NR222 Quiz review questions from all chapters and module review
example of tertiary prevention
rehab, stroke recovery program
A student nurse is educating her class about the three levels of prevention through different client care scenarios. Which scenario mentioned by the student nurse is an example of secondary prevention?
"A nurse takes charge of screening every client upon suspecting a chicken pox outbreak in the healthcare facility
Maslow's Hierarchy of Needs
(level 1) Physiological Needs, (level 2) Safety and Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self Actualization
A 9-year-old child has a difficult time making friends at school and being chosen to play on the team. He also has trouble completing his homework and, as a result, receives little positive feedback from his parents or teacher. According to Erikson's theory, failure at this stage of development results in: (Select all that apply.) 1. Feelings of inadequacy. 2. A sense of guilt. 3. A poor sense of self. 4. Feelings of inferiority. 5. Mistrust.
1, 4. School-age children need to feel real accomplishment and be accepted by peers to develop a sense of industry. Without proper support for learning new skills, or if skills are too difficult, they develop a sense of inadequacy and inferiority.
The nurse is aware that preschoolers often display a developmental characteristic that makes them treat dolls or stuffed animals as if they have thoughts and feelings. This is an example of: 1. Logical reasoning. 2. Egocentrism. 3. Concrete thinking. 4. Animism
4. This is the belief that inanimate objects have lifelike qualities; it is a component of magical thinking evident in preoperational thought.
Cultural Desire
A commitment to caring that moves an individual to learn more about others
Which clients are ideal candidates for interpreter service in order to prevent contributing health disparities? Select all that apply.
A.An African American client with a hearing impairment B.A non-English-speaking client in the emergency department C.An English-speaking client with a speech disorder D.An Native American who does not speak the language used at the facility E. A Spanish-speaking client ready to be discharged from the facility
Health promotion includes efforts related to secondary prevention. Which activities reflect secondary prevention interventions in relation to health promotion? Select all that apply.
A.Facilitating smoking cessation programs B.Referring clients with a chronic illness to a support group C. Administering influenza vaccines to older adults D.Encouraging regular dental checkups E.Teaching the procedure for breast self-examination
Cultural Skills
Ability to assess social, cultural, and biophysical factors influencing treatment
A nurse is assessing the health care disparities among population groups. Which area is the nurse monitoring?
Accessibility of health care services
Health Belief Model
Addresses the relationship between a person's beliefs and behaviors
tertiary prevention
After an injury has been treated or an illness enters a chronic phase, tertiary prevention prevents the lasting effects of the condition or tries to lessen their impact. For example, a recovering stroke patient will need rehabilitation and physical therapy to strengthen and condition the individual to live with his or her new disabilities.
Chronic illness (e.g., diabetes mellitus, hypertension, rheumatoid arthritis) may affect a person's roles and responsibilities during middle adulthood. When assessing the health-related knowledge base of both the middle-age patient with a chronic illness and his or her family, the assessment should include which of the following? (Select all that apply.) 1. Medical course of the illness 2. Prognosis for the patient 3. Coping mechanisms of the patient and family 4. Socioeconomic status 5. Need for community and social services.
Answer: 1, 2, 3, 5. When assessing the patient with a chronic illness, it is important that the nurse know how much the patient and his family know about how the illness has progressed and the long-term prognosis for the patient. This includes understanding the patient and families' ability and readiness to accept the illness and the outlook for the patient. Understanding the coping mechanisms used by the patient and family will assist the nurse in determining how to proceed to teach and counsel the patient and family regarding the patient's treatment regimen and whether there is a need and acceptance for community or social services to assist the patient and family.
Which of the following should be included in health teaching for a pregnant patient? (Select all that apply.) 1. Exposure of the fetus to alcohol, drugs, or tobacco can cause abnormal development. 2. Nutritional needs increase during pregnancy, and eating healthy foods is important. 3. Complementary and alternative therapies should always be avoided during pregnancy. 4. Provide education on self-care to reduce common discomforts of pregnancy, such as nausea. 5. Recommend birthing classes to prepare the mother for the birthing process.
Answer: 1, 2, 4, 5. A woman's diet and exposure to alcohol, drugs, and tobacco can have a significant effect on fetal development. Providing anticipatory guidance and education regarding nutritional needs, self-care needs, and preparation for birth is critical for a pregnant patient. Complementary and alternative therapies should be evaluated for safety during pregnancy but do not always have to be avoided.
