Health Promotion and Disease Prevention Flashcards

A practical nurse is working with a rural Indigenous community to develop a diabetes prevention program. The community elder expresses that traditional healing practices should be integrated into the program. Which action by the nurse BEST reflects the principles of culturally safe health promotion?

Answer: Collaborate with the elder and community members to co-design the program, integrating traditional practices alongside biomedical approaches

Culturally safe health promotion requires genuine partnership and co-design with communities, particularly Indigenous communities. Collaboration that integrates traditional knowledge alongside biomedical approaches respects community self-determination, builds trust, and produces more effective outcomes. Simply acknowledging suggestions, delegating to a liaison, or tokenistically adding cultural content without structural integration does not constitute culturally safe practice.

Using the upstream determinants of health framework, a practical nurse is analyzing elevated rates of childhood asthma in a low-income urban neighbourhood. Which intervention operates at the MOST upstream level?

Answer: Advocating for municipal policy changes to reduce industrial emissions in residential zones

The upstream metaphor distinguishes between treating illness after it occurs (downstream) and addressing the root social, economic, and environmental conditions that cause illness (upstream). Advocating for municipal policy to reduce industrial emissions targets the structural/environmental determinant causing asthma in the first place. Teaching inhaler technique, screening, and distributing purifiers are all downstream responses that manage consequences rather than eliminate the root cause.

A practical nurse is applying the Stages of Change (Transtheoretical) Model when counselling a client about smoking cessation. The client says, 'I know I should quit, but I'm not planning to do anything about it for now.' The nurse MOST accurately identifies this client as being in which stage, and which intervention is MOST appropriate?

Answer: Contemplation; explore ambivalence using motivational interviewing and help the client weigh pros and cons

The client acknowledges a need to quit ('I know I should') but has no immediate intention to act ('not planning to do anything about it for now'), which places them in the Contemplation stage — aware of the problem, ambivalent, but not committed to action. Motivational interviewing to explore ambivalence and weigh pros and cons is the evidence-based approach for this stage. Precontemplation involves no awareness of the need to change; Preparation involves active planning. Prescribing NRT without readiness is premature and nurse practitioners/physicians, not practical nurses, prescribe.

A practical nurse reviews population-level screening data and notes that a cervical cancer screening program has high sensitivity but low specificity. Which statement BEST describes the consequence of this test characteristic for the screened population?

Answer: A substantial proportion of individuals without cervical cancer will receive positive results, leading to unnecessary follow-up procedures

High sensitivity means the test correctly identifies most true positives (few false negatives — few missed cases). Low specificity means the test also flags many individuals who do not have the disease (high false positive rate). Consequently, a large proportion of people without cervical cancer will receive positive screening results and undergo unnecessary, potentially invasive, and anxiety-inducing follow-up procedures. This is a key trade-off in screening program design that practical nurses must understand when educating clients about screening implications.

A public health practical nurse is implementing a secondary prevention strategy for hypertension in a community. Which activity MOST accurately represents secondary prevention in this context?

Answer: Providing free blood pressure screening at a community event to detect undiagnosed hypertension in asymptomatic adults

Secondary prevention focuses on early detection and prompt treatment of disease before symptoms develop, with the goal of halting or slowing disease progression. Screening asymptomatic adults for undiagnosed hypertension is a classic example. Primary prevention (options A and D) occurs before disease onset by reducing risk factors or influencing determinants. Tertiary prevention (option C) manages established disease to minimize complications and disability. The distinction between secondary and tertiary is commonly tested at an advanced level.

A practical nurse working in occupational health identifies a cluster of repetitive strain injuries (RSIs) among workers in a food processing plant. Applying Haddon's Matrix to this injury prevention problem, which intervention addresses the HOST factor during the PRE-EVENT phase?

Answer: Implementing a pre-employment musculoskeletal screening program to identify workers with predisposing physical vulnerabilities

Haddon's Matrix maps injury prevention interventions across three phases (pre-event, event, post-event) and three factors (host, agent/vehicle, environment). The HOST refers to the human at risk; the PRE-EVENT phase is before the injury-causing mechanism occurs. Pre-employment musculoskeletal screening identifies host vulnerabilities (individual susceptibility) before workers are exposed — a host-level, pre-event intervention. Installing machinery guards addresses the agent/environment during the event phase. Surveillance is a systemic/environmental tool. Workstation redesign targets the environment in the pre-event phase, not the host.