In Australia health financing is based on universal health insurance that enables access to quality, low cost health care for all citizens. When it was first introduced in the 1970s it was called?

Question 1

Countries other than Australia have other significant health issues, as listed by the World Health organisation (WHO). After child and maternal health, a significant health priority area for countries to target is__________ (Select the one (1) correct answer)

essential medicines, cholera and urban health.

global information system on alcohol, substances and tobacco control.

sexually transmitted infections, meningococcal meningitis, and influenza virology.

infectious diseases for example HIV/AIDs, tuberculosis, malaria.

1 points

Question 2

In Australia health financing is based on universal health insurance that enables access to quality, low cost health care for all citizens. When it was first introduced in the 1970s it was called ________ (Select the one (1) correct answer)

public health insurance.

Medibank.

Medicare.

health insurance scheme.

Question 3

Private health insurance organisations in Australia function in addition to the universal public financing of Medicare. A significant role of the private health insurance system is to _______ (Select the one (1) correct answer)

stop people using the public system all together to ensure an entirely private system in the future.

help with the cost of non–Medicare funded services and assist with avoidance of waiting lists in the public system.

to pay for 75% of ancillary health costs for older people living in remote areas and to provide extra health care to eligible disabled people.

to ensure that people in high tax brackets do not attend public hospitals and obtain a better tax return by ticking the private health insurance box when submitting their tax declaration.

Question 4

The historical trauma experienced by Aboriginal and Torres Strait Islander people has been identified as affecting uptakes of health programmes that were set up to support health issues for the Aboriginal and Torres Strait Islander people. Significant improvements to participation have been made since which one (1) of the following has increased?

Large metropolitan hospitals have provided more health promotion services to Indigenous people in order to target their specific issues

Private health insurance changes have been made over the last two decades to offer less expensive medical treatment to Aboriginal and Torres Strait Islander people.

Increasing numbers of Aboriginal and Torres Strait Islander health workers and professionals employed within services for the Aboriginal and Torres Strait Islander people.

The Northern Territory Intervention was introduced in 1998 and has provided targeted medical equipment to Aboriginal people living in rural areas.

1 points

Question 5

A major historical development within perspectives of the nursing profession was a change to nurse education. Select which one (1) of the following summarises the significant changes that have occurred at the end of the last century.

Education of nurses has been allocated to providers who are medical doctors to ensure complex medical knowledge base.

Education of nurses has recently introduced concepts of discipline and standardisation of task completion and allocation to ensure standard practice.

Education of nurses was taken out of hospital-based, vocational style and transferred to universities and vocational education providers to standardise and professionalise.

Education of nurses was focused upon the use of high technology materials to modernise the profession.

Question 6

The historical development of health care in Australia allows us to understand context of current developments. Match the developments to the time frames provided.

The first universal health insurance was proposed then re-introduced based on the principle of equal access for all Australians.

The transfer or government monies via taxation, for free education, public housing, unemployment or sickness and disability care.

The first National allocation of health care responsibilities to the Commonwealth and States

The Pharmaceutical Benefits Scheme was introduced for the provision of free ‘life saving and disease preventing’ drugs.

Time frames

Developments

The declaration of the Australian constitution in 1901.

Term 1

Post second world war period based on the concept of the social wage.

Term 2

Coming into force in 1950 as a result of a 1947 Act of Parliament.

Term 3

An initial change was made in 1975 but later altered and redeveloped in the 1980’s.

Term 4

Question 7

Health Care in Australia is conducted in a range of environments with varying focusses. Match the following care environments to the services in the current models of care in which they operate in local areas as part of the Australian health care system.

Care environments

Community services nurse

Ambulatory clinic

Residential respite service

Operating theatre

Care environments

Arenas of care

Home health care

Term 1

Outpatient care

Term 2

Long-term care

Term 3

Acute hospital care

Term 4

4 points

Question 8

Australian governments and peak health bodies have been working toward a National approach to more standards of care which were once State and Territory based. Examples of current common care standards are listed below. Match them to the description of the standards.

