Chapter 01: The History of Health Care in Canada Thompson: Health and Health Care Delivery in Canada, 4th Edition MULTIPLE CHOICE 1. When and where was Canada’s first medical school established? a. Saskatoon, in 1868 b. Ottawa, in 1867 c. Montreal, in 1825 d. Kingston, in 1855 ANS: C
A B C D
Feedback Incorrect: The first medical school was not established in Saskatoon in 1868. Incorrect: The first medical school was not established in Ottawa in 1867. Correct: The first medical school in Canada was established in 1825 in Montreal. Incorrect: The first medical school was not established in Kingston in 1855.
2. In 1834, William Kelly deduced which public health principle? a. Vaccination can successfully eradicate smallpox. b. Education is directly related to health. c. Quarantine effectively contains infections. d. Sanitation and disease are related. ANS: D
A B C D
Feedback Incorrect: William Kelly did not deduce that smallpox could be eliminated with a vaccine. Incorrect: William Kelly did not deduce that education level was related to health. Incorrect: William Kelly did not introduce quarantine to contain disease. Correct: William Kelly suspected a relationship between sanitation and disease and deduced that water might be a source of contamination.
3. Which of the following volunteer organizations was involved in the evolution of health
care in Canada? a. The Order of St. John b. The Veterans Society c. The St. Andrew’s Society d. The Canadian Nurses Association ANS: A
A
Feedback Correct: The Order of St. John was introduced in Canada in 1883; the members had knowledge of first aid, disaster relief, and home nursing.
B C D
Incorrect: The Veterans Society did not play a part in the evolution of health care in Canada. Incorrect: The St. Andrew’s Society did not play a part in the evolution of health care in Canada. Incorrect: The Canadian Nurses Association did not play a part in the early evolution of health care in Canada.
4. What did the Hospital Insurance and Diagnostic Services Act (1957) propose? a. Provinces without a health insurance plan must pay additional federal tax. b. Provinces and territories with a health insurance plan would receive substantial
funding from the federal government. c. Certain services would no longer be funded by the federal government. d. Physicians would be allowed to charge a fee for service to the client. ANS: B
A B
C D
Feedback Incorrect: The Hospital Insurance and Diagnostic Services Act did not propose an increase in tax for provinces without a plan. Correct: Under the Hospital Insurance and Diagnostic Services Act (1957), provinces and territories with a health insurance plan would have funding matched by the federal government by 50 cents for every dollar. Incorrect: The Hospital Insurance and Diagnostic Services Act did not propose the removal of insured medical services. Incorrect: The Hospital Insurance and Diagnostic Services Act did not allow physicians to charge a fee for service.
5. What major change in political thinking occurred in post–World War II Canada in relation
to health care? a. Universities should educate more nurses. b. The government should not be required to provide access to primary health care. c. Individual families should be responsible for absorbing the cost of health care. d. Governments should be responsible for providing basic services like health care. ANS: D
A B C D
Feedback Incorrect: The need to educate more nurses was not part of post–World War II thinking in Canada. Incorrect: The lack of responsibility of the government to provide health care was not part of post–World War II thinking in Canada. Incorrect: The belief that families should bear the cost of health care was not part of the political thinking in post–World War II Canada. Correct: In post–World War II Canada, and in the aftermath of a depression, the thinking shifted to the idea that governments had an obligation to provide Canadians with a better standard of living, including access to quality health care.
6. What important act was passed by the government of Tommy Douglas in Saskatchewan in
1947? a. The Hospital Insurance Act b. The Medical Care Act c. The Hospital Insurance and Diagnostic Services Act d. The Canada Health Act ANS: A
A
B C D
Feedback Correct: The Hospital Insurance Act was passed by the government of Saskatchewan, led by Tommy Douglas, in 1947. It guaranteed Saskatchewan residents hospital care in exchange for a modest insurance premium payment. Incorrect: The Medical Care Act was not passed in Saskatchewan in 1947. Incorrect: The Hospital Insurance and Diagnostic Services Act was not passed in Saskatchewan in 1947. Incorrect: The Canada Health Act was not passed in Saskatchewan in 1947.
