Chapter 3: Health, Wellness, and Health Disparities
Which scenario accurately depicts the influence of one's religious beliefs? A.) A client who practices Islam requests a baptism for live birth. B.) A client who practices Orthodox Judaism will not eat pork. C.) A client who practices Conservative Catholicism opposes a blood transfusion. D.) A client who practice the Jehovah's Witnesses faith will not eat shellfish.
B.) A client who practices Orthodox Judaism will not eat pork. Explanation: Spiritual and religious beliefs and values are important components of a person's behaviors both in health and in illness. Examples of such influences include Roman Catholics' requirement of baptism for both live births and stillborn babies; Kosher dietary laws prohibiting the intake of pork and shellfish (practiced by orthodox and conservative Jews), and the opposition to blood transfusions common among Jehovah's Witnesses. Islam do not have a baptism ritual for newborns. Blood transfusion is acceptable in the belief system of the Catholic church. Consumption of shellfish is acceptable in the belief system of those who identify as Jehovah's Witnesses. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 55.
What are common sources of stress in family members due to a hospitalization of a family member? Select all that apply. Decrease in social interactions Alterations in roles Increase in exercise Alterations in lifestyle Economic problems
-Alterations in roles -Economic problems -Alterations in lifestyle -Decrease in social interactions Explanation: A chronic illness hospitalization can create stress for both the client and family because of alterations in role or lifestyle, frequent hospitalizations, economic problems, and decreased social interactions among family members. An increase in exercise would be more likely to relieve stress rather than increase it. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 53.
Which are factors that impact how a client defines health? Select all that apply. Family Culture Community Society Music
-Family -Culture -Community -Society Explanation: Each client defines health in terms of the client's own values and beliefs. The person's family, culture, community, and society also influence this personal perception of health. Music does not affect how a person defines health. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 48.
Which client growth needs are included in the love and belonging level of Maslow's hierarchy? (Select all that apply.) Self-respect Friendships Status Family Intimacy
-Family -Intimacy -Friendships Explanation: Love and belonging includes the need for affection, belonging, and meaningful relations with others (family, intimacy, friendships). Self-esteem includes self-respect and status. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 48.
Which nursing activity reflects care given on the tertiary level of healthcare delivery? A.) Assisting with transplant surgery B.) Teaching the client about exercise programs C.) Educating the client about safe habits D.) Recommending regular exams
A.) Assisting with transplant surgery Explanation: Tertiary care is health services provided at hospitals or medical centers that have complex technology and specialists. Educating the client about safe habits, recommending regular exams, and teaching the client about exercise programs are examples of primary care. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 56.
What is the definition of wellness? A.) Being without disease B.) An active state of being healthy C.) A desire to be without disease D.) Maximizing the state in which you live
B.) An active state of being healthy Explanation: Wellness, a reflection of health, is an active state of being healthy by living a lifestyle that promotes good physical, mental, and emotional health. It is not simply an absence of disease or a desire to be without disease, nor is it maximizing the state in which one lives. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 48.
An adolescent client reports having diarrhea before every test in school. The nurse recognizes that this client needs to focus on which dimension of health? A.) Physical dimension B.) Emotional dimension C.) Intellectual dimension D.) Sociocultural dimension
B.) Emotional dimension Explanation: This is an example of the emotional dimension. Long-term stress affects body systems, and anxiety affects health habits. The intellectual dimension encompasses cognitive abilities and past experiences, whereas the physical dimension includes factors such as genetics, gender, and race. The sociocultural dimension relates to a client's economic level, lifestyle, family, and culture. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, pp. 54-55.
The client is admitted with a gastrointestinal bleed. The health care provider ordered a colonoscopy. Which level of care encompasses this procedure? A.) Quaternary B.) Secondary C.) Primary D.) Tertiary
B.) Secondary Explanation: Secondary care delivery is when primary caregivers refer clients for consultation and additional testing. Therefore, this scenario portrays secondary level of care. Primary care delivery is provided by the first healthcare provider or agency a person contacts. Quaternary care is an extension of tertiary care and includes experimental medicine and procedures and highly uncommon, specialized surgeries. Tertiary care is health services provided at hospitals or medical centers that have complex technology and specialists. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 56.
Which needs are being met when a nurse recommends a senior citizen community center for an older client who is living alone? A.) Spiritual needs B.) Sociocultural needs C.) Intellectual needs D.) Emotional needs
B.) Sociocultural needs Explanation: Increased social interaction, as would be provided by visiting a senior citizen community center, would primarily address a client's sociocultural needs. Emotional needs address how the mind affects body functions and responds to body conditions. Long-term stress affects body systems, and anxiety affects health habits; conversely, calm acceptance and relaxation can actually change the body's responses to illness. The intellectual dimension encompasses cognitive abilities, educational background, and past experiences. Spiritual beliefs and values are assessed when addressing spiritual needs. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 55.