Standards

Palliative Care Standards

National Safety and Quality Health Service Standards

Enrolled Nurse Standards For Practice

Aged Care Accreditation Standards

Descriptions

Standards

Consisting of four (4) standards, their principles and expected outcomes to which homes must comply.

Term 1

Consisting of ten (10) standards, their intent and context, and listed criteria for items and actions that are required to meet the standard in wide variety of health services.

Term 2

Developed by the peak body, they represent a set of philosophical standards, reflecting a need to clearly articulate and promote a vision for compassionate and appropriate care

Term 3

The standards are the core to providing a framework for assessing practice and communicating expectations for practice and education.

Term 4

Question 9

The Australian health care system is complex and interdisciplinary. Match interdisciplinary team members and personnel with the roles they play within the health care system.

Interdisciplinary team member

Enrolled Nurse

Registered pharmacist

Physiotherapist

Social worker

Roles

Interdisciplinary team member

Prepares and dispenses drugs for therapeutic use

Term 1

Assists clients with psychosocial problems such as financial, housing, life skills

Term 2

Addresses the needs of the person based on a holistic assessment and following a plan of care in consultation with a registered nurse.

Term 3

Work with people with musculoskeletal problems to assess and support strength and mobility.

Term 4

Question 10

Take into account the biological, socio-cultural and social influences on health and match the impacts on health and illness for Australians to the commonly occurring outcomes (themes) of such impacts.

Impacts on health and illness

Ageing population

Obesity

Poverty

Smoking

Outcomes of health impacts

Impacts on health and illness

Increased number of people living with chronic illness for long periods of time.

Term 1

Acute and chronic illnesses, such as diabetes, that are secondary to the original health impact.

Term 2

Extensive impacts on all aspects of physiology and health, and particularly a major cause of cardiovascular and respiratory disease.

Term 3

General increase in likelihood of disease and illness states associated with poor diet, and poor preventative and general health care.

Term 4

Question 11

The health of immigrants, refugees and Aboriginal and Torres Strait Islander people can be impacted upon because of cultural barriers in society. Match the following cultural issues faced by such people to the common health impacts seen in clinical practice.

Cultural issues faced

Removal from traditional lands and family

Non-acceptance by dominant community

Belief in traditional medicine and mistrust of western medical structures

Environmental issues such as remoteness

Health impacts

Cultural issues faced

Fear, lack of knowledge and support to access services in a timely manner.

Term 1

Poor diet, inactivity, mental health issues, high level of risk taking behaviour.

Term 2

Poor local provision of or limited expertise in complex health problems.

Term 3

Late diagnosis and treatment of serious illness, if treatment is commenced at all.

Term 4

Question 12

The provision of services within the Australian health care system can be impacted by a variety of issues that can cause constraints on funding and resource availability. These issues can include social, political and economic factors. In the table below, match the three (3) correct type of issues with the statement.

A cultural issue

A political issue

Constraints on available funding

A social and economic issue

Statement

Type of issue

Clients wanting to be prescribed medication that is available overseas, but not yet in Australia, must pay full price for them because they are not yet approved for the Pharmaceutical Benefits Scheme.

Term 1

To have new drugs listed on the Pharmaceutical Benefits Scheme, they must go through rigorous cost effectiveness assessment, a safety assessment and be for a significant condition.

Term 2

People on low incomes are able to get a higher level of subsidy for approved Pharmaceutical Benefits Scheme drugs, compared to those on higher incomes.

Term 3

Question 13

Funding for public health services in Australia predominantly comes via the taxation system in the form of_________ (Select the one (1) correct answer)

rebates.

tax offsets.

Medicare.

co-payments.

Question 14

Identify the different levels in the structure of health care in Australia. (Select the one (1) correct answer)

Tertiary, secondary and community levels

Primary, secondary and tertiary levels

Public health care and private health care

Community, secondary and quaternary levels

Question 15

A brief overview of the Australian health care system’s structure including control and funding mechanisms follows. Complete the following paragraph by selecting the correct options from the box below

delivery

regional health networks

State and Territory

Australian Health Care Agreement

The States and Territories are responsible for efficient

Term 1

of health care services. Every five (5) years the Federal government enters into a new

Term 2

with the States and Territories. In 2011 arrangements for governance of funding and management of public hospitals changed to a National Health and Hospitals Agreement which included requirements for timely care and inclusion of local and

Term 3

. These structures were reversed with change of government to revert to

Term 4

management of hospitals.

