Chapter 1: The History of Community Health Nursing in Canada
Multiple Choice Questions
1. Who would a district or visiting nurse most likely work with in the early 1900s in Canada?
a. Families who could afford to pay
b. Poor and destitute families
c. The community
d. School children
Correct Answer: b (page 6); Learning Outcome 1 Complete test bank Community Health Nursing, A Canadian Perspective, 5th Edition
2. Which community health nursing specialty emerged in early 20th-century Canada to combat communicable disease, infant mortality, and childhood morbidity?
a. Visiting nursing
b. District nursing
c. Private duty nursing
d. Public health nursing
Correct Answer: d (page 5); Learning Outcome 2
3. In the early 20th century, most nurses were self-employed as private-duty nurses. Which statement below characterizes the social attitude of the era?
a. Public health was the responsibility of doctors
b. Visiting nurses were responsible for community health
c. The state was not responsible for health care
d. Women should not be working outside of the family
Correct Answer: c (page 4); Learning Outcomes 1 & 2
4. What was the primary reason for the establishment of school health programs?
a. Prevent ill children from becoming dependent citizens
b. Promote the health of all children
c. Provide food for children who lived in poverty
d. Treat sick children so they could work and contribute to the family income
Correct Answer: b (page 5); Learning Outcomes 3 & 4
5. The earliest forms for healthcare in Canada were:
a. The practices of Indigenous people
b. European settlers who were physicians
c. The wives of surgeons
d. The Grey Nuns
Correct Answer: a (page 2); Learning Outcomes 1, 2, 4, & 5
6. ___________________ were Canada’s first community nursing order who made significant contributions to promote health equity by providing access to health services, food, shelter, and education for people rendered vulnerable:
a. The Victorian Order of Nurses
b. The Grey Nuns
c. Public Health Nurses
d. School Nurses
Correct Answer: b (page 3); Learning Outcomes 1, 2, 3, & 4
7. The dual mandate of doing charitable work and providing affordable nursing care to the working and middle class was held by which agency?
a. The Margaret Scott Nursing Mission
b. The Victorian Order of Nurses
c. Indian Health Services
d. Public Health Services
Correct Answer: b (page 4); Learning Outcomes 1, 2, & 3
8. How were public health nurses and home visiting nurses different from nurses employed in other sectors of the healthcare system?
a. They received less compensation for their services
b. They were dependent on other health care professionals
c. They required post-diploma training at a university
d. They offered services to the elite living in urban districts
Correct Answer: c (page 4); Learning Outcomes 1 & 2
9. Which of the following were the first two public health nursing specialties?
a. TB nursing and school nursing
b. Private duty nursing and TB nursing
c. Home-visiting nursing and school nursing
d. Outpost nursing and school nursing
Correct Answer: a (page 5); Learning Outcomes 1 & 3
10. What was the role of the first public health nurses in Canada? Select all that apply.
a. To combat communicable diseases
b. To decrease infant mortality
c. To secure housing for the elite
d. To promote health of school children
Correct Answer: a, b, d (page 4); Learning Outcomes 3 & 4
11. Which organization is credited for establishing well-baby clinics?
a. The Grey Nuns
b. The Victorian Order of Nurses
c. The Red Cross
d. Provincial Health Departments
Correct Answer: c (page 5); Learning Outcome 1
12. Why did public health programs have limited success in rural and isolated areas?
a. There was a greater need for bedside nursing care
b. There were many physicians in the rural areas
c. There was higher need for health education and illness prevention
d. Local health departments were situated in rural areas
Correct Answer: a (page 6); Learning Outcomes 2 & 3
13. Which of the following roles best describes the work of the district and visiting nurse? Select all that apply.
a. They provided essential emergency care
b. They provided bed-side nursing and health education
c. They provided obstetrical care in the home
d. They provided preventative health teaching
Correct Answer: a, b, c, d (page 6); Learning Outcomes 1 & 2
14. How did publicly funded healthcare programs change the work of visiting nursing associations?
a. The Victorian Order of Nurses took over public health programs
b. Visiting nurses provided care to those who could not afford it
c. Hospital admission became the norm for those requiring obstetrical care
d. Chronically ill individuals no longer remained in community settings
Correct Answer: c (page 6); Learning Outcome 1
15. Military nursing requires the nurse to demonstrate which of the following competencies of community health nursing? Select all that apply.
