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NCEA Level 3 Health study materials
NCEA Level 3 Health study resources

NCEA Level 3 Health practice questions

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Question 1Health (Level 3 subject standards)

Under the New Zealand Health and Safety at Work Act 2015, what is the primary duty of a PCBU (person conducting a business or undertaking)?

  1. To provide personal protective equipment to visitors only
  2. To guarantee that no worker will ever be injured while at work
  3. To report every near miss to WorkSafe within 24 hours
  4. To ensure the health and safety of workers and others affected by the work, so far as is reasonably practicable Correct answer.

Explanation

The Act imposes a primary duty of care on a PCBU to ensure health and safety so far as is reasonably practicable, which balances risk against cost and feasibility. It is a duty of care, not an absolute guarantee, and it covers workers and other people affected by the work.

Question 2Health (Level 3 subject standards)

A community health worker wants to reduce the risk of spreading infection during a home visit. Which action best reflects standard infection-control practice?

  1. Perform hand hygiene before and after contact with the client and their environment Correct answer.
  2. Wear gloves for the entire visit regardless of the task
  3. Open all windows in the house for at least an hour
  4. Avoid touching any surfaces in the client's home

Explanation

Hand hygiene at the point of care, before and after contact, is the single most effective standard precaution against transmission. Gloves are task-specific and do not replace hand hygiene, and environmental measures alone do not interrupt contact transmission.

Question 3Health (Level 3 subject standards)

Which statement best describes the concept of health equity in a New Zealand context?

  1. Everyone receives exactly the same health services regardless of need
  2. Access to care is rationed equally across all regions
  3. Resources are directed according to need so that everyone can achieve their full health potential Correct answer.
  4. Health outcomes are determined mainly by individual lifestyle choices

Explanation

Health equity means fair distribution of resources according to need, recognising that different groups require different levels of support to reach the same health outcomes. It differs from equality, which gives identical treatment regardless of need.

Question 4Health (Level 3 subject standards)

Te Whare Tapa Whā is a Māori model of health. Which four dimensions does it describe?

  1. Taha tinana, taha hinengaro, taha whānau, taha wairua Correct answer.
  2. Taha wairua, taha whenua, taha hītori, taha ture
  3. Taha tinana, taha kai, taha moe, taha wai
  4. Taha hinengaro, taha pāpori, taha ōhanga, taha mātauranga

Explanation

Te Whare Tapa Whā describes wellbeing through four walls: physical (tinana), mental and emotional (hinengaro), family and social (whānau), and spiritual (wairua). All four must be strong for the house to stand.

Question 5Health (Level 3 subject standards)

A person is admitted to hospital and asks about their rights under the Code of Health and Disability Services Consumers' Rights. Which right allows them to be fully informed and to make an informed choice?

  1. Right 4
  2. Right 7 Correct answer.
  3. Right 2
  4. Right 9

Explanation

Right 7 of the Code covers informed consent, requiring consumers to be given the information they need to make an informed choice. It links directly to the right to be fully informed under Right 6.

Question 6Health (Level 3 subject standards)

Which of the following is an example of a primary prevention strategy in public health?

  1. Providing palliative care for terminal illness
  2. Immunising children against measles Correct answer.
  3. Rehabilitating a person after a stroke
  4. Screening for early-stage breast cancer

Explanation

Primary prevention acts before disease occurs, and immunisation prevents infection in the first place. Screening, rehabilitation and palliative care all act after disease has developed or caused harm.

Question 7Health (Level 3 subject standards)

According to the Ottawa Charter for Health Promotion, which action area involves creating supportive environments?

  1. Building healthy public policy
  2. Creating supportive environments Correct answer.
  3. Developing personal skills
  4. Strengthening community action

Explanation

The Ottawa Charter names five action areas, and one of them is explicitly creating supportive environments that protect and enhance health. The other options are separate action areas from the same charter.

Question 8Health (Level 3 subject standards)

What does the term 'cultural safety' mean in the delivery of health care in Aotearoa New Zealand?