Question 16

. A strength of the Australian health care system for local areas, is in __________ (Select the one (1) correct answer)

health practitioners and health care facilities, no matter where they are situated are held to high standards of practice and accountability through government and professional regulatory bodies.

the ability to have extensive consultations with local doctors at no additional costs, and at short notice to reduce the number of medical situations where ‘it’s too late’.

provision of prescription medications in local pharmacies for all citizens at no cost if the client can prove they live in a remote area by providing an official document.

provision of elective surgery in local public hospitals with little or no waiting period provided that the State Health Department has approved the premises and that Medicare has approved the prescribed drugs.

Question 17

A weakness of the Australian health care system for local areas, is that___________ (Select the one (1) correct answer)

public hospitals are not required to treat individuals with private health cover.

there are no services provided outside of hospitals in remote or low socio-economic areas.

expensive technology is withheld from treatment options for public patients, whereas patients with private health insurance have priority access to the best technology.

the breadth and variety of services available in the system are often only available in large metropolitan cities and rural and remote are neglected.

Question 18

Policies on health care are made by both Federal and State governments, which can cause a variety of problems. Other issues affecting policy development in the contemporary health environment are also varied. In the following table, match the issues impacting policy, to the most accurate description of the issue.

Issues impacting policy

Higher demand for services

Technology

Average length of stay in hospitals

Rural and remote provision of services

Descriptions

Issues impacting policy

People living longer with more chronic illnesses increases demand on services.

Term 1

The mean number of days that admitted patients stay in hospital, which impacts on costs of hospitals.

Term 2

The requirement for equitable service provision for chronic health problems in distant and sparsely populated regions.

Term 3

Techniques, instruments and medicines which are changing the nature of how procedures and treatments are conducted and their effects on people’s needs.

Term 4

Question 19

Which two (2) of the following current health issues in Australia will continue to have significant influences upon National health policy into the future?

Ageing population

Increased prevalence of chronic illness

The misuse of reconstructive surgery to fill in demand for cosmetic surgery.

Immigrant populations from third-world countries.

The overuse of vaccinations in preschool children.

Question 20

An example of the impacts of health and illness factors on people is when an older person requires support to maintain their activities of daily living in their home. Select which two (2) of the following are examples of significant impacts upon them as a result of health changes

Trying to navigate the complex array of services that could be used to support them to remain in the home.

Paying for aids and modifications to the home to maintain safety and functionality.

Attending a general practitioner for a health check every month or every week, even when travelling

Reading health information on a Government brochure provided by their practice nurse at home

Paying more expensive taxi fares because of the need to carry the medical equipment, e.g. walking aids.

Question 21

Health and illness factors can impact on the everyday life of a client. For young adults with insulin dependent diabetes (chronic illness), how would compliance with their maintenance regimes impact negatively in their everyday lives?

They cannot drink any alcohol if they are not eating food at the same time – they blood sugar levels would be too low

They can incur considerable costs for testing equipment and medications, and require regular specialist visits.

They are aware of healthy diets and must visit the diabetes educator fortnightly, otherwise their insulin pump won’t be reimbursed by Medicare.

They live and work within the general public at a variety of roles and activity levels.

Question 22

The principles and philosophical framework of Primary Health Care are concerned with which one (1) of the following?

Providing inter-sectoral acute, chronic and rehabilitative services in tertiary health care, under a framework of emphasis on consumer involvement, universal access and affordability of health care.

Providing inter-sectoral access, equity and participation in health care for all in a communitybased framework with emphasis on consumer involvement, universal access and affordability of health care.

Providing health promotional, acute, surgical and rehabilitative services based in medical centres and GP clinics with emphasis on consumer involvement, universal access and affordability of health care.

Providing wellbeing and disease preventative services in a framework of self-care and health focus with emphasis on consumer involvement, universal access and affordability of health care.

Question 23

The role of the Enrolled Nurse (EN) within the principles of primary health care is demonstrated by which of the following statements about the relationship with other health professionals?