A nurse observes that a client who has pneumonia is in the recovery and rehabilitation stage of the illness. Which statement describes the client response that the nurse would expect at this stage of the illness? A.) The client seeks medical attention. B.) The client gives up the dependent role. C.) The client recognizes symptoms of illness. D.) The client assumes a dependent role.
B.) The client gives up the dependent role. Explanation: In the recovery and rehabilitation stage, known as Stage 4, the person gives up the dependent role and resumes normal activities and responsibilities. The client would not seek medical attention, assume a dependent role, or recognize symptoms of illness in this stage. Stage 1 is when the client would recognize symptoms of the illness. Stage 2 is when the client would seek medical attention. Stage 3 is when the client would assume a dependent role. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 52
What have the models of health promotion and illness prevention been used for? A.) To define a medical framework for the care of the disabled. B.) To help health care providers understand health-related behaviors. C.) To create a forum for improving rehabilitative care. D.) To formulate care plans for the disabled population.
B.) To help health care providers understand health-related behaviors. Explanation: Several models of health promotion and illness prevention have been used to help health care providers understand health-related behaviors and adapt care to people from diverse economic and cultural backgrounds. The models include the health belief model, the health promotion model, the health-illness continuum model, and the agent-host-environment model. These models do not define a medical framework in the care of the disabled; these models do not create a forum for improving rehabilitative care; and these models do not formulate care plans for use with the disabled. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 59.
The nurse instructor has completed a session detailing major factors differentiating exacerbations from remissions. The instructor determines the session is successful when the students point out which factor(s) can contribute to exacerbations? Select all that apply. immune system is functioning poorly sleep has been disrupted due to family issues client is facing a potential eviction dietary log shows improvement on food choices skin turgor indicates good hydration status
-immune system is functioning poorly -sleep has been disrupted due to family issues -client is facing a potential eviction Explanation: Exacerbations of illnesses are often related to how poorly the immune system is functioning, the stressors the client is facing and overall health status (e.g., nutrition, sleep, hydration). Remission is the opposite and usually indicates how well the immune system is acting, how well the client is handling stressors, and his or her overall health status. Improving food choices and good hydration status are indications the individual is recovering and showing improvement in his or her health status. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities.
Which behaviors are necessary for a person to successfully adapt to a chronic illness? Select all that apply. earn to live as normally as possible Maintain a sense of hope Give up control of one's life Accept dependence and adjust to it Maintain a positive self-concept
-Learn to live as normally as possible -Maintain a positive self-concept -Maintain a sense of hope Explanation: To successfully adapt to a chronic illness, the person must learn to live as normally as possible and maintain a positive self-concept and sense of hope, despite symptoms and treatments. It is important that the person maintain a feeling of being in control of his or her life, as well as in control of the prescribed treatments. The client needs to maintain independence and not dependence on chronic illness outcomes. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 52.
Which activities would the nurse consider to be lifestyle risk factors for the development of health problems? Select all that apply. Avoiding exercise Family history of hypertension Living in an area with high smog levels Participating in extreme sports Maintaining a stressful job
-Participating in extreme sports -Maintaining a stressful job -Avoiding exercise Explanation: A sedentary lifestyle, high stress, and participation in risky sports are all examples of lifestyle-related risk factors for disease and illness. A family history of an illness is a genetic risk factor. Pollution is an environmental consideration. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 48.
When providing holistic care to a client, the nurse recognizes that which behaviors are necessary? Select all that apply. Instruct the client that health is an inactive process. Focus on a standard definition of health and beliefs. Understand and respect each person's responses to illness. Apply the model of health that is most popular. Understand and respect each person's definition of health.
-Understand and respect each person's definition of health. -Understand and respect each person's responses to illness. Explanation: To give holistic care, the nurse must understand and respect each person's own definition of health and responses to illness and should be familiar with models of health and illness. Health is an active process in which a person moves toward maximum potential. Focusing on a standard definition of health and beliefs does not address the individuality of the client. Applying the model of health that is most popular does not address the individuality of the client. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 54.