  1. The service is delivered in a culturally neutral way
  2. The service is provided only by practitioners of the same ethnicity as the client
  3. The practitioner learns basic greetings in several languages
  4. The health practitioner is aware of their own culture and its impact on care, and the recipient determines whether care is culturally safe Correct answer.

Explanation

Cultural safety requires practitioners to reflect on their own cultural position and power in the relationship, with the recipient of care as the judge of whether safety has been achieved. It is not about surface gestures or ethnic matching.

Question 9Health (Level 3 subject standards)

A population health analyst notices that Pacific peoples in New Zealand experience higher rates of type 2 diabetes. Which explanation is most consistent with a social determinants of health approach?

  1. Higher rates are simply random variation in the data
  2. Differences arise from factors such as income, housing, food security and access to culturally appropriate services Correct answer.
  3. Pacific peoples are genetically predisposed to diabetes and little can be done
  4. The difference reflects a lack of individual willpower within the group

Explanation

A social determinants approach attributes health differences to the conditions in which people live, including income, housing, food security and access to services. It rejects blaming individuals or genetic determinism as full explanations.

Question 10Health (Level 3 subject standards)

A nurse is caring for a competent adult who refuses a recommended treatment. What is the most appropriate response under New Zealand law and the Code of Rights?

  1. Respect the refusal after ensuring the person is fully informed of the consequences Correct answer.
  2. Delay all care until the person changes their mind
  3. Proceed with treatment because it is in the person's best interests
  4. Ask the family to consent on the person's behalf

Explanation

A competent adult has the right to refuse treatment, even where the refusal may lead to harm, provided they have been fully informed. The practitioner's obligation is to ensure informed refusal, not to override it.

Question 11Health (Level 3 subject standards)

Which of the following best describes the purpose of the Health Quality and Safety Commission (HQSC) in New Zealand?

  1. To fund hospital building projects
  2. To investigate individual complaints from consumers
  3. To monitor and improve the quality and safety of health and disability services nationally Correct answer.
  4. To set the price of prescription medicines

Explanation

The HQSC leads national quality and safety improvement across health and disability services, including programmes on infection prevention and adverse events. It does not fund infrastructure, investigate individual complaints or set medicine prices.

Question 12Health (Level 3 subject standards)

A public health team wants to reduce smoking rates in a low-income community. Which combination best reflects a health promotion approach consistent with the Ottawa Charter?

  1. Combine smoke-free policy, community-led initiatives, supportive environments, personal skills and reorientation of services Correct answer.
  2. Provide nicotine patches to individuals only
  3. Increase the price of tobacco without other measures
  4. Run a single advertising campaign on television

Explanation

The Ottawa Charter calls for action across five areas, including healthy public policy, supportive environments, community action, personal skills and reorientation of services. Combining strategies addresses both individual and structural factors.

Question 13Health (Level 3 subject standards)

What is the main purpose of the Health and Disability Commissioner (HDC) in New Zealand?

  1. To promote and protect consumers' rights and resolve complaints about health and disability services Correct answer.
  2. To register and discipline nurses
  3. To fund primary health organisations
  4. To prosecute health practitioners in court

Explanation

The HDC promotes and protects consumer rights under the Code and resolves complaints through investigation and resolution processes. Professional registration and discipline sit with regulatory authorities such as the Nursing Council.

Question 14Health (Level 3 subject standards)

A community has high rates of rheumatic fever among children. Which intervention is most appropriately described as primary prevention at a population level?

  1. Rehabilitation programmes for children with heart failure
  2. Prompt antibiotic treatment of children with strep throat to prevent rheumatic fever Correct answer.
  3. Heart surgery for children who develop valve damage
  4. Screening for existing heart valve damage

Explanation

Prompt treatment of streptococcal throat infection prevents the development of rheumatic fever, making it primary prevention. Surgery, rehabilitation and screening all act after disease or damage has occurred.

Question 15Health (Level 3 subject standards)

Which statement best explains why Māori health models such as Te Whare Tapa Whā are important in health service planning?