The EN works through direct consultation with the other health care professionals in the delivery of accessible, community driven health care.

The EN works in the delivery of accessible, community driven health care.

The EN works through consultation with the Registered Nurse and in collaboration with the other health care professionals in the delivery of accessible, community driven health care.

The EN works in collaboration with the other health care professionals in the delivery of accessible, community driven health care.

Question 24

There are different models of health and wellness. Which one (1) of the models is reflected in the following statement? ‘This model recognises individual states of health and wellness as a position on the continuum’.

Health promotion model.

High-level wellness model.

Health illness continuum model.

Holistic health model.

Question 25

Approaches to health outside of Western based medical models often share some fundamental tenets, such as the use of natural products. Another similarity between non-western health practices is _______

the need to create balance in the body, mind and spirit.

the invocation of animal spirits in healing.

the practice of hovering hands over the body to feel vibrational variations.

the approach of testing responses on the feet to diagnose other organ or system problems.

Question 26

Promoting wellness and illness principles can be influenced by the perceptions of individuals. Match the following common perceptions to the correct principles statement.

Common perception

The emotional and social elements of a person’s life

A focus on optimising one’s health potential.

A holistic view of six (6) dimensions of one’s life of which physical health is a part, but not all that contributes to wellness.

A state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.

Principles statement

Common perception

Health can be defined by each person in a different way.

Term 1

The meaning of wellness

Term 2

Some of the components of wellbeing

Term 3

The view of the dimensions of wellness.

Term 4

Question 27

In an Enrolled Nurse’s contemporary practice there is increasing likelihood that a person’s care regime will include non-western forms of medicine. The EN’s role is to apply knowledge of complementary and alternate therapies to the care of the person by_________ (Select the one (1) correct answer)

informing them that all alternate therapies are dangerous and should not be used.

explaining that any complementary therapies are not taken into account when they are assessed for western medicine because they make no difference.

assisting the person to access more products from the internet because they are less expensive.

ensuring the person is aware of potential interactions of prescribed medications and treatment with other herbs and medicines.

Question 28

Which one (1) of the following professional bodies has a function of nursing disciplinary matters and outcome decisions?

Australian Health Professional Regulation Agency

Nursing and Midwifery Board of Australia

Australian Nursing and Midwifery Federation

Australian Nursing and Midwifery Accreditation Council

Question 29

The Nursing and Midwifery Board of Australia (NMBA) is responsible for registration of nurses and midwives and development of standards, codes and guidelines for the professions. Match the following codes and guidelines to their descriptions.

NMBA codes and guidelines

Enrolled Nurse Standards For Practice

Codes of professional conduct for nurses

Codes of ethics for nurses

Descriptions

NMBA codes and guidelines

This Code outlines the nursing profession’s commitment to respect, promote, protect and uphold the fundamental rights of people who are both the recipients and providers of nursing and health care.

Term 1

Sets the minimum standards for practice a professional person is expected to uphold both within and outside of professional domains in order to ensure the ‘good standing’ of the nursing profession.

Term 2

The core practice standards that provide the framework for assessing Enrolled Nurse (EN) practice.

Term 3

Question 30

Nursing in Australia is regulated and supported by regulatory, industrial and professional bodies. An example of an industrial body in support of the profession is the Australian Nursing and Midwifery Federation. Its main function is ________

advancement of the industrial, political and professional status of members.

regulation all health professionals in Australia.

responsibility for registration and accreditation of nurses in Australia.

the peak professional nursing organisation, lobbying governed, policy analysis and development.

Question 31

A critical aspect to the nursing profession in the contemporary setting is to maintain practice within the standards of care for one’s own work role. In a palliative care setting with a distressed family, which one (1) of the following strategies would reflect that the EN is practicing within their role and standards?

Speaking to the medical team and asking them to speak to the client and family.

Consulting with the Registered Nurse about the family’s concerns and making a referral to support services.

Speaking to the social worker or counsellor and telling them that they should contact the client and family.