7. What important recommendation was embodied in the Hall Report? a. Individuals should take responsibility for some of their health care costs. b. Preventive health measures would be a wise investment. c. Extra billing should not be part of Canada’s health care system. d. Provinces should retain full control as well as financial responsibility for health
care. ANS: C
A B C
D
Feedback Incorrect: The Hall Report did not propose that individuals pay for some of their health care costs. Incorrect: The Hall Report did not propose that preventive health measures would be a wise investment. Correct: The Hall Report recommended an end to extra billing and suggested that, instead, doctors be allowed to operate entirely outside of the Medical Care Act. Incorrect: The Hall Report did not propose that provinces should retain all financial responsibility for health care.
8. Why did the Established Programs Financing (EPF) mechanism of funding become
inadequate for health care? a. The government imposed many corporate tax cuts. b. Health care spending increased dramatically, causing provincial and territorial overspending. c. The cost of education took up more dollars than had been anticipated. d. The population of Canada increased much faster than was anticipated. ANS: B
A
Feedback Incorrect: Tax cuts did not cause the inadequacy of funding.
B
C D
Correct: In the few years following the introduction of the EPF Act, health care spending continued to increase dramatically, resulting in provincial and territorial overspending and necessitating cuts to health care. Incorrect: Education cost was not the reason for inadequate health care funds. Incorrect: The population increase was not the reason for inadequate funding of health care.
9. Which of the following is a main principle of the Canada Health Act? a. Health insurance should cover 100% of dental care. b. Health insurance should cover all medical services. c. All residents of Canada should be provided with health care. d. Eligible Canadians should receive accessible health care. ANS: D
A B C D
Feedback Incorrect: Health insurance for dental care was not covered by the Canada Health Act. Incorrect: The Canada Health Act mandated insurance for all medically necessary services. Incorrect: The Canada Health Act sought to provide care for all eligible Canadians, not every person living here. Correct: One of the Canada Health Act’s goals was to provide accessible health care to eligible Canadians.
10. Which amendment to the Canada Health Act did the Romanow Report recommend? a. Canadians should pay user fees when they access the health care system. b. Funds for health care should be donated from private sources. c. The criterion of accountability should be added. d. Canadians in less accessible areas should pay a higher insurance premium. ANS: C
A B C D
Feedback Incorrect: The Romanow Report did not recommend user fees. Incorrect: The Romanow Report did not recommend funding for health care from private sources. Correct: The Romanow Report recommended that the criterion of accountability should be added to the Canada Health Act. Incorrect: The Romanow Report did not recommend that rural Canadians pay higher insurance for health care.
11. What was the main intent of the Indian Act (1867)? a. Registration of refugees from India. b. Recognition of the ‘Shaman’ as a powerful healer. c. Assimilation of Indigenous People. d. Elimination of smallpox. ANS: C
A B C
D
Feedback Incorrect: Registration of refugees from India was not the main intent of The India Act. Incorrect: Recognition of the ‘Shaman’ as a powerful healer was not the intent of The India Act. Correct: The British North American Act (1867) and the India Act (1867) set the stage for assimilation of Indigenous People, applying numerous restrictions to their practices and way of life. Incorrect: The elimination of smallpox was not the intent of The India Act.
12. Refugees are provided with mental services under what level of government? a. Provincial and Territorial governments b. Federal Interim Health Program c. Refugees are not provided any health services d. All levels of government provide mental health services for refugees ANS: A
A B
C D
Feedback Correct: Provision of mental health care is the responsibility of individual provinces and territories. Incorrect: Refugees are provided with basic medical health services under the Federal Interim Health Program. Provision of mental health care is left up to individual provinces and territories. Incorrect: Provision of mental health care is the responsibility of individual provinces and territories Incorrect: Provision of mental health care is the responsibility of individual provinces and territories
13. Oral history indicates that prior to contact with Europeans, Indigenous People suffered
from which of the following illnesses? a. Diabetes and cancer. b. Smallpox and measles. c. Arthritis and jaw abscesses. d. Addictions to drugs and alcohol. ANS: C
A B C D
Feedback Incorrect: Oral history indicates that Indigenous People did not suffer from diabetes and cancer prior to contact with Europeans. Incorrect: Oral history indicates that Indigenous people did not suffer from smallpox and measles prior to contact with Europeans. Correct: Oral history indicates that Indigenous People suffered from arthritis and jaw abscesses prior to contact with Europeans. Incorrect: Oral history indicates that Indigenous People did not suffer from addictions to drugs and alcohol prior to contact with Europeans.