  1. They replace clinical guidelines with traditional practices
  2. They apply only to Māori patients and have no relevance to others
  3. They provide a holistic framework that recognises spiritual, family and emotional dimensions often missing from biomedical models Correct answer.
  4. They are primarily used for administrative reporting

Explanation

Māori health models broaden the biomedical focus to include spiritual, family and emotional wellbeing, supporting holistic and culturally appropriate service design. They complement rather than replace clinical guidelines.

Question 16Health (Level 3 subject standards)

A health practitioner is asked to share a client's personal health information with a family member who is not the client. Under the Privacy Act 2020 and the Health Information Privacy Code, what is the appropriate approach?

  1. Share only if the family member is a health professional
  2. Share only if the client consents or an exception such as serious risk to safety applies Correct answer.
  3. Refuse to share under any circumstances
  4. Share the information freely because family members have a right to know

Explanation

Health information may be disclosed with the client's consent or where a specific exception applies, such as a serious threat to safety. Disclosure to family without consent is generally a breach of the rules.

Question 17Health (Level 3 subject standards)

Which of the following best describes the concept of 'health literacy'?

  1. The literacy rate of a country's population
  2. The level of funding allocated to health promotion
  3. The ability to obtain, understand and use health information to make informed decisions Correct answer.
  4. The number of health services available in a region

Explanation

Health literacy is the capacity to access, understand, appraise and apply health information to make decisions and take action. It is broader than general literacy and depends on both individual skills and the demands of health systems.

Question 18Health (Level 3 subject standards)

A public health researcher is analysing why a health promotion programme failed to reduce obesity in a low-income suburb. Which analysis best reflects a critical health perspective?

  1. The programme failed because the weather was poor
  2. The programme failed because participants lacked motivation
  3. The programme failed because there were too many participants
  4. The programme failed because it focused on individual behaviour while ignoring food affordability, built environment and structural barriers Correct answer.

Explanation

A critical perspective examines how structural and environmental factors shape health behaviour and outcomes. Programmes that focus only on individual choices often fail when underlying barriers such as cost and environment are not addressed.

Question 19Health (Level 3 subject standards)

Which of the following best explains the principle of 'equity-focused' resource allocation in New Zealand's health system?

  1. Funding is determined solely by the number of hospital beds
  2. Funding is distributed equally to every district regardless of population need
  3. Funding is allocated only to private providers
  4. Funding is weighted toward populations with greater health need, such as Māori and Pacific peoples and rural communities Correct answer.

Explanation

Equity-focused allocation weights resources toward groups with greater need and worse outcomes, aiming to reduce avoidable disparities. Equal per-capita funding would not address existing inequities.

Question 20Health (Level 3 subject standards)

A practitioner is reviewing an adverse event where a patient received the wrong medication. Which approach best reflects a restorative, safety-focused response?

  1. Identify and punish the individual who made the error
  2. Focus on identifying system factors, supporting the patient and staff, and making changes to prevent recurrence Correct answer.
  3. Record the event but take no further action
  4. Suppress the incident to protect the organisation's reputation

Explanation

A restorative and safety-focused approach examines system factors, supports those affected and implements changes to prevent recurrence. Punitive or suppressive responses undermine reporting and learning.

Question 21Health (Level 3 subject standards)

Which statement most accurately describes the relationship between the Treaty of Waitangi and health policy in Aotearoa New Zealand?

  1. The principles of partnership, participation and protection guide how health services should respond to Māori health needs Correct answer.
  2. The Treaty requires that all health services be delivered in te reo Māori
  3. The Treaty has no relevance to health services
  4. The Treaty applies only to land and fisheries

Explanation

The Treaty principles of partnership, participation and protection have been applied to health policy to guide responsiveness to Māori health needs and reduce inequities. They do not require all services in te reo Māori, nor are they limited to land.

Question 22Health (Level 3 subject standards)

A district health board wants to evaluate whether a new community mental health programme is effective. Which evaluation design best allows a judgement about whether observed improvements are due to the programme?

  1. Interview the programme staff about their views
  2. Compare outcomes for participants with a comparable group not receiving the programme, using pre- and post-measures Correct answer.
  3. Count the number of people who attended
  4. Ask participants whether they enjoyed the programme

Explanation

A comparison group with pre- and post-measures helps separate programme effects from other influences. Satisfaction, attendance and staff views are useful process data but cannot support causal conclusions alone.

