Chapter 3

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:

age and developmental stage. explaination Age and developmental stage are important considerations in the health belief model. Other factors are influential, but age and developmental stage are paramount.

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?

Modifiable explaination 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.

An older adult client who has been hospitalized due to a stroke is about to be discharged from a rehabilitation center where the client had to relearn how to perform activities of daily living, including feeding and dressing. The client has often voiced a desire to be as active as possible. The client now expresses a strong desire to go home. The nurse recognizes that these statements made by the client indicate that the client is:

giving up the dependent role. explaination By stating that the client wants to be as active as possible, as well as healthy, the client is reflecting a desire to give up a dependent role and become more independent. Therefore, when at home, the client wants to resume normal activities and responsibilities. The client seems hopeful and not hopeless.

The client is admitted with a gastrointestinal bleed. The physician ordered a colonoscopy. Which level of care encompasses this procedure?

Secondary explaination 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.

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?

Sociocultural and intellectual explaination That the patient 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.

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?

Teaching about adhering to a low-sodium diet explaination 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.

An older adult patient 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?

Assuming a dependent role explaination The stage of assuming a dependent role often requires assistance in carrying out activities of daily living. As well, the patient 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 patient's present circumstances.

Why are health promotion and illness prevention a key responsibility of nurses?

Chronic illnesses are the leading health problem in the world. explaination 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.

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?

Instructing a client on how to use crutches explaination 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).

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?

It has a gradual onset and lasts for a long time. explaination 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.