is 41, and for RPNs, it is 46. The aging population is creating the greater demand for nursing services. Neither the replacement of nurses at the bedside by new technology nor the focus of health trends on natural and alternative therapies is a factor identified as contributing to the shortage of nurses. DIF: Apply REF: 19, Box 2-1 OBJ: Discuss principal factors influencing health care reform and the current health care delivery system. TOP: Planning MSC: CPNRE: Foundations of Practice 3. A nurse working with a group of Indigenous parents refers to Treaty 6, which includes a provision for health care services and is often referred to as which of the following? a. The Truth and Reconciliation Act. b. The “medicine chest” clause. c. The Indigenous band agreements. d. The land and relationship understanding. ANS: B Treaty 6 was often referred to as the “medicine chest” clause, as it included a provision for health care services to be provided to Indigenous communities. The Indian Act, the Indian band agreements (signed with the British government before Confederation), and relationship agreements do not refer to Treaty 6. DIF: Understand REF: 20 OBJ: Identify initiatives related to enhancing quality of the Canadian health care delivery system. TOP: Planning MSC: CPNRE: Foundations of Practice 4. Which of the following is an example of a true health promotion service provided by a nurse? a. An immunization clinic. b. A diabetic support group. c. A prenatal nutrition class. d. A smoking cessation clinic. ANS: C Community clinics offer prenatal nutrition classes that promote the health of the woman, fetus, and infant. Building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and reorienting health services are part of health promotion service. An immunization clinic is an example of disease and injury prevention. A diabetic support group may be an example of a rehabilitation service, to help patients adapt to a change in lifestyle. A smoking cessation clinic may be offered as part of a rehabilitation service or as a disease and injury prevention intervention. DIF: Apply REF: 28 OBJ: Describe five levels of health care and associated types of services. TOP: Implementation MSC: CPNRE: Foundations of Practice 5. When conducting a health care system class for immigrants to Canada, the nurse informs them that the federal government is responsible for which of the following? a. Providing health care insurance plans. b. Managing and planning insurable health services. c. Delivering health services to targeted groups. d. Providing long-term care services. ANS: C The federal government is charged with delivering, or co-delivering, health care services for targeted groups. Health care insurance plans, managing and planning insurable health services, and providing long-term care services are the jurisdiction of the provinces or territories. DIF: Apply REF: 22 OBJ: Identify and define the principles of the Canada Health Act and significant legislation related to the Canadian health care system. TOP: Implementation MSC: CPNRE: Foundations of Practice 6. The nurse initiated a support group for adolescent parents and is teaching them about chlorinated water and child immunizations, which are all examples of which of the following? a. b. c. d. Health promotion. Disease and injury prevention. Supportive care. Rehabilitation. ANS: B Disease and injury prevention includes illness prevention (chlorinated water, immunizations) and support groups. Health promotion services include antismoking services, advocacy for healthy public policy, and provision of wellness services. Supportive care describes services provided over a prolonged period to people who are disabled, who have never been able to function independently, or who have a terminal disease. Rehabilitation, such as physiotherapy, involves restoring optimal health. DIF: Apply REF: 28 OBJ: Describe five levels of health care and associated types of services. TOP: Implementation MSC: CPNRE: Foundations of Practice 7. Primary care is best described as which of the following? a. Early detection and routine care, as well as prevention. b. Provision of a specialized medical service. c. Treatment of all patients with a minimum level of health insurance. d. Provision of medical services in a patient’s home. ANS: A Primary care is the first contact of a patient with the health care system that leads to a decision regarding a course of action to resolve any actual or potential health problem. The focus is on early detection and routine care, with emphasis on education to prevent recurrences. Provision of a specialized medical service by a specialist or through referral is an example of secondary care. No patient is refused treatment on the basis of level of insurance. Medical services provided in the patient’s home, although not very common, could be categorized under primary care but would not best describe primary care. DIF: Understand REF: 28 OBJ: Identify various settings and models of care delivery in the Canadian health care delivery