14. What does the Indigenous medicine wheel represent?
a. b. c. d.
Body, mind, community and nature imbalances. Medicine Man, Shaman, herbal healers, and life-givers. Plants, herbs, roots, and fungi as treatments. Spiritual, physical, cognitive and emotional parts of a person.
ANS: D
A B C D
Feedback Incorrect: The medicine wheel does not represent body, mind, community and nature imbalances. Incorrect: The medicine wheel does not represent the Medicine Man, Shaman, herbal healers, and life-givers. Incorrect: The medicine wheel does not represent plants, herbs, roots, and fungi as treatments. Correct: The medicine wheel represents four parts of a person – spiritual, physical, cognitive, and emotional.
15. Segregated hospitals for Indigenous People operated with little regard for traditional
healing practices or Indigenous culture. What disease initially lead to the establishment of segregated hospitals for Indigenous People? a. smallpox. b. tuberculosis. c. influenza. d. whooping cough. ANS: B
A B C D
Feedback Incorrect: The Segregated hospitals for Indigenous People were not initially established to segregate Indigenous People with smallpox. Correct: The Segregated hospitals for Indigenous People were initially established to segregate Indigenous People with tuberculosis. Incorrect: The Segregated hospitals for Indigenous People were not initially established to segregate Indigenous People with influenza. Incorrect: The Segregated hospitals for Indigenous People were not initially established to segregate Indigenous People with whooping cough.
16. Which organization is part of a worldwide humanitarian network providing emergency aid
and disaster relief at home and abroad? a. The Order of St. John. b. Canadian Blood Services. c. Victorian Order of Nurses. d. Canadian Red Cross. ANS: D
A B
Feedback Incorrect: The Order of St. John is not part of a worldwide humanitarian network providing emergency aid and disaster relief at home and abroad. Incorrect: The Canadian Blood Services are not part of a worldwide
C
D
humanitarian network providing emergency aid and disaster relief at home and abroad. Incorrect: The Victorian Order of Nurses is not part of a worldwide humanitarian network providing emergency aid and disaster relief at home and abroad. Correct: The Canadian Red Cross remains part of a worldwide humanitarian network providing emergency aid and disaster relief at home and abroad.
17. At what level is the entry to practice for Registered Nurses in Canada (except Quebec). a. Baccalaureate. b. Diploma. c. Graduate. d. Certificate. ANS: A
A B C D
Feedback Correct: The level of entry to practice for Registered Nurses in Canada (except Quebec) is a baccalaureate degree. Incorrect: The level of entry to practice for Registered Nurses in Canada (except Quebec) is not a diploma. Incorrect: The level of entry to practice for Registered Nurses in Canada (except Quebec) is not a graduate degree. Incorrect: The level of entry to practice for Registered Nurses in Canada (except Quebec) is not a certificate.
18. When and where did Canada’s last residential school close? a. Saskatchewan, in 1996. b. Manitoba, in 1931. c. Saskatchewan, in 1968. d. Manitoba, in 1986. ANS: A
A B C D
Feedback Correct: Canada’s last residential school closed in Saskatchewan in 1996. Incorrect: Canada’s last residential school did not close in Manitoba in 1931. Incorrect: Canada’s last residential school did not close in Saskatchewan in 1968. Incorrect: Canada’s last residential school did not close in Manitoba in 1986.
19. Priorities identified in the Advancing the Mental Health Strategy for Canada: A
Framework for Action (2017-2022) include strategies for which of the following? a. Management of health records. b. The opioid crisis. c. Access to psychiatrists. d. Health promotion. ANS: B
A
B
C
D
Feedback Incorrect: Priorities identified in the Advancing the Mental Health Strategy for Canada: A Framework for Action (2017-2022) do not include strategies for management of health records. Correct: Priorities identified in the Advancing the Mental Health Strategy for Canada: A Framework for Action (2017-2022) include strategies to cope with the opioid crises exploding across the country. Incorrect: Priorities identified in the Advancing the Mental Health Strategy for Canada: A Framework for Action (2017-2022) do not include strategies for addressing access to psychiatrists. Incorrect: Priorities identified in the Advancing the Mental Health Strategy for Canada: A Framework for Action (2017-2022) do not include strategies for health promotion.