A 36-year-old patient newly diagnosed with type 1 diabetes shares with you that he is frustrated with the time it takes to prepare meals and monitor his exercise and blood sugar. He also is having trouble understanding his insulin schedule. Which of the following suggestions would be most appropriate? (Select all that apply.) 1. Provide patient education materials that are easy to read. 2. Refer this patient to a diabetes support group. 3. Refer the patient to his endocrinologist. 4. Suggest that the patient make an appointment with a registered dietitian. 5. Suggest to modify his schedule
Answer: 1, 2, 4, 5. Adults are often impatient with the time and energy requirements that a chronic health problem requires for proper management. Patient-centered educational materials and support groups often help patients deal with these challenges. Working with a dietitian will help the patient identify ways to modify his eating habits. Helping the patient incorporate nutritional and exercise health behaviors into his schedule is also important.
A nurse sees a 76-year-old woman in the outpatient clinic. She states that she recently started to notice a glare in the lights at home. Her vision is blurred, and she is unable to play cards with her friends, read, or do her needlework. Which of the following nursing interventions are appropriate? (Select all that apply.) 1. Refer her to an ophthalmologist. 2. Suggest large-print books and playing cards. 3. Reassure her that this is part of normal aging. 4. Suggest lower-wattage light bulbs to decrease glare. 5. Assess her home environment for safety.
Answer: 1, 2, 5. This patient most likely has cataracts and should be referred to an ophthalmologist. While common, cataracts are not considered to be part of normal aging. In the meantime, using large-print books or playing cards and reducing home safety hazards would be beneficial. Lower-wattage light bulbs would not be helpful
Which of the following are examples of the conventional reasoning form of cognitive development? (Select all that apply.) 1. A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her. 2. A young father is considering whether or not to return to school for a graduate degree. He considers the impact the time commitment may have on the needs of his wife and infant son. 3. A teenage girl is encouraged by her peers to engage in shoplifting. She decides not to join her peers in this activity because she is afraid of getting caught in the act. 4. A single mother of two children is unhappy with her employer. She has been unable to secure alternate employment but decides to quit her current job. 5. A young man drives over the speed limit regularly because he thinks he is an excellent driver and will not get into a car accident.
Answer: 1, 2. A person using conventional reasoning sees moral reasoning based on his or her own personal internalization of societal and others' expectations. A person wants to fulfill the expectations of the family, group, or nation and also to develop a loyalty to and actively maintain, support, and justify the order
A 45-year-old woman who is obese tells a nurse that she wants to lose weight. Which assessment findings may be contributing factors to the woman's obesity? (Select all that apply.) 1. The woman works in an executive position that is very demanding. 2. The woman says that she has little time to prepare meals at home and eats out at least four nights a week. 3. The woman works out at the corporate gym at 5 am three mornings per week. 4. The woman says that she tries to eat "low-cholesterol" foods to help lose weight.
Answer: 1, 2. Demanding and stressful work environments can lead to frequent "stress" eating of non-nutritious foods. Frequently eating away from home and eating fast food have been identified as contributing factors to obesity
Intimate partner violence (IPV) is linked to which of the following factors? (Select all that apply.) 1. Alcohol abuse 2. Marriage 3. Pregnancy 4. Unemployment 5. Drug use
Answer: 1, 3, 4, 5. IPV is linked to harmful health behaviors such as alcohol abuse and drug use. Other risk factors include unemployment and pregnancy.
Which are examples of positive health habits that may prevent the development of chronic illness later in life? (Select all that apply.) 1. Routine screening and diagnostic tests 2. Unprotected sexual activity 3. Regular exercise 4. Consistent seat belt use 5. Excess alcohol consumption
Answer: 1, 3, 4. Routine screening and diagnostic tests (i.e., laboratory screening for serum cholesterol or serum glucose levels, mammography or colonoscopy) will provide early detection of health issues. Regular exercise helps maintain weight and improve musculoskeletal functioning. Seat belt use saves lives and reduces the extent of injury in motor vehicle accidents.
A nurse is completing an assessment on a 27-year-old female patient. Which questions best assess the psychosocial aspects of this young woman's health? (Select all that apply.) 1. Do you feel safe in your home and at work? 2. How many fruits and vegetables do you typically eat every day? 3. Describe your relationship with your family. 4. Have you had the vaccine to prevent HPV? 5. What are your long-term career goals?
Answer: 1, 3, 5. Young adults need physical and emotional resources and support systems to meet the many challenges, tasks, and responsibilities they face. Asking assessment questions such as feeling safe at home and at work, satisfaction with family relationships, and identifying long-term career goals provides information about the young adult's psychosocial health that supports successful maturation in this developmental stage. Assessment questions about the intake of fruits and vegetables and the HPV vaccine do not assess the patient's psychosocial health
A 71-year-old patient enters the emergency department after falling down stairs at church. The nurse is conducting a fall history with the patient and his wife. They live in a one-level ranch home. He has had diabetes for over 15 years and experiences some numbness in his feet. He wears bifocal glasses. His blood pressure is stable at 130/70. The patient does not exercise regularly and states that he experiences weakness in his legs when climbing stairs. He is alert, oriented, and able to answer questions clearly. What are the fall risk factors for this patient? (Select all that apply.) 1. Impaired vision 2. Residence design 3. Blood pressure 4. Leg weakness 5. Exercise history
Answer: 1, 4, 5. Risk factors for falling include sensory changes such as visual loss, musculoskeletal conditions affecting mobility (in this case weakness), and deconditioning (from lack of exercise). The mere presence of a chronic disease is not a risk factor unless it is a condition such as a neurological disorder that alters mobility or cognitive function. The patient's blood pressure is stable, and there is no report of orthostatic hypotension. A one-floor residence should not pose risks.
