Health Promotion and Disease Prevention Flashcards

A practical nurse is working with a community health team applying the Population Health Promotion Model (PHPM). The team wants to prioritize an intervention addressing the social determinants of health for a low-income neighbourhood with high rates of type 2 diabetes. Which action BEST reflects intervening at the community level using a health promotion strategy?

Answer: Partnering with municipal planners to advocate for a subsidized grocery store in the neighbourhood

The PHPM emphasizes acting on social determinants of health at the community and societal levels. Advocating for a subsidized grocery store addresses food insecurity — a structural determinant — rather than individual behaviour change. Pamphlets and individual counselling target individual-level change, and screening is a disease-prevention activity rather than upstream health promotion.

A practical nurse is reviewing immunization records for a 55-year-old client who received the primary series of tetanus-diphtheria-pertussis (Tdap) as an adult 12 years ago and has never had a herpes zoster (shingles) vaccine. The client is a non-smoker, has controlled hypertension, and works as a long-term care aide. Which vaccine is MOST urgently indicated based on current Canadian immunization guidelines and occupational risk?

Answer: Recombinant zoster vaccine (RZV) two-dose series, because of age and occupational exposure to immunocompromised residents

The recombinant zoster vaccine (Shingrix/RZV) is recommended for adults ≥50 years and is particularly important for healthcare workers in long-term care who may expose vulnerable immunocompromised residents. The Td booster is due at 10 years, but since Tdap was given 12 years ago (not Td), the next booster would be Td — however, the greater urgency and clinical significance here is the missing RZV. Pneumococcal vaccine is not specifically indicated by hypertension alone without additional risk factors. Annual influenza is always needed but does not represent the most urgently missing protection.

During a prenatal class, a practical nurse is teaching about the Ottawa Charter for Health Promotion. A participant asks how the charter's principle of 'reorienting health services' applies to prenatal care. Which response BEST reflects this principle?

Answer: Shifting the focus of prenatal visits from managing obstetric risk to building the parent's capacity for informed decision-making and community support

Reorienting health services means moving beyond a biomedical, disease-management focus toward services that support health promotion and empower individuals. Option B directly reflects this by shifting the clinical encounter from risk detection (biomedical model) toward capacity-building and community connection. Regular appointments and screening (options A and C) reflect disease prevention within the medical model. Referral to mental health (option D) is a health protection/secondary prevention action, not a reorientation of services.

A practical nurse working in a correctional facility notices that incarcerated clients are released without a follow-up plan for managing their latent tuberculosis infection (LTBI) treatment. The nurse wants to apply Leavell and Clark's levels of prevention. Which level of prevention is MOST relevant to ensuring continuity of LTBI treatment after release?

Answer: Secondary prevention — ensuring treatment completion to prevent progression from latent to active TB

Latent TB infection has already been identified (early detection has occurred). Ensuring LTBI treatment is completed prevents progression to active disease, which is the goal of secondary prevention at the disability-limitation sub-level — halting disease progression in someone already identified with a condition. Primary prevention would target uninfected individuals. Tertiary prevention applies after active disease with established disability. Option B is incorrect because it describes new screening rather than treatment completion.

A practical nurse is conducting a community needs assessment using Precede-Proceed model principles. During the epidemiological assessment phase, the nurse identifies that a rural First Nations community has a cervical cancer incidence rate three times the provincial average. Which finding would MOST directly inform the educational and ecological assessment (Phase 3) of the model?

Answer: Cultural mistrust of the healthcare system due to intergenerational trauma from residential schools reduces health-seeking behaviour

The educational and ecological assessment (Phase 3 of Precede-Proceed) identifies predisposing, enabling, and reinforcing factors that influence health behaviours. Cultural mistrust rooted in historical trauma is a predisposing factor — an attitudinal/belief factor that directly affects willingness to engage with screening. Lack of a colposcopy clinic is an enabling factor (access barrier) relevant to Phase 3 but is less foundational than the predisposing cultural factor. Low vaccination rates and mortality data belong to the epidemiological assessment (Phase 2). The correct answer is D because it is the most direct predisposing determinant shaping behaviour.

A practical nurse is evaluating the effectiveness of a workplace smoking cessation program using the Transtheoretical Model (TTM). At program entry, 40% of participants were in the precontemplation stage. After 6 months, process evaluation shows high attendance at group sessions but no reduction in the facility's overall smoking rate. Which interpretation is MOST accurate?

Answer: Success should be measured by stage progression, since precontemplators moving to contemplation represents meaningful change even without immediate cessation

The TTM recognizes that behaviour change is a process through stages: precontemplation → contemplation → preparation → action → maintenance. For individuals in precontemplation, the immediate goal is moving to contemplation — not cessation. Measuring success only by smoking rate ignores stage movement, which is a valid and meaningful proximal outcome. Discontinuing the program based solely on smoking rates misapplies outcome evaluation. There is no evidence that pharmacotherapy is needed or that group sessions are inappropriate. The 18-month claim is arbitrary and unsupported by TTM principles.