The nurse working in the community is assigned to the care of several clients. Which client(s) may require assistance to overcome barriers to accessing adequate care? Select all that apply. an employed woman, pregnant for the second time a client who is a migrant and works on a farm an older adult client living independently a client who has been unemployed for 6 months a student entering a local university
-a client who is a migrant and works on a farm -an older adult client living independently -a client who has been unemployed for 6 months Explanation: Everyone, regardless of age, gender, level of education, religion, sexual orientation, ethnic origin, social position, or wealth, is entitled to equal services for sustaining health. Disparities exist among various groups, including the poor, such as unemployed clients; racial and ethnic minorities, such as migrant farm workers; those affected by gender differences; older adults; and people with disabilities. Students entering a university and employed pregnant mothers are not categorically at risk for health disparities. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 62.
Which nursing intervention is an example of tertiary preventive care? A.) Assisting with speech therapy a client with a traumatic brain injury B.) Administration of immunizations to a 6-month-old child C.) Blood pressure screenings at a senior center D.) Teaching stress reduction classes at a wellness center
A.) Assisting with speech therapy a client with a traumatic brain injury Explanation: Tertiary prevention begins after the illness and is used to help rehabilitate clients. Speech therapy is an example of tertiary preventive care. The administration of immunizations and teaching stress reduction classes are examples of primary preventive care. Blood pressure screening is an example of secondary preventive care. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 59.
A client with a lump in the breast calls the healthcare provider to schedule an appointment for an evaluation. Based on the client's actions, what stage of illness is the client demonstrating? A.) Assuming the sick role B.) Experiencing the symptoms C.) Assuming the dependent role D.) Achieving recovery and rehabilitation
A.) Assuming the sick role Explanation: Seeking out a healthcare provider for diagnosis and treatment is an example of assuming the sick role. Experiencing the symptoms occurs when a person recognizes one or more symptoms. Assuming the dependent role is characterized by the client's decision to accept the diagnosis and follow the prescribed treatment plan. Achieving recovery and rehabilitation is characterized by the client giving up the dependent role and resuming normal activities and responsibilities. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 52.
A client comes to the health center for a routine visit. During the visit, the client tells the nurse, "I'm motivated to do things now to make sure I'm the healthiest I can be." When planning this client's care, the nurse should focus on which area? A.) Health promotion B.) Illness prevention C.) Self-concept D.) Diagnosis of disease
A.) Health promotion Explanation: Health promotion is the behavior of a person who is motivated by a personal desire to increase well-being and health potential. In contrast, illness/disease prevention, also called health protection, is behavior motivated by a desire to avoid or detect disease or to maintain functioning within the constraints of an illness or disability. Self-concept incorporates both how people feel about themselves (self-esteem) and the way they perceive their physical self (body image). Diagnosis of disease involves a medical aspect such that a disease is traditionally diagnosed—and treatment is prescribed—by a health care provider or advanced practice nurse, whereas nurses focus on the person with an illness. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, Health Promotion, p. 56.
The nurse is giving a talk to a local community group on the harms of smoking. The nurse tells the group that a risk factor is something that increases a person's chances for illness or injury. What type of risk factor is smoking? A.) Modifiable B.) Nonmodifiable C.) Primary D.) Secondary
A.) Modifiable Explanation: Risk factors are defined as modifiable (things a person can change, such as quitting smoking) and nonmodifiable (things that cannot be changed, such as a family history of cancer). Primary and secondary are not associated with risk factors. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 55.
The nurse is preparing to talk to a local community group regarding chronic illness. The nurse informs the group that both external and internal factors influence a person's health. When discussing the fact that the male client has a higher chance of developing lung cancer due to his gender, which dimension is the nurse referring to? A.) Physical dimension B.) Emotional dimension C.) Intellectual dimension D.) Environmental dimension
A.) Physical dimension Explanation: The physical dimension includes genetic inheritance, age, developmental level, race, and gender. These components strongly influence the person's health status and health practices. Since lung cancer is more frequent in men, the male client is at a higher risk of developing lung cancer due to his gender. Emotional dimension refers to feelings. Intellectual dimension is cognitive ability. Environmental dimension is related to a client's environment, including work and school. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 54.
A nurse is immunizing children against measles. This is an example of what level of preventive care? A.) Primary B.) Secondary C.) Tertiary D.) Chronic
A.) Primary Explanation: Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Immunizations are an example of primary health promotion. Secondary health promotion and illness prevention focus on screening for early detection of disease, with prompt diagnosis and treatment of any found. Tertiary health promotion and illness prevention begin after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate clients to a maximum level of functioning. The term chronic is not related to health promotion. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 56.