At a well-child examination, the mother comments that her toddler eats little at mealtime, will sit only briefly at the table, and wants snacks all the time. Which of the following should the nurse recommend? (Select all the apply.) 1. Provide nutritious snacks for a healthy diet. 2. Offer rewards for eating at mealtimes. 3. Avoid snacks so she is hungry at mealtime. 4. Offer finger foods so she can eat as she walks. 5. Explain to her why eating at mealtime is important
Answer: 1, 4. Mealtime has psychosocial and physical significance. If the parents struggle to control toddlers' dietary intake, problem behavior and conflicts can result. Toddlers often develop "food jags," or the desire to eat one food repeatedly. Rather than becoming disturbed by this behavior, encourage parents to offer a variety of nutritious foods at meals and to provide only nutritious snacks between meals. Toddlers are unlikely to sit down at the table for extended meals, so finger foods are recommended.
A 63-year-old patient is retiring from his job at an accounting firm where he was in a management role for the past 20 years. He has been with the same company for 42 years and was a dedicated employee. His wife is a homemaker. She raised their five children, babysits for her grandchildren as needed, and belongs to numerous church committees. What are the major concerns for this patient? (Select all that apply.) 1. The loss of his work role 2. The risk of social isolation 3. A determination on whether the wife will need to start working 4. How the wife expects household tasks to be divided in the home in retirement 5. The age the patient chose to retire
Answer: 1, 4. The psychosocial stresses of retirement are usually related to role changes with a spouse or within the family and to loss of the work role. Often there are new expectations of the retired person. This patient is not likely to become socially isolated because of the size of the family. Whether the wife will have to work is not a major concern at this time, nor is the age of the patient
Sequence the skills in the expected order of gross-motor development in an infant, beginning with the earliest skill. 1. Can lift head 45 degrees off table, when prone 2. Pulls self to standing position 3. Sits upright without support 4. Rolls from back to abdomen 5. Rolls from abdomen to back
Answer: 1, 5, 4, 3, 2. Although the pace of growth and development varies for each individual, it usually follows the same pattern. Lifting of head while prone occurs first, followed by turning and rolling, and then sitting, followed by standing.
A patient has been laid off from his construction job and has many unpaid bills. He is going through a divorce from his marriage of 15 years and has been praying daily to help him through this difficult time. He does not have a primary health care provider because he has never really been sick, and his parents never took him to a physician when he was a child. Which external variables influence the patient's health practices? (Select all that apply.) 1. Difficulty paying his bills 2. Praying daily 3. Age of patient (46 years) 4. Stress from the divorce and the loss of a job 5. Family practice of not routinely seeing a health care provider
Answer: 1, 5. External factors impacting health practices include family beliefs and economic impact. The way that patients' families use health care services generally affects their health practices. Their perceptions of the seriousness of diseases and their history of preventive care behaviors (or lack of them) influence how patients think about health. Economic variables may affect a patient's level of health by increasing the risk for disease and influencing how or at what point the patient enters the health care system.
When Ryan was 3 months old, he had a toy train; when his view of the train was blocked, he did not search for it. Now that he is 9 months old, he looks for it, reflecting the presence of: 1. Object permanence. 2. Sensorimotor play. 3. Schemata. 4. Magical thinking.
Answer: 1. He is now in Piaget's later stage of sensorimotor thought and has learned that objects exist even though he cannot see or touch them.
When taking care of patients, a nurse routinely asks whether they take any vitamins or herbal medications, encourages family members to bring in music that the patient likes to help the patient relax, and frequently prays with her patients if that is important to them. The nurse is practicing which model? 1. Holistic 2. Health belief 3. Transtheoretical 4. Health promotion
Answer: 1. The nurse is using a holistic model of care that takes a more holistic view of health by considering emotional and spiritual well-being and other dimensions of an individual to be important aspects of physical wellness. The holistic health model of nursing attempts to create conditions that promote optimal health. Nurses using the holistic nursing model recognize the natural healing abilities of the body and incorporate complementary and alternative interventions such as music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery because they are effective, economical, noninvasive, nonpharmacological complements to traditional medical care
A nurse is conducting a home visit with a new mom and her three children. While in the home the nurse weighs each family member and reviews their 3-day food diary. She checks the mom's blood pressure and encourages the mom to take the children for a 15- to 30-minute walk every day. The nurse is addressing which level of need, according to Maslow? 1. Physiological 2. Safety and security 3. Love and belonging 4. Self-actualization
Answer: 1. The nurse's actions address the basic physiological needs of nutrition, physical activity, and oxygen. According to Maslow, basic needs must be met before meeting higher level needs.
