Chapter 1: Health and Wellness
MULTIPLE CHOICE
1. There are different ways to define health and illness. What is the most commonly cited
definition of health?
a. Health is the absence of disease.
b. Health is a function of the physiological state.
c. Health is a state of well-being involving the whole person.
d. Health is the ability to pursue activities of daily living.
ANS: C
The nurse should consider the total person when formulating a definition of “health.” Health
is a positive concept emphasizing social and personal resources, as well as physical capacities.
Health is seen as a resource for everyday living, rather than as the object of living.
Health is considered to be more than merely the absence of disease.
The definition of health has broadened beyond the physiological state to include mental,
social, and spiritual well-being.
An individual who is able to pursue activities of daily living (ADLs) may not define himself
or herself as healthy. Life conditions such as environment, diet, and lifestyle practices may
negatively affect one’s health long before one is unable to perform ADLs.
DIF: Comprehension REF: 2
2. The population health promotion model aims to develop actions for improving health. In
addition to asking “On what should we take action?” “How should we take action?” and
“Why should we take action?” What is the fourth major question explored by the model?
a. “With whom should we act?”
b. “When should we take action?”
c. “Which government should action?”
d. “Where should we first act?”
ANS: A
The fourth question is With whom should we act?
When should we take action? is not one of the four questions.
Which government should action? is not one of the four questions.
Where should we first act? is not one of the four questions.
DIF: Knowledge REF: 12 (Figure 1-5)
3. “Health promotion is multisectoral” is a principle of health promotion. What does this
principle mean?
a. Relationships between individual, social, and environmental factors must be
recognized.
b. Physical, mental, social, ecological, cultural, and spiritual aspects of health must
be recognized.
c. In order to change unhealthy living and working conditions, areas other than health
must also be involved.
d. Health promotion uses knowledge from disciplines such as social, economic,
political, environmental, medical, and nursing sciences, as well as from firsthand

experience.
ANS: C
In order to change unhealthy living and working conditions, areas other than health must also
be involved explains the principle, “Health promotion is multisectoral.”
Relationships between individual, social, and environmental factors must be recognized
explains the principle, “Health promotion addresses health issues in context.”
Physical, mental, social, ecological, cultural, and spiritual aspects of health must be
recognized explains the principle, “Health promotion supports a holistic approach.”
Health promotion uses knowledge from disciplines such as social, economic, political,
environmental, medical, and nursing sciences, as well as from firsthand experience explains
the principle, “Health promotion draws on knowledge from a variety of sources.”
DIF: Comprehension REF: 11
4. What priority strategy for health promotion in Canada is seen as important to incorporate in
nursing education curricula?
a. Knowledge of disease prevention
b. Strategies for health promotion
c. Policy advocacy
d. Concepts of determinants of health
ANS: C
Increasingly, policy advocacy is incorporated into nursing role statements and nursing
education curricula. Nurses should think about policies that have contributed to health
problems, policies that would help to alleviate health problems, and how nursing champions
public policies.
Disease prevention is an integral part of nursing curricula.
Health promotion is a fundamental part of nursing curricula.
Nursing curricula integrate determinants of health.
DIF: Comprehension REF: 11
5. The population health approach emphasizes individual and collective social factors that
influence a population’s health. Which of the following is considered a population-level
determinant?
a. Education
b. Personal health practices and coping skills
c. Biology and genetic endowment
d. Income and social status
ANS: A
Education is considered a population-level determinant.
Personal health practices and coping skills are considered an individual-level determinant.
Biology and genetic endowment is considered an individual-level determinant.
Income and social status is considered an individual-level determinant.
DIF: Application REF: 5
6. Which of the following has been identified as the greatest determinant of health affecting
Canadians?

a. Education
b. Health services
c. Social support networks
d. Income and social status
ANS: D
Income and social status is the greatest determinant of health.
Some investigators suggest that literacy and education are important influences on health
status because they affect many other health determinants.
Approximately 25% of a population’s health status is attributed to the quality of its health care
services.
Social support affects health, health behaviours, and health care utilization, but is not the
greatest determinant of health.
DIF: Application REF: 5
7. A paraplegic client is in the hospital for an electrolyte imbalance. At which level of
prevention is the client receiving care?
a. Primary prevention level
b. Secondary prevention level
c. Tertiary prevention level
d. Health promotion level
ANS: B
The secondary prevention level focuses on early detection of disease once pathogenesis has
occurred, so that prompt treatment can be initiated to halt disease and limit disability.
The primary prevention level focuses on health promotion and specific protection measures
such as immunizations, and the reduction of risk factors such as smoking.
The tertiary prevention level focuses on minimizing residual disability.
Health promotion is a focus of the primary prevention level.
DIF: Application REF: 10
8. The nurse incorporates levels of prevention as based on client needs and the type of nursing
care provided. Which one of the following nursing activities is an example of tertiary-level
preventive caregiving?
a. Teaching a client how to irrigate a new temporary colostomy
b. Providing a lesson on hygiene for an elementary school class
c. Informing a client that immunizations for her infant are available through the
health department
d. Arranging for a hospice nurse to visit with the family of a client with cancer
ANS: D
Tertiary prevention occurs when a defect or disability is permanent and irreversible. At this
level, the hospice nurse aims to help the client and his or her family to achieve a high level of
function, despite the limitations caused by the client’s illness.
Teaching a client how to irrigate a new colostomy would be an example of secondary
prevention. If the colostomy is to be permanent, care may later move to the tertiary level of
prevention.
Providing a lesson on hygiene for an elementary school class would be an example of primary
prevention.

Informing a client about available immunizations would be an example of primary prevention.
DIF: Application REF: 10
9. Since the early 1990s, which group has had the highest amount of absenteeism of all workers
in Canada?
a. “White collar sector” workers
b. Nurses
c. Workers in the trades
d. Transport and equipment operators
ANS: B
There is considerable concern regarding negative workplace conditions in the health care
sector. Nurses have had the highest or second-highest rate of absenteeism of all workers in
Canada since the early 1990s.
Rates of absenteeism for the “white collar sector” were not given.
Rates of absenteeism for workers in the trades were not given.
Rates of absenteeism for transport and equipment operators were not given.
DIF: Application REF: 7
10. According to research about nutrition in Canada, which one of the following statements is
true?
a. Canadians have increased their total fat and salt consumption.
b. Canadians report that their children eat the recommended daily number of fruits
and vegetables.
c. More than half of Canadian children aged 2 to 17 years are overweight or obese.
d. Ten percent of Canadians are overweight or obese.
ANS: A
True. Moreover, one-quarter of Canadians overall, and one-third of teens aged 14 to 18 years,
had eaten at a fast-food outlet the previous day, exposing them to foods high in fats and salts.
False. Seventy percent of children aged 4 to 8 ate fewer than the minimum servings of fruits
and vegetables daily.
False. Twenty-six percent of children aged 2 to 17 years were overweight or obese.
False. In 2001, 56% of men and 39% of women were overweight or obese.
DIF: Application REF: 8
11. Which of the following is one of the five health promotion strategies identified by the Ottawa
Charter for Health Promotion?
a. Create supportive environments
b. Strengthen educational opportunities
c. Develop a medical approach
d. Minimize stressful situations
ANS: A
Create supportive environments is one of the five broad health promotion strategies identified
by the Ottawa Charter for Health Promotion. These strategies are: building healthy public
policy, creating supportive environments, strengthening community action, developing
personal skills, and reorienting health services.

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