The nurse's community outreach class is giving a presentation on seat belts and child safety seats at the local firehouse every weekend in October. Which level of health promotion is this an example of? A.) Primary B.) Secondary C.) Tertiary D.) Medical
A.) Primary Explanation: Primary health promotion and illness prevention is directed toward promoting good health and preventing the development of disease process or injury. Primary-level activities include immunization clinics, providing poison-control information, and education about seat belt and child-safety seat use. Secondary-level activities include screening programs and early identification of disease. Tertiary-level prevention is concerned with returning the client to the optimal function after diagnosis. Medical is not a level of health promotion or illness prevention. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 56.
The nurse is holding a cholesterol screening at a local pharmacy this Saturday morning. What level(s) of health promotion is this screening an example of? A.) Secondary B.) Tertiary C.) All three levels D.) Primary
A.) Secondary Explanation: Screenings, such as those for blood pressure, cholesterol, glaucoma, HIV, and skin cancer, are considered nursing activities that fall under the category of secondary health promotion. Secondary health promotion and illness prevention focus on screening for early detection of disease, with prompt diagnosis and treatment of those found. Secondary health promotion involves measures that actually help prevent disease from occurring in the first place, such as a presentation to school children about healthy food choices and the importance of being active. Tertiary health promotion involves rehabilitation following the development of a chronic condition, to help prevent further progression and associated complications of the condition, such as cardiac exercise classes for clients recovering from a heart attack. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 56.
A client has been admitted to the hospital for treatment of pancreatitis secondary to alcoholism. The client states that it is nearly impossible to quit drinking because of the deep entrenchment of alcohol use in the client's circle of friends and line of work. As well, the client claims to have thought that drinking only beer and foregoing hard alcohol would prevent health problems. This client is exhibiting health consequences rooted in which human dimensions? A.) Sociocultural and intellectual B.) Environmental and spiritual C.) Emotional and environmental D.) Physical and emotional
A.) Sociocultural and intellectual Explanation: That the client is situated in a context that normalizes heavy alcohol use is an example of the sociocultural dimension. The client's ignorance of the health consequences of drinking beer rather than spirits is a component of the intellectual dimension. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 55.
A client has had a total knee replacement and is receiving care that includes learning to walk with a walker. What level of prevention is most applicable to this client? A.) Tertiary prevention B.) Primary prevention C.) Secondary prevention D.) Residual prevention
A.) Tertiary prevention Explanation: Tertiary prevention in health care deals with rehabilitation of the client. Teaching the client to walk with a walker is tertiary prevention. Primary prevention refers to health promotion or illness prevention. Secondary prevention refers to screening and early detection of disease. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 56.
Which model is most useful in examining the cause of disease in an individual, based upon external factors? A.) The Agent-Host-Environment Model B.) The Health-Illness Continuum C.) The High-Level Wellness Model D.) The Health Belief Model
A.) The Agent-Host-Environment Model Explanation: The Agent-Host-Environment Model is useful for examining the cause of disease in an individual. The agent, host, and environment interact in ways that create risk factors. The Health-Illness Continuum is a way to measure a person's level of health. The High-Level Wellness Model is characterized by functioning to one's maximum potential while maintaining balance and purposeful direction in the environment. The Health Belief Model is used to describe health behaviors. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 61.
When admitting an adolescent to the hospital, the nurse anticipates that the client will respond to questions about the client's health beliefs based primarily on the client's: A.) age and developmental stage. B.) health promotion activities. C.) peer influence and education. D.) gender and medical history.
A.) age and developmental stage. Explanation: Age and developmental stage are important considerations in the health belief model. Other factors are influential, but age and developmental stage are paramount. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 54.
A client has a Staphylococcus infection in a decubitus ulcer. In this case, Staphylococcus is the: A.) agent. B.) environment. C.) host. D.) disease.
A.) agent. Explanation: The agent is any factor that leads to illness. The client is the host of the infection. The environment is setting in which the infection occurs. The disease is a pathological process that can result from the infection. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 61.
The concept of holism is based on the belief that: A.) individuals cannot be seen apart from the environment. B.) health is achieved by treatment from health care providers. C.) individuals can be seen in an atomistic fashion. D.) health is achieved through medical care.
A.) individuals cannot be seen apart from the environment. Explanation: Holism is based on the belief that people cannot be fully understood if examined solely in pieces apart from their environment. The opposite of holism is the view that individuals can be treated atomistically or can achieve health through medical care or health care providers. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 55.
A community health nurse arranges for a dentist to teach local children in the school district how to properly brush their teeth. Which goal will the nurse set for this event? A.) illness prevention B.) health promotion C.) high-level wellness D.) reversal of self-care deficit
B.) health promotion Explanation: The education on lifestyle choices is part of health promotion activity, which focuses on protecting the person's health. Brushing one's teeth is a lifestyle choice. The goal of the prevention of illness is to detect and prevent the illness. High-level wellness focuses on maximizing the person's highest potential for functioning. Reversal of self-care deficits would involve therapeutic interventions that are directed at contributing factors. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 48.