A nurse is caring for a man who is recently retired and who appears withdrawn. He says he is "bored with life." The nurse helps this individual find meaning in life by: 1. Encouraging him to reflect on his relationships with others. 2. Encouraging relocation to a new city. 3. Explaining the need to simplify life. 4. Encouraging him to adopt a new pet.
Answer: 1. You can enhance feelings of integrity by encouraging older adults to reflect upon meaningful relationships, such as relationships with a higher power, family members, or the community.
A nurse is teaching the mother of a young infant about prevention of sudden infant death syndrome (SIDS). Which of the following statements indicates that the teaching has been effective? (Select all that apply.) 1. "I'll let the baby sleep in bed with me so I can watch her." 2. "I'll remove stuffed animals and pillows from the crib." 3. "I'll place my baby on her back for sleep." 4. "I'll be sure to keep my baby's room cool." 5. "I'll keep a crib bumper in the bed to prevent drafts."
Answer: 2, 3, 4. Safeguards that reduce the risk of SIDS include proper positioning on the back; removing stuffed animals, soft bedding, and pillows; and avoiding overheating the infant.
A nurse is participating in a health and wellness event at the local community center. A woman approaches and relates that she is worried that her widowed father is becoming more functionally impaired and may need to move in with her. The nurse asks about his ability to complete activities of daily living (ADLs). ADLs include independence with: (Select all that apply.) 1. Driving. 2. Toileting. 3. Bathing. 4. Daily exercise. 5. Eating.
Answer: 2, 3, 5. Activities of daily living are self-care tasks that measure function and are markers for the ability to live independently. Although driving and daily exercise are important to quality of life and health maintenance, they would not necessarily impact a person's ability to live independently.
A patient's family member is considering having her mother placed in a nursing center. The nurse has talked with the family before and knows that this is a difficult decision. Which of the following criteria does the nurse recommend in choosing a nursing center? (Select all that apply.) 1. The center needs to be clean, and rooms should look like a hospital room. 2. Adequate staffing is available on all shifts. 3. Social activities are available for all residents. 4. The center provides three meals daily with a set menu and serving schedule. 5. Staff encourage family involvement in care planning and assisting with physical care.
Answer: 2, 3, 5. Adequate staffing, provision of social activities, and active family involvement are essential. Meals should be high quality with options for what to eat and when it is served. A nursing center should be clean, but it should look like a person's home rather than a hospital.
A nurse working on a medical patient care unit states, "I am having trouble sleeping, and I eat nonstop when I get home. All I can think of when I get to work is how I can't wait for my shift to be over. I wish I felt happy again." What are the best responses from the nurse manager? (Select all that apply.) 1. "I'm sure this is just a phase you are going through. Hang in there. You'll feel better soon." 2. "I know several nurses who feel this way every now and then. Tell me about the patients you have cared for recently. Did you find it difficult to care for them?" 3. "You can take diphenhydramine over the counter to help you sleep at night." 4. "Describe for me what you do with your time when you are not working." 5. "The hospital just started a group where nurses get together to talk about their fee
Answer: 2, 4, 5. This nurse is experiencing symptoms of compassion fatigue. The nurse manager needs to establish a therapeutic relationship with the nurse. Acknowledging personal thoughts and feelings and talking with other nurses to identify coping strategies can help this nurse work through the feelings associated with compassion fatigue. Engaging in healthy behaviors and establishing a good work-life balance may also help.
During a home health visit a nurse talks with a patient and his family caregiver about the patient's medications. The patient has hypertension and renal disease. Which of the following findings place him at risk for an adverse drug event? (Select all that apply.) 1. Taking two medications for hypertension 2. Taking a total of eight different medications during the day 3. Having one physician who reviews all medications 4. Patient's health history of renal disease 5. Involvement of the caregiver in helping with medication administration
Answer: 2, 4. The patient is at risk for an adverse drug event (ADE) because of polypharmacy and his history of renal disease, which affects drug excretion. Taking two medications for hypertension is common. Having one physician review all medications and involving a family caregiver are desirable and are safety factors for preventing ADEs
According to Piaget's cognitive theory, a 12-year-old child is most likely to engage in which of the following activities? (Select all that apply.) 1. Using building blocks to determine how houses are constructed 2. Writing a story about a clown who wants to leave the circus 3. Drawing pictures of a family using stick figures 4. Writing an essay about patriotism 5. Hanging out with a best friend
Answer: 2, 5. As adolescents mature, their thinking moves to abstract and theoretical subjects. They have the capacity to reason with respect to possibilities. They typically have a close friend and enjoy spending time with friends.