Question 23Health (Level 3 subject standards)

Which of the following is the best example of secondary prevention in mental health?

  1. Running a national anti-stigma campaign
  2. Early identification and treatment of young people showing early signs of depression Correct answer.
  3. Supporting a person to manage long-term schizophrenia in the community
  4. Teaching resilience skills to all secondary school students

Explanation

Secondary prevention focuses on early detection and prompt treatment of disease that is already developing. Universal resilience teaching and anti-stigma campaigns are primary prevention, while long-term management is tertiary.

Question 24Health (Level 3 subject standards)

A health service wants to improve access for Deaf clients who use New Zealand Sign Language. Which action best reflects the principle of accessibility under the Code of Rights?

  1. Provide written information in English only
  2. Require clients to bring their own interpreter
  3. Ask a family member to interpret sensitive consultations
  4. Provide qualified NZSL interpreters and accessible information at no cost to the client Correct answer.

Explanation

Right 5 of the Code requires effective communication, which includes providing qualified interpreters and accessible information where needed. Relying on family or requiring clients to arrange their own interpreter can compromise privacy and accuracy.

Question 25Health (Level 3 subject standards)

Which statement best explains the concept of 'intersectionality' when analysing health inequities?

  1. Every individual experiences disadvantage in exactly the same way
  2. Health outcomes are determined by a single factor such as ethnicity
  3. Overlapping social identities such as ethnicity, gender and income combine to shape distinct experiences of advantage and disadvantage Correct answer.
  4. Only gender matters when analysing health outcomes

Explanation

Intersectionality examines how multiple social identities and structures overlap to produce distinct experiences of advantage and disadvantage. It rejects single-factor explanations and assumes that disadvantage is not uniform across groups.

Question 26Health (Level 3 subject standards)

Which model of health used in Aotearoa New Zealand describes wellbeing as a house supported by four walls representing taha tinana, taha hinengaro, taha whānau and taha wairua?

  1. Meihana model
  2. Fonofale model
  3. Te Pae Mahutonga
  4. Te Whare Tapa Whā Correct answer.

Explanation

Te Whare Tapa Whā, developed by Mason Durie, uses the image of a wharenui whose four walls are physical, mental/emotional, family/social and spiritual wellbeing. All four dimensions must be strong for the house to stand, which is why health services assess them together.

Question 27Health (Level 3 subject standards)

In the Determinants of Health framework, which factor is best classified as a structural (upstream) determinant rather than an individual lifestyle factor?

  1. The availability and cost of affordable housing in a city Correct answer.
  2. A person's choice to attend a gym class twice a week
  3. A person's decision to drink sugar-sweetened beverages daily
  4. An individual's habit of walking to work each morning

Explanation

Structural or upstream determinants are the social, economic and physical conditions that shape health opportunities, such as housing affordability, income, education and neighbourhood design. Individual behaviours sit downstream and are themselves influenced by these structural conditions.

Question 28Health (Level 3 subject standards)

What does the principle of 'informed consent' require before a health procedure can proceed?

  1. That the client receives adequate information and freely agrees to the procedure Correct answer.
  2. That the practitioner decides what information is in the client's best interests to withhold
  3. That a family member approves the decision on the client's behalf in all cases
  4. That the client signs a form regardless of whether they understand the information

Explanation

Informed consent requires that the client be given adequate, accurate information about the procedure, its risks and alternatives, and then freely agrees without coercion. It is a process of communication, not merely a signature, and competent adults make their own decisions.

Question 29Health (Level 3 subject standards)

Which document sets out the rights of people receiving health and disability services in New Zealand, including the right to be treated with respect and the right to complain?

  1. The Code of Health and Disability Services Consumers' Rights Correct answer.
  2. The Health and Safety at Work Act 2015
  3. The Privacy Act 2020
  4. The Medicines Act 1981

Explanation

The Code of Health and Disability Services Consumers' Rights, issued under the Health and Disability Commissioner Act, sets out ten rights for consumers of health and disability services. These include respect, fair treatment, dignity, effective communication, informed choice and the right to complain.