a. A narrow vision that does not involve primary or secondary care
b. The ability to provide population health approaches
c. The ability to adapt practice in diverse settings
d. The ethical comportment to address conflicts that involve violence
Correct Answer: b, c, d (page 6); Learning Outcomes 2, 3, & 4
16. Which of the following types of community health nursing refers to nurses providing services in the most remote geographic locations?
a. Visiting nursing
b. Public health nursing
c. Outpost nursing
d. District nursing
Correct Answer: c (page 7); Learning Outcome 2
17. Which group played an important role in developing the social and healthcare services in smaller communities?
a. The Victorian Order of Nurses
b. The politicians
c. District and visiting nurses
d. Women volunteers
Correct Answer: d (page 5); Learning Outcome 2
18. The first group of public health officials implemented infant and child welfare programs in the early 20th century. What was the focus of these programs? Select all that apply.
a. Postpartum home visits soon after birth
b. Home visits to assess childcare practices
c. Home visits to assess hygienic conditions
d. Promoting breastfeeding in various locations
Correct Answer: a, b, c, d (page 5); Learning Outcome 2, 3, & 4
19. Which of the following programs were taken over by the health department as part of the process of consolidating all public health programs?
a. School health programs
b. Social welfare programs
c. Well-baby programs
d. Home visiting programs
Correct Answer: a (page 5); Learning Outcomes 2 & 3
20. Which of the following organizations is viewed as Canada’s oldest and most experienced visiting nursing organization?
a. The Red Cross
b. The Victorian Order of Nurses
c. The Grey Nuns
d. Provincial health departments
Correct Answer: b (page 9); Learning Outcome 1
21. Early school-based initiatives involved which of the following activities?
a. Immunizations at various ages
b. Medical inspections of children followed by home visits
c. Breakfast and lunch programs
d. Sanitation and access to potable water
Correct Answer: b (page 5); Learning Outcomes 1, 3, & 4
22. How did the reduction in government spending in the 1980s and 1990s affect community health nurses?
a. Increased funding for physical infrastructure
b. Re-institutionalization of mental health patients
c. Improved capacity to follow-up with patients with communicable diseases
d. Reduced nursing staff numbers and levels of service
Correct Answer: d (page 9); Learning Outcome 1
23. In which year was the Community Health Nurses Association of Canada established?
a. 1995
b. 2000
c. 1987
d. 1976
Correct Answer: c (page 10); Learning Outcome 1
24. Which document continues to be recognized as a visionary document with recommendations for shifting resources and policy in the direction of primary health care, home healthcare, and health promotion, which nurses as key players in the system?
a. The Alma-Ata Declaration
b. The Ottawa Charter for Health Promotion
c. The Medical Care Act
d. The Romanow Commission’s report
Correct Answer: d (page 11); Learning Outcomes 1 & 3
25. General public health nursing practice emerged from which type of nursing
a. School nursing
b. Visiting nursing
c. Outpost nursing
d. Home-visiting nursing
Correct Answer: a (page 11); Learning Outcomes 1 & 2
Short Answer Questions
26. Contrast the three sectors of nursing that existed in Canada in the 20th century.
Correct Answer: Hospital nurses, private-duty nurses, and public health nurses (including visiting nurses). Differences in practice settings/locations, pay/funding, educational preparation, focus of care, types of clientele (page 4; Learning Outcomes 1 & 2).
27. Discuss the role that women’s volunteerism and leadership in communities played in the development of community health nursing.
Correct Answer: They worked on community development, the made the development of healthcare services a priority; they lobbied local officials, served tea at child welfare clinics, sewed layettes for destitute families, provided transportation, made referrals, raised funds, and enabled CHNs to fulfill their professional obligations to the fullest extent possible (page 4; Learning Outcomes 1, 2, 3, & 4).
28. Discuss why local physicians sometimes did not support local public health programs
Correct Answer: Because they feared that the PHNs would provide primary care and thus compete with them for both patients and income (page 5; Learning Outcome 1).
29. Discuss how increased government responsibility for the healthcare of Canadians had an impact on public health nursing.
Correct Answer: Programs were expanded between 1940 and 1970; shift in focus from child health, immunization, and communicable disease control to a focus on decreasing morbidity and mortality from chronic diseases and injuries; increased demands on time for the early postpartum discharge home visiting program (page 8; Learning Outcomes 1, 2, 3, & 4).
30. The early practice of community health nursing was generalist in nature, consisting of a comprehensive range of services, including home healthcare and health promotion. Why did community health nursing become specialized over time?
Correct Answer: specialization occurred as a response to social, economic, and political forces, including the expanding knowledge of society (page 11; Learning Outcomes 2, 3, & 4).
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