The nurse teaches parents how to have their children learn impulse control and cooperative behaviors. This would be during which of Erikson's stages of development? 1. Trust versus mistrust 2. Initiative versus guilt 3. Industry versus inferiority 4. Autonomy versus sense of shame and doubt
Answer: 2. Toddlers are learning that parents and society have expectations about behaviors and that they must learn to control their behavior
A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with them. The nurse is acting as the patient's: 1. Educator. 2. Advocate. 3. Caregiver. 4. Communicator
Answer: 2. An advocate protects the patient's human and legal right to make choices about his or her care. An advocate may also provide additional information to help a patient decide whether to accept a treatment or may find an interpreter
When nurses are communicating with adolescents, they should: 1. Ask closed-ended questions to get straight answers. 2. Ask the adolescent to collaborate on plan of care. 3. Avoid looking for meaning behind adolescents' words or actions. 4. Avoid discussing sensitive issues such as sex and drugs.
Answer: 2. Do not avoid discussing sensitive issues. Asking questions about sex, drugs, and school opens the channels for further discussion. Ask open-ended questions. Look for the meaning behind their words or actions. Be alert to clues to their emotional state. Adolescents should be involved in their plan of care.
A nurse conducted an assessment of a new patient who came to the medical clinic. The patient is 82 years old and has had osteoarthritis for 10 years and diabetes mellitus for 20 years. He is alert but becomes easily distracted during the assessment. He recently moved to a new apartment, and his pet beagle died just 2 months ago. He is most likely experiencing: 1. Dementia. 2. Depression. 3. Delirium. 4. Anxiety
Answer: 2. Factors that often lead to depression include presence of a chronic disease or a recent change or life event (such as loss). Patients are alert but easily distracted in conversation.
A nurse is completing a health history with the daughter of a newly admitted patient who is confused and agitated. The daughter reports that her mother was diagnosed with Alzheimer's disease 1 year ago but became extremely confused last evening and was hallucinating. She was unable to calm her, and her mother thought she was a stranger. On the basis of this history, the nurse suspects that the patient is experiencing: 1. Normal aging. 2. Delirium. 3. Depression. 4. Worsening dementia
Answer: 2. Hallmark characteristics of delirium are acute confusion, hallucinations, and agitation. These symptoms are not part of the normal aging process. As dementia worsens, there is a gradual rather than sudden change in memory, usually not accompanied by hallucinations. Depression does not present with acute confusion and agitation.
You are caring for a 4-year-old child who is hospitalized for an infection. He tells you that he is sick because he was "bad." Which is the most correct interpretation of his comment? 1. Indicative of maladaptive stress response 2. Representative of his cognitive development 3. Suggestive of excessive discipline at home 4. Indicative of his developing sense of inferiority
Answer: 2. If two events are related in time or space, preschool children link them in a causal fashion. For example, the hospitalized child reasons, "I cried last night, and that's why the nurse gave me the shot."
A nurse is assessing an older adult brought to the emergency department following a fall and wrist fracture. The patient is very thin and unkempt, has a stage 3 pressure injury on her coccyx, and has old bruising to the extremities in addition to her new bruises from the fall. She defers all of the questions to her caregiver son, who accompanied her to the hospital. What is the nurse's next step? 1. Call social services to begin nursing home placement. 2. Ask the son to step out of the room so that she can complete her assessment. 3. Call adult protective services because you suspect elder mistreatment. 4. Assess the patient's cognitive status.
Answer: 2. The assessment leads you to suspect elder mistreatment, but the nurse needs more information directly from the patient before calling social services or the adult protective services or telling the patient she cannot return home. The nurse will best get this information by asking the son to leave so that she can privately ask the patient direct questions. If the son refuses to leave, this will be another indication that elder mistreatment may be occurring. Cognitive testing will be important but is not the priority.
Using the Transtheoretical Model of Change, order the steps that a patient goes through to make a lifestyle change related to physical activity. 1. The individual recognizes that he is out of shape when his daughter asks him to walk with her after school. 2. Eight months after beginning walking, the individual participates with his wife in a local 5K race. 3. The individual becomes angry when the physician tells him that he needs to increase his activity to lose 30 lb. 4. The individual walks 2 to 3 miles, 5 nights a week, with his wife. 5. The individual visits the local running store to purchase walking shoes and obtain advice on a walking plan.