When chronic illnesses and disabilities are present, individuals benefit most from activities that: A.) help them eat well. B.) help them maintain independence. C.) preserve their social interactions. D.) accomplish financial stability.
B.) help them maintain independence. Explanation: Although their chronic illnesses and disabilities cannot be eliminated, adults can benefit most from activities that help them maintain independence and achieve an optimal level of health. The other answers, while beneficial, are not as helpful. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 52.
The recognition of health as an ongoing process toward a person's highest potential of functioning is defined as: A.) agent-host-environment. B.) high-level wellness. C.) health belief model. D.) illness.
B.) high-level wellness. Explanation: High-level wellness is defined as recognizing health as an ongoing process toward a person's highest potential of functioning. The Health Belief Model focuses on how the client's beliefs about health influence the client's health and response to health and health care. Illness is a person's response to disease. the Agent-Host-Environment model explores the factors that contribute to infection in a client. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 50.
A nurse is providing care for client who experienced a stroke. Which nursing intervention reflects the tertiary level of prevention? A.) discuss family history of hypertension B.) provide care transition at discharge for speech therapy C.) conduct mental status assessment every 2 hours D.) assess blood pressure every 4 hours
B.) provide care transition at discharge for speech therapy Explanation: Tertiary prevention minimizes the consequences of a disorder through aggressive rehabilitation or appropriate management of the disease. An example is speech therapy to help restore ability. Blood pressure and mental status exams are examples of secondary prevention associated with the acute stroke. Discussing family history is also secondary prevention in terms of assessing for further risk factors. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, Tertiary Health Promotion and Illness Prevention, p. 59.
A 48-year-old client was just diagnosed with type 2 diabetes mellitus. The client has a body mass index of 35 and leads a sedentary lifestyle. The nurse informs the client of risk factors for the diagnosis and the need to change diet and exercise behavior. Which client statement indicates a need for further teaching? A.) "I need to start slow on an exercise program approved by my healthcare provider." B.) "Over 80% of cases of type 2 diabetes could be prevented if the risk factors were eliminated." C.) "There is nothing that can be done anyway; chronic diseases cannot be prevented." D.) "The major causes of chronic diseases are known."
C.) "There is nothing that can be done anyway; chronic diseases cannot be prevented." Explanation: The major causes of chronic diseases are known, and if these risk factors were eliminated, over 80% of cases of heart disease, stroke, and type 2 diabetes would be prevented and over 40% of cases of cancer would be prevented. Of the ten leading causes of death in the United States, seven are chronic illnesses. The statement that the client should start slow on an exercise program approved by the client's healthcare provider is true. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 51.
The nurse is planning care for several clients in an outpatient clinic. Which client requires follow-up care due to a chronic condition? A.) A client diagnosed with diabetes mellitus (DM) who stubbed the great toe and now has a wound B.) A client returning for a follow-up visit after a shoulder sprain 1 week ago C.) A client with chronic obstructive pulmonary disease (COPD) who is wheezing and coughing D.) A client who fell off a roof 2 weeks ago and is experiencing continuous lower back pain
C.) A client with chronic obstructive pulmonary disease (COPD) who is wheezing and coughing Explanation: Chronic illnesses have expected symptoms, such as the client with COPD who has damage to the lungs that cannot be reversed. Symptoms of this chronic condition include shortness of breath, wheezing, and a chronic cough. The other clients all have new or recent injuries that are acute in nature and require immediate care rather than long-term follow-up (note that diabetes mellitus, although a chronic condition itself, can be associated with complications that are acute, such as an injury to the toes). Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 51.
What is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity? A.) Holism B.) Wellness C.) Host D.) Health
D.) Health Explanation: The World Health Organization defines health as "a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity." Wellness is a dynamic and conscious process of making choices to achieve one's highest level of potential. Holism is care that addresses all dimensions of a person, including mind, body, and spirit. Host is the person who experiences an infection. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 48.
An older adult client has been recently diagnosed with vascular dementia. Because the client lives alone and has poorly controlled hypertension, the client has begun to receive home healthcare. This new aspect of the client's care is characteristic of which stage of illness? A.) Experiencing the symptoms B.) Assuming the sick role C.) Assuming a dependent role D.) Achieving recovery and rehabilitation
C.) Assuming a dependent role Explanation: The stage of assuming a dependent role often requires assistance in carrying out activities of daily living. As well, the client often requires care, which may be provided in the home. Experiencing symptoms and assuming a sick role may precede (or accompany) this process. Recovery and rehabilitation are not evident in the client's present circumstances. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 52.