Question 30Health (Level 3 subject standards)

Which statement best describes the role of a 'health navigator' or kaiāwhina in primary care?

  1. They help clients and whānau access services and coordinate their care across providers Correct answer.
  2. They carry out surgical procedures under supervision
  3. They set national funding levels for district health services
  4. They prescribe medicines independently for chronic conditions

Explanation

Health navigators and kaiāwhina support people to move through the health system, helping with access, coordination and cultural support, particularly for groups facing barriers. Their role is relational and practical rather than clinical prescribing or governance.

Question 31Health (Level 3 subject standards)

What is meant by 'health inequity' as distinct from 'health inequality'?

  1. Any measured difference in health status between two groups
  2. A difference in health caused solely by genetic inheritance
  3. A difference in health that exists only between countries, not within them
  4. A difference in health that is avoidable, unfair and rooted in unjust social arrangements Correct answer.

Explanation

An inequality is any observed difference in health, whereas an inequity is a difference judged to be avoidable, unjust and produced by social arrangements such as poverty, discrimination or unequal access. The distinction matters because not every difference is unfair, but inequities are targets for action.

Question 32Health (Level 3 subject standards)

In epidemiology, what does 'incidence' measure?

  1. The number of new cases of a disease arising in a population over a defined period Correct answer.
  2. The average length of stay in hospital for a condition
  3. The total number of existing cases of a disease in a population at one point in time
  4. The proportion of a population who have been vaccinated

Explanation

Incidence counts new cases occurring in a population during a specified period, and is used to measure risk of developing disease. Prevalence, by contrast, counts all existing cases at a point or over a period.

Question 33Health (Level 3 subject standards)

Which action best reflects the health promotion principle of 'building healthy public policy'?

  1. Distributing leaflets about exercise at a community event
  2. Introducing legislation that requires lower salt levels in processed foods Correct answer.
  3. Training one nurse to give brief smoking-cessation advice
  4. Running a one-off fitness class for staff at a single workplace

Explanation

Building healthy public policy means changing laws, regulations and organisational rules so that healthy choices become the easier choices for whole populations. Legislation on food composition is a policy-level change, whereas individual classes, leaflets and single-clinician training operate at a much smaller scale.

Question 34Health (Level 3 subject standards)

A community health service wants to reduce barriers for Māori clients. Which action best demonstrates the principle of partnership under Te Tiriti o Waitangi?

  1. Translating pamphlets into te reo Māori without changing service delivery
  2. Appointing a single Māori staff member to handle all Māori clients
  3. Consulting Māori once after the service design is finalised
  4. Involving local iwi and Māori providers as equal decision-makers from the planning stage Correct answer.

Explanation

Partnership requires Māori to be involved as equal partners in decision-making from the outset, not consulted after decisions are made. Genuine partnership shares power over design, resourcing and priorities, and supports Māori-led solutions such as Māori health providers.

Question 35Health (Level 3 subject standards)

A public health team is planning a programme to reduce alcohol-related harm. Which approach best reflects the 'harm reduction' philosophy?

  1. Focusing only on prosecuting people who drink in public places
  2. Refusing to engage with people who will not commit to stopping alcohol
  3. Providing a medically supervised withdrawal service and safe drinking education for people who continue to drink Correct answer.
  4. Requiring total abstinence as the only acceptable outcome for all participants

Explanation

Harm reduction accepts that some people will continue to use a substance and works to reduce the associated harms rather than demanding abstinence as a precondition for help. Supervised withdrawal and safer-use education keep people engaged and lower risks such as overdose and injury.

Question 36Health (Level 3 subject standards)

A researcher finds that children living in cold, damp housing have higher rates of respiratory infection. Which concept does this finding best illustrate?

  1. The principle of random sampling
  2. The inverse care law
  3. The social gradient in health Correct answer.
  4. The biomedical model of disease

Explanation

The social gradient describes how health outcomes worsen progressively with lower socioeconomic position, and housing quality is a key pathway. Cold, damp housing clusters among lower-income households, so the associated respiratory burden is not evenly distributed across society.