Answer: 3, 1, 5, 4, 2. This sequence follows the order of the steps of transtheoretical model of change: precontemplation, contemplation, preparation, action, and maintenance
A nurse is completing an assessment on a male patient, age 24. Following the assessment, the nurse notes that his family history is not significant for chronic illnesses, and his physical and laboratory findings are within normal limits. Because of these findings, nursing interventions are directed toward activities related to: (Select all that apply.) 1. Instructing him to return in 2 years. 2. Instructing him in secondary prevention. 3. Instructing him in health promotion activities. 4. Instructing him about routine screenings. 5. Instructing him about proper vaccinations.
Answer: 3, 4, 5. While young adults generally have a minimum of major health problems, lifestyles such as tobacco or alcohol abuse, risky sexual activity, obesity, and lack of physical activity put them at risk for health problems. Instructing young adults in health promotion activities can decrease the risk for lifestyle-related health issues in the young adult. Proper vaccinations (e.g., flu vaccines and boosters to routine childhood vaccinations, such as tetanus) and regular health screenings are also important to maintain health.
A 50-year-old woman has elevated serum cholesterol levels that increase her risk for cardiovascular disease. One method to control this risk factor is to identify the patient's current diet trends and describe dietary changes to reduce the risk. This nursing activity is a form of: 1. Referral. 2. Counseling. 3. Health education. 4. Stress-management techniques
Answer: 3. Health teaching offers dietary information to the woman to enable her to make decisions about her dietary health practices in an attempt to lower her cholesterol.
Which factor affects a middle-age adult's adherence to a treatment plan? 1. Gender 2. Lifestyle 3. Motivation 4. Family history
Answer: 3. Motivation plays a key role in adherence with a prescribed course of therapy. Motivation can be influenced by a variety of factors, including age, experience, family history, social support, and pressure by health care providers
A 15-year-old patient tells the nurse that she is sexually active. What is the best action by the nurse? 1. Contact her parents to alert them of her need for birth control. 2. Explain that having sex is not appropriate for her age-group. 3. Counsel her on safe sex practices and on minimizing health risks. 4. Ask her to have her partner come to the clinic for STI testing
Answer: 3. Nurses need to be sensitive to the emotional cues from adolescents before initiating health teaching to know when the teen is ready to discuss concerns. In addition, discussions with adolescents need to be private and confidential. Adolescents define health in much the same way as adults and look for opportunities to reach their physical, mental, and emotional potential.
A patient discharged a week ago following a stroke is currently participating in rehabilitation sessions provided by nurses, physical therapists, and registered dietitians in an outpatient setting. In what level of prevention is the patient participating? 1. Primary prevention 2. Secondary prevention 3. Tertiary prevention 4. Transtheoretical prevention
Answer: 3. Tertiary prevention involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration following surgery. Tertiary prevention activities are directed at rehabilitation rather than diagnosis and treatment. Care at this level aims to help patients achieve as high a level of functioning as possible, despite the limitations caused by illness or impairment. This level of care is called preventive care because it involves preventing further disability or reduced functioning.
Based on the Transtheoretical Model of Change, what is the most appropriate response to a patient who states: "Me, stop smoking? I've been smoking since I was 16!" 1. "That's fine. Some people who smoke live a long life." 2. "OK. I want you to decrease the number of cigarettes you smoke by one each day, and I'll see you in 1 month." 3. "What do you think is the greatest reason why stopping smoking would be challenging for you?" 4. "I'd like you to attend a smoking-cessation class this week and use nicotine replacement patches as directed."
Answer: 3. The patient's response indicates that he is in the precontemplation stage and not intending to make a change in behavior in the next 6 months. In this stage the patient is not interested in information about the behavior and may be defensive when confronted with the information. Asking an open-ended question about smoking may stimulate the patient to identify a reason to begin a behavioral change. Nurses are challenged to motivate and facilitate health behavior change in working with individuals.
A parent has brought her 6-month-old infant in for a well-child check. Which of her statements indicates a need for further teaching? 1. "I can start giving her whole milk at about 12 months." 2. "I can continue to breastfeed for another 6 months." 3. "I can give her plenty of fruit juice to increase her vitamin intake." 4. "I can start giving her solid food now, introducing one food at a time."
Answer: 3. The use of fruit juices and nonnutritive drinks such as fruit-flavored drinks or soda should be avoided since these do not provide sufficient and appropriate calories during this period.
Elizabeth, who is having unprotected sex with her boyfriend, comments to her friends, "Did you hear about Kathy? You know, she fools around so much; I heard she was pregnant. That would never happen to me!" This is an example of adolescent: 1. Imaginary audience. 2. False-belief syndrome. 3. Personal fable. 4. Sense of invulnerability.
Answer: 4. Adolescents can be risk takers and believe that they are immune to the negative consequences of behaviors; they are just beginning to be future oriented in their thought process and see everything as black or white.