20. In 2016, the federal minister of health met with first ministers to initiate talks on a new
Canadian Health Accord. What was the outcome? a. No deal has been reached and negotiations are ongoing. b. To continue with the 2014 Accord. c. Each province and territory negotiated their own terms of agreement. d. All jurisdictions eventually accepted the initial offer. ANS: C
A B C D
Feedback Incorrect: The outcome of the talks on the new Canadian Health Accord was not that no deal was reached and negotiations are ongoing. Incorrect: The outcome of the talks on the new Canadian Health Accord was not to continue with the 2014 Accord. Correct: The outcome of the talks on the new Canadian Health Accord was that each province and territory negotiated their own terms of agreement. Incorrect: The outcome of the talks on the new Canadian Health Accord was not that all jurisdictions eventually accepted the initial offer.
Chapter 02: The Role of the Federal Government in Health Care Thompson: Health and Health Care Delivery in Canada, 4th Edition MULTIPLE CHOICE 1. Which of the following criterion are used by Health Canada to measure health? a. Quality of life, longevity, and perception of health status b. Longevity, lifestyle, and effective use of the public health care system c. Activity level, longevity, and nutritional status d. Education level, longevity, and proper medication use ANS: B
A B C D
Feedback Incorrect: Quality of life and medication use are not the criteria stated by Health Canada. Correct: Longevity, lifestyle, and effective use of the public health care system are the criteria of health used in Health Canada’s mission statement. Incorrect: Although activity level and nutritional status are implicated in health, they are not in the Health Canada definition. Incorrect: Education level and medication use are not the criteria stated by Health Canada.
2. What is the federal government’s responsibility in relation to health care in Canada? a. To administer a national drug insurance plan b. To recruit medical personnel c. To provide financial support d. To administer a federal health insurance plan ANS: C
A B C D
Feedback Incorrect: The federal government does not administer a drug insurance plan. Incorrect: The federal government does not recruit personnel. Correct: The primary responsibility of the federal government is to provide financial support to the provinces for health care. Incorrect: The federal government does not administer a health insurance plan.
3. What is the primary function of the Canadian Institute of Health Research (CIHR)? a. Directing and funding research b. Reviewing international research c. Setting ethical guidelines for research d. Obtaining funding for research from private companies ANS: A
A B
Feedback Correct: The primary function of CIHR is directing and funding research. Incorrect: Reviewing research from other countries is not the primary function of
C D
CIHR. Incorrect: Setting ethical guidelines for research is not the primary function of CIHR. Incorrect: Obtaining funding for research from private companies is not the primary function of CIHR.
4. Which of the following is a major role of the Public Health Agency of Canada (PHAC)? a. Promoting prenatal screening b. Ensuring Medicare coverage for all residents c. Ensuring equal access to health care d. Taking prompt action to contain viruses ANS: D
A B C D
Feedback Incorrect: Promoting prenatal screening is not a mandate of PHAC. Incorrect: Ensuring Medicare coverage for all residents is not a mandate of PHAC. Incorrect: Ensuring equal access to health care is not a mandate of PHAC. Correct: Taking prompt action to contain viruses is a major function of PHAC.
5. How does the World Health Organization (WHO) influence Health Canada? a. Funds Canadian vaccination campaigns b. Recommends actions regarding population health initiatives c. Ensures equal education standards for physicians d. Advises Health Canada on funding issues ANS: B
A B C D
Feedback Incorrect: WHO does not fund vaccination campaigns in Canada. Correct: WHO recommends policies and actions regarding population health issues across the world. Incorrect: WHO does not have input into physician education in Canada. Incorrect: WHO does not advise Health Canada on funding issues.
6. What is the purpose of the World Health Assembly? a. To make policies for the World Health Organization (WHO) b. To put political pressure on governments regarding health care issues c. To evaluate and disseminate research d. To allow delegates to meet officials from pharmaceutical companies ANS: A
A B C
Feedback Correct: The main purpose of the World Health Assembly is to determine polices for WHO and to approve budgets for program funding. Incorrect: Putting political pressure on governments regarding health care issues is not the purpose of the World Health Assembly. Incorrect: Evaluating research is not the purpose of the World Health Assembly.