Setting up an appointment with the palliative care team for the client and family on the behalf of the Registered Nurse

1 points

Question 32

A valuable resource to support your knowledge of the current health issues that will inform ongoing health policy for Australia, is the ______________ (Select the one (1) correct answer)

Health care Australia managed services reports.

ABC Health online website for health and wellbeing.

Australian Institute of Health and Welfare report on Australia’s health.

Defence Health Australia annual report on current health issues.

Question 33

Australians are, in general, able to access a wide variety of existing health services to support their current health issues. In the following tables, match the appropriate health service to the description of a health issue.

Diabetes Educators

Renal dialysis centres

Drug and alcohol rehabilitation units

Cardiac catheterisation units

Description

Health service

A person with heart disease who has had heart attacks caused by blockage of coronary arteries.

Term 1

A person with kidney failure that needs to have their blood filtered

Term 2

A person who has a long term chronic disease and is struggling to understand how to manage their diet and blood glucose levels.

Term 3

A person who is unable to function to their full potential due to overuse and misuse of substances, causing them lifestyle distress and dysfunction.

Term 4

Question 34

Florence Nightingale is often described as the founder of modern nursing. One (1) of the most significant historical contributions she made was to change the way nurses were perceived by the public, based upon which one (1) of the following innovations of the time?

The introduction of formal nursing training based upon both theory knowledge and clinical experience.

The use of systematic hand washing in clinical settings before changing dressings to avoid contamination

That nurses should come from a religious background to ensure they are focussed on the holistic benefits to the patient

The use of evidence based practice in her hospitals to avoid conflict with medical doctors and the Medical Board of England.

Question 35

Scenario 1: team meeting (Questions 35-36 refer to this scenario)

You are working as an Enrolled Nurse in a specialist, multidisciplinary service that is focussed on diabetes management. The service is due to have an audit attended by the relevant accreditation agency. You are participating in a team meeting in preparation for the audit. Because of the stress of the coming audit there is some tension within the group.

In thisscenario you need to contribute to the meeting to demonstrate your collaboration within the team, while considering your role as an enrolled nurse. Which two (2) of the following describe contributions you could make to the team meeting to support positive group dynamics?

That you could take on the roles of the other team members whilst they prepare for the audit

Your understanding of the situation and what your concerns are.

Acknowledgement that this can be a stressful event for everyone.

The fact that there is not much that you could do given your level of accountability.

You could offer to act as personal assistant for your supervisor to help reduce workload

2 points

Question 36

Scenario 1: team meeting (Questions 35-36 refer to this scenario)

Considering that the audit process is causing stress, why should you and the service participate in the process? Select the most appropriate answer from the following.

Because you have to do what you are told within you role, without question.

Because you are required to perform activities of audit for accreditation purposes as part of your code of ethics.

Because it is a standard quality compliance activity within health services and participation is a function of professional practice and compliance with organizational procedures.

Because it is solely your responsibility to maintain the accreditation standards for the service you work within.

Question 37

Both the practice of professional nursing and nursing knowledge has evolved from nursing theories. Match the theoretical concepts or frameworks that guide nursing care with the relevant theorist.

Nightingale

Abdellah

Orem

Benner

Theoretical concept or framework

Theorist

Emphasized delivery of nursing care to the whole person using a problem-solving approach the nurse formulates a plan of care to help clients meet their physical, social, intellectual and spiritual needs, via 21 nursing problems.

Term 1

Depicted the goal of nursing as helping client achieve health through self-care. Nursing is seen as a service required when individuals are unable to care for themselves, or self-care deficit.

Term 2

Viewed nursing as a development of skills and an understanding of patient care over time, thus the nurse moves from a novice to an expert

Term 3

Environmental adaptation theory, with a focus on the basic needs of humanity to survive.

Term 4

Question 38

To better support a person toward positive health outcomes for them and their family, an appropriate agency to refer to is the Immunize Australia Program. To answer the following question, you are required to access the programmer’s website using the link provided.

http://www.immunise.health.gov.au/

Identify two (2) of the six (6) sections that people can search further to find out more about the agencies and information available to them regarding immunization.