Why are health promotion and illness prevention a key responsibility of nurses? A.) Chronic illnesses can cause pain and suffering. B.) Treatment of chronic illnesses is very expensive. C.) Chronic illnesses are the leading health problem in the world. D.) People do not like to be sick and feel bad.
C.) Chronic illnesses are the leading health problem in the world. Explanation: Because chronic illnesses are the leading health problems in the world, health promotion and illness prevention activities are vital to nursing care. By endorsing health promotion and illness prevention, the nurse can assist the client to achieve optimal health even with a chronic illness. It is true that treating chronic illnesses can be expensive, they do cause pain and suffering, and people do not like to be sick, but these are not the most important reasons for promoting health and preventing illnesses. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 51.
When providing care to a client, the nurse integrates knowledge that a client's beliefs and actions are related and influenced by the client's personal expectations in relation to health and illness. The nurse is demonstrating an understanding of which health model? A.) Clinical model B.) Holistic health model C.) Health belief model D.) High-level wellness model
C.) Health belief model Explanation: According to the health belief model, a client's beliefs and actions are related and influenced by the client's personal expectations in relation to health and illness. According to the clinical model, health is defined narrowly as the absence of signs and symptoms of disease or injury. The holistic model views individuals as ever-changing systems of energy, and the interaction of a person's mind, body, and spirit within the environment. The high-level wellness model is the recognition of health as an ongoing process toward a person's highest potential of functioning. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, pp. 59-60.
The nurse is caring for a client admitted to the hospital with pneumonia and associated pleuritic chest pain. Which would be a priority when creating the nursing care plan? A.) Monitoring fluid intake and output. B.) Effective pain management. C.) Monitoring airway clearance. D.) Effective infection control measures.
C.) Monitoring airway clearance. Explanation: Priority management, according to Maslow's hierarchy, starts at physiological needs, such as the need for oxygen, food, water, rest, and elimination. Therefore, difficulty breathing is the priority issue that the nurse must manage because it affects the ability of the client to get adequate oxygen. Symptoms such as pain, thirst, and needing to urinate, although important, are not a priority over difficulty breathing. Likewise, infection control is important but is not priority. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 51.
A client who recently underwent a coronary artery bypass graft is taking furosemide and metoprolol following the procedure. While developing a plan for a heart-healthy diet with the nurse, the client states that diet did not contribute to the heart disease and that the client should be fine just continuing to take the medications. According to the Stages of Change Model, which stage of change is the client in related to diet? A.) Maintenance B.) Preparation C.) Precontemplation D.) Contemplation
C.) Precontemplation Explanation: The precontemplation stage is the first stage change, in which the client does not indicate any intention to make a change within the next 6 months. During the precontemplation stage, the client is not even thinking about or considering making a change. During the contemplation stage, the client is considering making a change. During the preparation stage, the client has decided to make a change and is preparing for it. During the maintenance stage, the client attempts to maintain the change in lifestyle begun in an earlier stage. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 61.
The nurse is caring for a client with a diagnosis of heart failure. This admission is the client's third admission within 90 days. The nurse educates the client with the goal of preventing readmission. Which nursing activity for this client would represent tertiary level prevention? A.) Screening for tuberculosis B.) Assessing for risk factors for heart disease C.) Teaching about adhering to a low-sodium diet D.) Screening for breast cancer every 5 years
C.) Teaching about adhering to a low-sodium diet Explanation: Tertiary health promotion and illness prevention begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate the client to a maximum level of functioning. Nursing activities on a tertiary level include teaching a client with heart failure the importance of adhering to a low-sodium diet. Primary prevention is directed toward promoting health and preventing the development of disease processes or injury. This client has a diagnosis. Secondary health promotion and illness prevention focus on screening for early detection of disease with prompt diagnosis and treatment of diseases found. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 58.
A nurse refers an HIV-positive client to a local support group. This is an example of what level of preventive care? A.) Primary B.) Secondary C.) Tertiary D.) Chronic
C.) Tertiary Explanation: Tertiary health promotion and illness prevention begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate clients to a maximum level of functioning. Referring an HIV-positive client to a local support group would be an example of tertiary preventive care. Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Secondary health promotion and illness prevention focus on screening for early detection of disease, with prompt diagnosis and treatment of any found. The term chronic is not related to health promotion. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 56.