Question 37Health (Level 3 subject standards)

A health practitioner is considering whether to disclose a client's infection status to a third party who may be at risk. Which principle best guides this decision alongside privacy obligations?

  1. The practitioner's personal opinion about the client's behaviour
  2. The financial cost of disclosure to the service
  3. The client's right to absolute confidentiality in every circumstance
  4. The duty to warn or protect identifiable third parties from serious harm Correct answer.

Explanation

Privacy and confidentiality are strong duties, but they are not absolute; where there is a serious and identifiable risk to a specific person, a duty to warn or protect may justify limited disclosure. Any disclosure should be the minimum necessary and follow legal and organisational guidance.

Question 38Health (Level 3 subject standards)

Which situation is the clearest example of tertiary prevention?

  1. A cardiac rehabilitation programme helping people recover and function after a heart attack Correct answer.
  2. A screening programme that detects early-stage breast cancer
  3. A vaccination programme for children before they are exposed to disease
  4. A campaign encouraging people to stop smoking before they develop illness

Explanation

Tertiary prevention aims to reduce the impact of an established disease by restoring function, preventing complications and supporting rehabilitation. Cardiac rehabilitation after a heart attack fits this because the disease is already present and the focus is on limiting disability and recurrence.

Question 39Health (Level 3 subject standards)

A service evaluates a new programme and finds it produced good outcomes for participants, but the evaluation cannot tell whether those outcomes would have occurred without the programme. Which evaluation design element is missing?

  1. More promotional material
  2. A longer programme name
  3. A comparison or control group Correct answer.
  4. A larger budget

Explanation

Without a comparison or control group, it is impossible to separate the programme's effect from natural recovery, maturation or other changes occurring at the same time. A comparison group provides the counterfactual against which outcomes can be judged.

Question 40Health (Level 3 subject standards)

A practitioner notices that an older Māori client is being spoken to only through an accompanying family member. Which action best demonstrates culturally safe practice?

  1. Assume the client cannot understand English and proceed without checking
  2. Address the client directly, check their preferred language and involve whānau appropriately Correct answer.
  3. Continue speaking to the family member to save time
  4. Refer the client to another service without explanation

Explanation

Cultural safety requires the practitioner to reflect on power in the interaction and to uphold the client's dignity and autonomy. Speaking directly to the client while respecting whānau involvement and checking language preferences keeps the client at the centre of their own care.

Question 41Health (Level 3 subject standards)

Which statement best explains why 'intersectoral action' is important in health promotion?

  1. Intersectoral action removes the need for community involvement
  2. Only government agencies can deliver health promotion
  3. Many determinants of health lie outside the health sector, such as housing, education and transport Correct answer.
  4. Health outcomes are shaped mainly by the health sector alone

Explanation

Because health is shaped by housing, education, income, transport and environment, improving population health requires coordinated action across sectors. The health sector alone cannot change these determinants, so partnership across government, community and industry is essential.

Question 42Health (Level 3 subject standards)

A client with limited English is asked to sign a consent form for a procedure. Which action best supports valid informed consent?

  1. Asking a child relative to interpret the conversation
  2. Asking the client to sign first and explaining the procedure afterwards
  3. Using a qualified interpreter and confirming the client's understanding before signing Correct answer.
  4. Proceeding because the form is in English and the client nodded

Explanation

Valid consent depends on the client understanding the information, so professional interpreting and teach-back are needed when language is a barrier. Using a qualified interpreter protects accuracy and confidentiality, unlike relying on a child or on non-verbal cues.

Question 43Health (Level 3 subject standards)

Which measure best describes the 'burden of disease' in a population?

  1. The average waiting time for elective surgery
  2. The number of hospital beds available per 1,000 people
  3. The proportion of the population enrolled with a general practice
  4. Disability-adjusted life years lost to premature death and living with disability Correct answer.

Explanation

Burden of disease is commonly quantified using disability-adjusted life years, which combine years of life lost to premature mortality with years lived with disability. This gives a single measure of the total health loss from different conditions.

Question 44Health (Level 3 subject standards)

A health service reviews an adverse event and asks staff to describe what happened without fear of individual punishment, focusing on system factors. Which approach does this reflect?