system. TOP: Assessment MSC: CPNRE: Foundations of Practice 8. A patient comes to the ambulatory care clinic for management of a chronic condition and asks the nurse for an explanation of the Medicare system. The nurse’s response is based on the knowledge that it is which of the following? a. Canada’s national health insurance system. b. A fee-for-service insurance plan. c. A plan in which monies from provincial taxes are used for nursing homes. d. A social insurance program for low-income earners. ANS: A Medicare is a key element of Canada’s social safety net. It is Canada’s national health insurance system, in which taxes are used to finance medically necessary services for all citizens, thus providing “free” health care to all. Medicare is not a fee-for-service insurance plan, a plan in which monies from provincial taxes are used for nursing homes, or a social insurance program for low-income earners. DIF: Understand REF: 19 OBJ: Discuss the evolution of Canada’s social safety net and Medicare. TOP: Implementation MSC: CPNRE: Foundations of Practice 9. In teaching a group of older persons about health care spending, a nurse tells them that about 14% of the Canadian population is within their age group and that this group accounts for what percentage of health care spending? a. 25%. b. 35%. c. 45%. d. 55%. ANS: C Older persons account for 45% of health care spending in Canada, not 25%, not 35%, and not 55%. DIF: Apply REF: 22 OBJ: Discuss principal factors influencing health care reform and the current health care delivery system. TOP: Implementation MSC: CPNRE: Foundations of Practice 10. To whom do the principles of the Canada Health Act of 1984 apply? a. Members of the Canadian Armed Forces. b. Insured residents of Canada. c. Inmates of federal penitentiaries. d. Royal Canadian Mounted Police (RCMP). ANS: B The principles of the Canada Health Act apply to all insured residents of Canada (i.e., eligible residents) but exclude members of the Canadian Armed Forces, Royal Canadian Mounted Police (RCMP), eligible veterans, inmates of federal penitentiaries, and some refugee claimants. DIF: Understand REF: 20 OBJ: Identify and define the principles of the Canada Health Act and significant legislation related to the Canadian health care system. TOP: Assessment MSC: CPNRE: Foundations of Practice 11. When a mother brings her child to be seen in a nurse-managed setting, over concerns that her child’s rash could be measles, what type of care is rendered? a. Respite care. b. Primary care. c. Supportive care. d. Secondary care. ANS: B Primary care focuses on early detection and routine care and can be offered in nurse-managed clinics. Respite care is a component of supportive care. Supportive care describes services provided to disabled and terminally ill patients over a prolonged time period. Secondary care is the provision of specialized medical services by a physician specialist or through referral from a primary care provider. DIF: Understand REF: 28 OBJ: Describe five levels of health care and associated types of services. TOP: Assessment MSC: CPNRE: Foundations of Practice 12. Which of the following is one of the four pillars of primary health care, as described by the National Primary Health Care Awareness Strategy (2006)? a. Teams. b. Universality. c. Health promotion. d. Immediate access to primary care. ANS: A Teams are one of the four pillars, along with access, information, and healthy living. The four pillars do not include universality, health promotion, or immediate access to primary health care. DIF: Understand REF: 25, Box 2-3 OBJ: Identify various settings and models of care delivery in the Canadian health care delivery system. TOP: Planning MSC: CPNRE: Foundations of Practice 13. Mr. Jones is 72 years old. He is ambulatory and is to be discharged from hospital after a total hip replacement, with requirements for daily physiotherapy and respiratory therapy. What is the most appropriate facility referral for the nurse to make? a. A rehabilitation centre. b. An assisted-living facility. c. A community health clinic. d. A home care agency. ANS: D A home care agency provides health services to individuals and families in their homes. Home care was created to provide individualized care for people after hospital discharge but has increasingly included patients in a range of ages from very young to very old; those with mental, physical, or developmental challenges; and those requiring recovery to end-stage care. A rehabilitation centre is not required, as Mr. Jones is ambulatory. Assisted-living facilities are community-based residential facilities in which adults live in their own apartments and are provided with a range of support services such as meals, social and recreational programs, and laundry A community health clinic is the first point of contact, offering a range of primary services that emphasize prevention, health promotion, health education, community development, and partnerships to develop a healthy local community. DIF: Apply REF: 26 | 27 OBJ: Identify various settings and models of care delivery in the Canadian health care delivery system. TOP: Implementation MSC: CPNRE: Foundations of Practice 14. What is an appropriate referral for an older patient who requires some assistance with daily activities within a partially protective environment? a. Respite care. b. Rehabilitative care. c. Assisted living. d. Extended care. ANS: C Such a patient requires assisted living. Assisted living allows adults to receive a range of support services, including personalized assistance in achieving a level of independence. Personal assistance services are “designed to promote maximum dignity and independence,” including meal preparation, personal hygiene practice, mobility, and socialization. Respite care is a service that provides short-term relief for family caregivers or persons providing home care to the ill or disabled. Rehabilitative care provides therapy and training, with the goal of decreasing the patient’s dependence on care. An extended, or long-term, care facility provides intermediate medical, nursing, or custodial care for patients recovering from acute or chronic illness or disabilities. DIF: Apply REF: 26 | 27 OBJ: Identify various settings and models of care delivery in the Canadian health care delivery system. TOP: Implementation MSC: CPNRE: Foundations of Practice 15. The Canadian Patient Safety Institute (CPSI) provides leadership in building and advancing a safer health care system. According to the CPSI, about two thirds of preventable incidents that occur during hospitalization are related to what? a. Procedures. b. Care or medication. c. Patient accidents. d. Infection control. ANS: B According to the CPSI, about two thirds of preventable events are either care related or medication related. About one third of the events are related to procedures or patient accidents. Infections fall under the category of care. DIF: Remember REF: 30 OBJ: Discuss principal factors influencing health care reform and the current health care delivery system. TOP: Planning MSC: CPNRE: Foundations of Practice 16. “Residents temporarily absent from their home province are to have their incurred services paid for by the home province, in the same amount that would have been paid by the home province.” This statement reflects which principle of the Canada Health Act (1984)? a. Portability. b. Universality. c. Public administration. d. Accessibility. ANS: A This statement describes the principle of portability. The principle of universality means that 100% of the insured persons of a province are covered by the health care plan. The principle of public administration means that the health care plan must be administered and operated on a nonprofit basis by a public authority, responsible to the provincial government and subject to audits of its accounts and financing transactions. The principle of accessibility means that the health care plan of a province must provide for (1) insured health services and reasonable access by insured persons; (2) reasonable compensation to physicians and dentists for all insured services rendered; and (3) payments to hospitals in regard to the cost of insured health services. DIF: Understand REF: 21, Table 2-1 OBJ: Identify and define the principles of the Canada Health Act and significant legislation related to the Canadian health care system. TOP: Planning MSC: CPNRE: Foundations of Practice 17. A Canadian is explaining to a non-Canadian friend the benefits of the Canadian health care system. The Canadian discusses being able to access surgical or medical hospital-based care with no out-of-pocket charges; mentions that if he or she must travel for work to another province within Canada, he or she is still covered; and explains that it is easy to access health care services and the care received is respectful and embraces diversity. Which of the following principles of the Canada Health Act of 1984 is the Canadian describing? a. Universality, public administration, and protection. b. Comprehensiveness, public administration, and portability. c. Universality, accessibility, and protection. d. Accessibility, portability, and comprehensiveness. ANS: D The principles described by the Canadian include universality, portability, accessibility, and comprehensiveness. The ability to access surgical or medical hospital-based care with no out-of-pocket charges refers to comprehensiveness; the ability to reasonably access health care services refers to accessibility; and respectful care that embraces diversity refers to universality. Portability refers to the ability to access health care services in another province. Public administration is another principle of the Canadian Health Act but is not described by the Canadian. Protection is not a principle of the Canadian Health Act. DIF: Apply REF: 21 OBJ: Identify and define the principles of the Canada Health Act and significant legislation related to the Canadian health care system. TOP: Assessment MSC: CPNRE: Foundations of Practice