Older adults frequently experience a change in sexual activity. Which best explains this change? 1. The need to touch and be touched is decreased. 2. The sexual preferences of older adults are not as diverse. 3. Medication side effects often impact sexual functioning. 4. Frequency and opportunities for sexual activity may decline
Answer: 4. As a result of loss of a loved one or a chronic illness in themselves or their partner, opportunities for sexual activity may decline. Aging does not change the need for touch, and older adults are diverse. Only select medications impact sexual functioning
Dave reports being happy and satisfied with his life. What do we know about him? 1. He is in one of the later developmental periods, concerned with reviewing his life. 2. He is atypical, since most people in any of the developmental stages report significant dissatisfaction with their lives. 3. He is in one of the earlier developmental periods, concerned with establishing a career and satisfying long-term relationships. 4. It is difficult to determine Dave's developmental stage since most people report overall satisfaction with their lives in all stages.
Answer: 4. Each of the life stages can be achieved successfully and result in satisfaction, including old age.
Parents are concerned about their toddler's negativism. To avoid a negative response, which of the following is the best way for a nurse to demonstrate asking the toddler to eat lunch? 1. Would you like to eat your lunch now? 2. Would you like to sit at the big table to eat? 3. When would you like to eat your lunch with your friends? 4. Would you like apple slices or applesauce with your sandwich?
Answer: 4. Nurses and parents can deal with the negativism by limiting the opportunities for a "no" answer
When preparing a 4-year-old child for a procedure, which method is developmentally most appropriate for the nurse to use? 1. Allowing the child to watch another child undergoing the same procedure 2. Showing the child pictures of what he or she will experience 3. Talking to the child in simple terms about what will happen 4. Preparing the child through play with a doll and toy medical equipment
Answer: 4. Preschoolers are in the preoperational stage of cognitive development and learn more easily when play is used to teach.
A 34-year-old female executive has a job with frequent deadlines. She notes that when the deadlines appear, she tends to eat highfat, high-carbohydrate foods. She also explains that she gets frequent headaches and stomach pain during these deadlines. After receiving health education from the nurse, the executive decides to try yoga. In this scenario yoga is used as a(n): 1. Outpatient referral. 2. Counseling technique. 3. Health promotion activity. 4. Stress-management technique
Answer: 4. Relaxation techniques, such as imagery, biofeedback, and yoga, help recondition the patient's response to stress. Yoga is an ancient practice of controlling body and mind by which there is a physical and mental harmony. It is frequently used as an effective intervention for stress and stress-related physical symptoms.
You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which statement best describes this code? 1. Improves self-health care 2. Protects the patient's confidentiality 3. Ensures identical care to all patients 4. Defines the principles of right and wrong to provide patient care
Answer: 4. When giving care, it is essential to provide a specified service according to standards of practice and to follow a code of ethics. The code of ethics is the philosophical ideals of right and wrong that define the principles you will use to provide care to your patients. It serves as a guide for carrying out nursing responsibilities to provide quality nursing care and as a guide to the ethical obligations of the profession.
Holistic Health Model
Assesses the whole person because it views the mind, body, and spirit as interdependent and functioning as a whole within the environment. Health depends on all these factors working together!
Reiki therapy
Biofield therapy derived from ancient Buddhist rituals; practitioner places hands on or above a body area and transfers "universal life energy," providing strength, harmony, and balance to treat a patient's health disturbances
A nurse is using Campinha-Bacote's model of cultural competency. Which areas will the nurse focus on to become competent? (select all that apply)
Campinha-Bacote's model of cultural competency has five interrelated components: cultural awareness; cultural knowledge; cultural skills; cultural encounters; and cultural desire. Cultural transition is not a component of this model.
action stage
Coach: Provides training, prompting, leadership, and instruction. Caregiver: Implements the nursing process to assist with antismoking medications, patches, and other support materials and aids as appropriate. Teacher: Provides practical strategies to deal with urges, withdrawal, and emotions
A nurse is providing care to a patient from a different culture. Which action by the nurse indicates cultural competence?
Communicates effectively in a multicultural context
linguistic competence
Communicating in a manner easily understood by diverse audiences
precontemplation stage
Communicator: Establishes therapeutic relationship upon which to build trust and honest, factual communication. Educator: Available to provide accurate information so that individual can weigh pros and cons of behavior. Supportive Advocate: Reaches out to encourage and offer help while protecting the individual's right to self-determination
contemplation stage
Counselor: Guides in problem solving, supports self-determination, and shows that change is possible and necessary. Educator: Reinforces education about the evidence of smoking effects, success with abstinence, and available options to support smoking cessation. Critical Thinker: Uses the nursing process to support change with the patient
The nurse outlines the primary prevention needs for flu immunization by explaining how an attenuated virus activates WBCs to create antibodies. The individual chooses not to be immunized.