Question 39

There are times when you will need to interpret information about sources of funding for the people for whom you care, to make sense of the context they are in. Access the website’s information so that you can answer the question following.

https://www.humanservices.gov.au/customer/subjects/medicare-services

Indicate a benefit that is relevant for people who have reached a threshold of costs for health services and what the benefit means for their ongoing costs.

Question 40

There are a range of factors which commonly affect health for people. Outline three (3) common factors which affect health. In your answer briefly describe the effect on health and give an example of a group of people for which the factor is a very common risk.

An example answer is: Substance abuse is a high risk to health, which can cause serious side effects, organ failure and sudden death. It is often focussed in younger people from 15 to 30 years.

Question 41

One of the current perspectives in the profession which relates to nursing practice is Evidence Based Practice (EBP). Give a brief description of what EBP represents and how it is applied to maintain standards of nursing care.

Question 42

Health promotion is often very costly to the nation but also very important to support health, so should be evaluated for effectiveness. From the following passage, first identify a health promotion strategy that has been implemented then give a brief evaluation of what has been said about the outcomes of the strategy and the suggestion for a future approach.

‘Potentially avoidable hospitalisations (PAHs) refer to hospitalisations that may (potentially) have been avoided by providing timely and appropriate primary health care, including preventive care. Chronic diseases account for more than half of all PAHs. Widespread implementation of chronic disease management programmes, has not led to statistically significant reduction in the rates of PAH. The rates have increased in vulnerable populations (Indigenous Australians, rural/remote residents, socioeconomically disadvantaged, elderly). Effective programmes for vulnerable populations are condition- and con text-specific as many experience multiple disadvantage, including more advanced illness, comorbidities, poor health literacy and low socioeconomic status. Overall, a targeted approach that is ‘fit for purpose’ may be needed to ensure that programmes to reduce PAHs reach those most in need.’

http://www.phcris.org.au/news/newsfeed/2016/june/pir.php (accessed 27th July 2016)

Health promotion strategy:

Evaluation:

Suggestion for a future approach:

Question 43

Scenario 2: patient load and scope of practice ( Questions 43-44 refer to this scenario)

You are a student Enrolled Nurse participating in clinical placement in a busy medical-surgical ward within an organisation that has a policy regarding nursing workloads which states; ‘Appropriate Patient Allocation = Better Outcomes’.

This is your first placement on a hospital ward and you are allocated two (2) surgical clients for this shift (postoperative clients with IV therapy and wound drains) and two (2) medical patients (an Aboriginal and Torres Strait Islander person, who needs full assistance with all ADLs and a person with IV medications).

To ensure you comply with the relevant Codes of ethics, conduct and standards for practice, and in consultation with colleagues and your supervisor, you identify that this patient load is likely to be outside your scope of practice and therefore not safe.

Applying jurisdictional requirements of the organisation to the Decision Making Framework for nurses to address your scope of practice, determine whether it is appropriate or not to accept the allocation of patients. In your answer ensure you address reasons for your determination, organisational compliance and how you are working within the parameters of nursing practice relevant to your role (as per the scenario).

Question 44

Scenario 2: patient load and scope of practice (Questions 57-58 refer to this scenario)

You are a student Enrolled Nurse participating in clinical placement in a busy medical-surgical ward within an organization that has a policy regarding nursing workloads which states; ‘Appropriate Patient Allocation = Better Outcomes’.

Refer to the above scenario. In adapting to the role of the EN who works in collaboration with the RN, in accordance to the EN scope of practice, organisational policy, relevant legislation, nursing standards, and principles of practice within the context of care, identify the most appropriate strategy/ies that you should take in this situation to maintain safety of the clients.

Question 45

Give an example of how nurses could incorporate the process of ‘assessment’, as described in Henderson’s nursing theory, into nursing practice on a regular basis. A brief overview of theory has been supplied below.

Henderson’s theory: Described the goal of nursing as helping people to gain independence as rapidly as possible. Identified 14 basic needs which provide the framework for nursing care.

Question 46

Give an example of a situation where you might be required to discuss funding sources and health insurance with a person or their family/carer. In your answer also discuss why it is important to the person to have the conversation in this situation.

In Australia health financing is based on universal health insurance that enables access to quality, low cost health care for all citizens. When it was first introduced in the 1970s it was called?

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