The nurse in a free clinic caring for clients uses the Health Belief Model, which is based on three components. What is the main focus for this model? A.) How people interact with their environments B.) How health is a constantly changing state C.) What people believe to be true about their health D.) Factors that predispose a person to infectious diseases
C.) What people believe to be true about their health Explanation: The Health Belief Model focuses on what people perceive or believe to be true about themselves in relation to their health. The Health Promotion Model focuses on how people interact with their environments, as they pursue health. The Health-Illness Continuum Model focuses on health as a constantly changing state, whereas The Agent-Host-Environment Model explains how certain factors place a person at risk for an infectious disease. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 59.
A pregnant client at 10 weeks' gestation is receiving education by the nurse about the importance of abstaining from alcohol while pregnant. What statement made by the client demonstrates an understanding of the education provided? A.) "Abstaining from alcohol will prevent any type of congenital disorder." B.) "If I drink alcohol while pregnant, my child will have a hereditary disorder." C.) "Alcohol use while pregnant will predispose my child to idiopathic illness." D.) "I should abstain from alcohol to prevent the development of a fetal alcohol spectrum disorder."
D.) "I should abstain from alcohol to prevent the development of a fetal alcohol spectrum disorder." Explanation: Congenital disorders such as fetal alcohol spectrum disorders may be prevented by the client abstaining from alcohol while pregnant. Fetal alcohol spectrum disorders are congenital disorders caused by an undetermined amount of alcohol ingested by the mother which affects the fetus in the developmental stages of growth. Abstaining from alcohol will not prevent all types of congenital disorders, but clients should be educated about a variety of preventative measures in order to prevent interruption of the growth and development of the fetus. An idiopathic illness is one in which the cause is undetermined. A hereditary disorder is genetic and not altered by substance intake during pregnancy. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, Nursing Care to Promote Health and Prevent Illness, p. 62.
An exacerbation refers to the reactivation of a disease. Which condition is associated with exacerbation? A.) Congenital illness B.) Hereditary illness C.) Acute illness D.) Chronic illness
D.) Chronic illness Explanation: Exacerbation is the increase in activity of a disease and aggravation of symptoms. This occurs periodically in clients with chronic diseases. It is often a result of physical, chemical, or emotional stress. Congenital illness (such as atrial septal defect), hereditary illness (such as cystic fibrosis), and acute illness (such as influenza) do not have exacerbation and remission stages. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 51.
What is a misconception about chronic disease? A.) Chronic illness typically does not result in sudden death. B.) The major cause of chronic disease is known. C.) Almost half of chronic deaths occur prematurely in people under 70 years of age. D.) Chronic illnesses cannot be prevented.
D.) Chronic illnesses cannot be prevented. Explanation: A misconception regarding chronic disease is that chronic illnesses cannot be prevented. Almost half of chronic deaths occur prematurely in people under 70 years of age. Chronic illness typically does not result in sudden death. The major cause of chronic disease is known. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 51.
A client has been admitted to the hospital for the treatment of diabetic ketoacidosis, with a random blood glucose reading of 575 mg/dL (31.91 mmol/L), vomiting, and shortness of breath. This client has experienced which phenomenon? A.) Morbidity B.) Risk factor C.) Infection D.) Exacerbation
D.) Exacerbation Explanation: This client has experienced a significant exacerbation of a chronic disease (diabetes mellitus), which has manifested as an acute threat to the client's health. Morbidity is an epidemiological statistic of the frequency of a disease. The client's problem does not have an infectious etiology. A risk factor is any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or injury. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 51.
The nurse is working in an acute care setting and performs primary, secondary, and tertiary prevention. Which activity performed by the nurse is classified as tertiary prevention? A.) Promoting safety in the home B.) Counseling a client about a low-sodium diet C.) Assessing a client's blood glucose level D.) Instructing a client on how to use crutches
D.) Instructing a client on how to use crutches Explanation: Tertiary prevention is used after an injury or sickness to help rehabilitate the client or to decrease potential risk and further damage, such as instructing the client on how to use crutches. Promoting safety in the home and counseling a client about a low-sodium diet are examples of primary prevention (preventing a disease from occurring in the first place). Assessing blood glucose level is an example of secondary prevention (screening to detect a disease early). Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 56.
A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). The nurse explains to the client that COPD is a chronic disease. Why is COPD considered a chronic disease A.) It persists for a long time. B.) It is a sequela of acute illness. C.) It takes a long time to cure.structive pulmonary disease (COPD). The nurse explains to the client that COPD is a chronic disease. Why is COPD considered a chronic disease? D.) It has a gradual onset and lasts for a long time.