  1. A just culture Correct answer.
  2. A punitive disciplinary model
  3. A blame culture
  4. A complaints-only model

Explanation

A just culture distinguishes between honest error and reckless behaviour, encouraging open reporting while still holding people accountable for deliberate wrongdoing. It focuses on system design, such as processes and communication, so that lessons can be learned and recurrence prevented.

Question 45Health (Level 3 subject standards)

Which of the following best describes the purpose of 'health equity' as a goal in health service planning?

  1. Allocating resources and designing services so that avoidable differences in health outcomes are reduced Correct answer.
  2. Ensuring services are available only to those who can pay
  3. Maximising the total number of services provided nationally
  4. Providing exactly the same resources to every individual regardless of need

Explanation

Health equity means working to remove avoidable and unjust differences in health between groups, which may require allocating more resources or support where need is greater. It is not the same as giving everyone identical treatment, because equal inputs can preserve unequal outcomes.

Question 46Health (Level 3 subject standards)

A researcher finds that a group of women experience poorer access to screening than the general population. Which interpretation best reflects an intersectional analysis?

  1. Their access is determined solely by their age
  2. Their access is random and unrelated to social factors
  3. Their access is shaped by the combined effects of gender, ethnicity, income and other social positions Correct answer.
  4. Their poorer access is explained entirely by their gender

Explanation

Intersectionality holds that social identities and systems of disadvantage interact, so the experience of a group cannot be read from a single category. Poorer screening access may reflect the combined effects of gender, ethnicity, income and location, which produce risks that are greater than any one factor alone.

Question 47Health (Level 3 subject standards)

A district health service wants to reduce inequities for Pacific families. Which action best reflects the Fonofale model in service design?

  1. Scheduling appointments without considering family involvement
  2. Involving extended family and church community in care planning and recognising culture and spirituality Correct answer.
  3. Focusing only on individual physical symptoms at each appointment
  4. Referring all Pacific clients to a single general practitioner regardless of preference

Explanation

The Fonofale model places family as the foundation, with culture and values as posts and spirituality, environment and time forming the roof. Applying it means designing care that engages the extended family and community and respects cultural and spiritual dimensions, rather than treating the individual in isolation.

Question 48Health (Level 3 subject standards)

The inverse care law describes which pattern?

  1. People with the greatest need receive the most care and resources
  2. Care is allocated strictly by waiting time alone
  3. People with the greatest health need receive the least access to good-quality care Correct answer.
  4. Care quality is identical regardless of social position

Explanation

The inverse care law, described by Julian Tudor Hart, states that the availability of good medical care tends to vary inversely with the need for it in the population served. This arises because disadvantaged groups face more barriers such as cost, transport and workforce shortages in their areas.

Question 49Health (Level 3 subject standards)

A policy analyst argues that a targeted programme for one ethnic group is unfair because it does not treat everyone the same. Which response best reflects an equity-based public health argument?

  1. Universal programmes always produce equal outcomes for all groups
  2. Equity means every group must receive identical services in every situation
  3. Differential need can justify differential provision so that outcomes become more equal Correct answer.
  4. Targeting a group is unfair regardless of the evidence about need

Explanation

Equity focuses on fair outcomes, not identical inputs; where a group faces greater barriers or need, additional or tailored provision may be required to reach a comparable standard of health. This is consistent with Te Tiriti obligations and with evidence that universal approaches can leave disadvantaged groups behind.

Question 50Health (Level 3 subject standards)

A practitioner is told a client has a rare condition and is unsure whether the proposed treatment is evidence-based. Which action best reflects the principle of evidence-based practice?

  1. Rely solely on the practitioner's past experience with unrelated conditions
  2. Delay all care until the client finds their own research
  3. Combine the best available research evidence with clinical expertise and the client's values and preferences Correct answer.
  4. Proceed with the treatment because a colleague recommended it

Explanation

Evidence-based practice integrates the best available research evidence, the practitioner's clinical expertise and the client's values, preferences and circumstances. It is not simply following a colleague's advice or relying on habit, and it involves shared decision-making with the client.