Health Literacy: The individual did not have the ability to understand health information and make decisions based on that understanding.
cultural competence
Delivering care that is respectful of the needs of diverse patients
Health Promotion Model
Directed at increasing a patient's level of well-being
preparation stage
Guide: Helps the smoker through unfamiliar circumstances and guides plan development with evidence-based science Motivator/Change Agent: Creates motivation through honest involvement, active listening, and encouragement. Coordinator: Links available resources and creates supportive network for success
Example of Primary Prevention
Immunizations, wearing a bike helmet,
orientation
Meeting, creating rapport, and establishing trust through honesty and empathy.
maintainence
Mentor: Provides follow-up support, consultation, and referrals as needed. Researcher: Measures outcomes over time to build the science of nursing and effective interventions. Innovator: Creates new solutions for unseen problems particular to each client's smoking recovery
working
Mutual problem solving to accomplish therapeutic goals.
cuture
People who share values and beliefs that are different from people outside the group
Implementation
Perform the nursing actions identified in planning Implementation of nursing interventions must be evidence-based and have rationale.
preinteraction phase
Planning and starting the nursing process before the purposeful interaction with the client begins.
Nurse who educates clients about the importance of wearing seat belts, immunizing against the flu, and creating a healthy diet plan is working in a __________________ prevention role.
Primary
A nurse is providing care to a culturally diverse population. Which action indicates the nurse is successful in the role of providing culturally congruent care?
Provides care that fits the patient's valued life patterns and set of meanings
Evaluate
Review the patient progress to see if interventions were effective The nurse will evaluate as often as necessary to track client's progress and need for change.
secondary prevention
Secondary prevention prevents an existing illness or injury condition from becoming worse. For example, heart attack patients are prescribed an aspirin a day to reduce their chance of further heart problems. Another secondary prevention measure is screening to detect a disease of which an individual is unaware of having, such as breast cancer, diabetes, or colon cancer. Detecting the disease allows for treatment and hopefully prevents worsening of the condition.
cultural awareness
Self-examination of one's own background, recognizing bias and prejudices
termination
Separating from the formal therapeutic relationship
SMART goals
Specific, Measurable, Attainable, Realistic, Timely
An experienced nurse tells the student nurse, "I have found that most Hispanic immigrants live in unsanitary conditions but are hard workers." How should the student nurse best classify this statement?
Stereotyping
Transcultural Nursing
Study of cultures to understand the similarities and differences across human groups
Example of Secondary Prevention
Taking low dose of aspirin to prevent heart attack , mammogram,
psychomotor domain
The domain involved in the learning of a new procedure or skill; often called the doing domain.
primary prevention
The goal of primary prevention is to stop illness or injury before it happens. For instance, anti-smoking laws are a form of primary prevention, as are immunizations, seat belts, car seats, sunscreen, and educating clients about health promotion, nutrition, and safety.
Diagnosis
The nurse applies clinical judgment to the client's human response to actual or potential health problems. The diagnosis is based on assessment findings.
Planning
The nurse plans interventions to help the patient achieve optimal health outcomes using Nursing Outcome Classification (NOC) outcomes and Nursing Intervention Classification (NIC) interventions.
Assessment
The nursing assessment is what you find when you gather information about the client's condition. Data includes both subjective (what the patient/family states) and objective (measurable) findings.
What is the goal of Healthy People 2020?
To eliminate health disparities related to race, ethnicity, and socioeconomic status
The nurse conducts nutritional education about carbohydrate intake with his newly diagnosed diabetic patient who often seemed impatient. Within an hour, the nurse notices that the patient is eating a large piece of chocolate cake a family member brought from home.
Transtheoretical Model of Change: The patient is most likely in the contemplation or precontemplation stage in which behavior change is not intended. Communicating facts about diabetes does not translate to changing behavior—the patient is not ready.
cultural knowledge
Understanding diverse groups' values, beliefs, and care practices
A nurse is beginning to use patient-centered care and cultural competence to improve nursing care. Which step should the nurse take first?
assessing own bias and beliefs
Which topic is most important for the nurse to teach in a community health promotion class of middle-aged adults?
cessation of smoking
affective learning domain
changing attitudes, values, and feelings
Which action indicates the nurse is meeting a primary goal of cultural competent care for patients?
provides care to transgender patients
A nursing student lists examples of health promotion activities that can help clients maintain or enhance their present levels of health. Which examples are accurate?
good nutrtion, regular excercise
A nurse is assessing the client's meaning of illness. Which area of focus by the nurse is priority?
on the way patient reacts to disease
What type of health promotion strategies does the nurse describe while teaching a new mother about immunizations?
primary Prevention