D.) It has a gradual onset and lasts for a long time. Chronic illness has a gradual onset and lasts for a long time. It is usually seen in old age. It may or may not be due to acute illness. Chronic diseases are a major cause of morbidity in the population. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 51.
Which is an example of tertiary health promotion? A.) Family counseling B.) Water treatment C.) Pap tests D.) Rehabilitation
D.) Rehabilitation Explanation: Tertiary health promotion and disease prevention begin after an illness is diagnosed and treated to reduce disability and to help rehabilitate clients to a maximum level of functioning. Therefore, rehabilitation is an example of tertiary health promotion. Family counseling and Pap tests are examples of secondary health promotion. Water treatment is an example of primary health promotion. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 56.
Consultation and diagnostic tests are included in which level of health care? A.) Tertiary care B.) Primary care C.) Extended care D.) Secondary care
D.) Secondary care Explanation: Consultation and diagnostic tests are included in the secondary level of health care. The first contact with a general health care provider is the primary care, and the referral to a highly specialized facility for desensitization is the tertiary care level. The secondary and tertiary care facilities are equipped to provide highly specialized care. Extended care is care provided to clients who no longer require acute hospital care. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 51.
A mammogram represents which level of prevention? A.) Tertiary prevention B.) Primary prevention C.) Medical prevention D.) Secondary prevention
D.) Secondary prevention Explanation: Secondary prevention includes screening for those at risk to develop illness, or those who could be diagnosed early in the process, and thus receive prompt treatment. Primary prevention refers to health promotion and illness prevention. Tertiary prevention refers to rehabilitation or prevention of complications after diagnosis with a disease. Medical is not a level of prevention. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 56.
The nurse provided teaching to a client newly diagnosed with gout. Which behavior observed by the nurse indicates the client understood the teaching? A.) Applies heat to painful, swollen joints B.) Orders seafood and red meat from the lunch menu C.) Performs range-of-motion exercises on painful joints D.) Selects foods low in purine from the dinner menu
D.) Selects foods low in purine from the dinner menu Explanation: Gout is arthritic-type pain exacerbated by purine in the diet. As such, selecting foods low in purine while filling out the dinner menu indicates the client understood the teaching. Performing range-of-motion exercises on painful, swelling joints should not be done, as this exacerbates the symptoms. Ice, not heat, should be applied to painful joints. Seafood is high in purine and red meat is high in fat; both should be avoided with gout. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, Stage 4: Achieving Recovery and Rehabilitation, p. 52.
The nurse recognizes that the client who makes the decision to accept a new diagnosis and follow the prescribed treatment plan is in which stage of an illness? A.) Stage 4-Achieving Recovery B.) Stage 1-Experiencing symptoms C.) Stage 2-Assuming the sick role D.) Stage 3-Assuming a dependent role
D.) Stage 3-Assuming a dependent role Explanation: Stage 3 is characterized by the client's decision to accept the diagnosis and follow the treatment plan. Stage 1 is the beginning of symptoms. Stage 2 is where a client describes himself or herself as being sick and seeks validation from others. Stage 4 is recovery and rehabilitation and is the final stage of the illness. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 52.
A nurse is caring for a client who has COPD, a chronic illness of the lungs. The client is in remission. Which statement best describes a period of remission in a client with a chronic illness? A.) The symptoms of the illness reappear. B.) The disease is no longer present. C.) New symptoms occur at this time. D.) Symptoms are not experienced.
D.) Symptoms are not experienced. Explanation: Chronic illnesses usually have a slow onset and many have periods of remission (the disease is present but the client does not experience symptoms). Exacerbation is when the symptoms of the disease reappear. Chronic illnesses do not go away; the disease continues to be present. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 51.
The nurse is planning care for clients on the floor. Which client would most benefit from the nurse including interventions addressing emotional health? A.) adolescent client who is feeling sad and lonely after visiting hours ended B.) postpartum parent cradling their newborn C.) client with a new onset of acute kidney injury D.) client who is experiencing paranoid delusions
D.) client who is experiencing paranoid delusions Explanation: A client who develops paranoid delusions when faced with stressors is experiencing an alteration in emotional health. Nursing interventions that allow the client to feel safe and cope effectively with the stressors of life can enhance emotional health. A client with acute kidney injury has a physical health problem, an adolescent who is feeling sad and lonely after visiting hours has altered social health but is displaying expected emotions for this age group, and a postpartum parent cradling their infant is displaying appropriate bonding. Reference: Taylor, C., Lynn, P., & Bartlett, J., Fundamentals of Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2019, Chapter 3: Health, Wellness, and Health Disparities, p. 50.
