Chapter 42

The nurse meets with patients who have quit smoking or are planning to quit. Which statement made by a patient would lead the nurse to conclude that that patient is in the maintenance stage of change?

"Each day I don't smoke, I put money that I would have spent in a jar to pay for a vacation."

The nurse is conducting a risk appraisal related to the patient's lifestyle choices. What questions would be appropriate for the nurse to ask? Select all that apply.

"What is your job?" "What is your marital status?" "What are your hobbies?" "Are you sexually active?"

A patient with morbid obesity was enrolled in a weight loss program last month and has attended four weekly meetings. But now he believes he no longer needs to attend meetings because he has "learned what to do." He informs the nurse facilitator about his decision to quit the program. What should the nurse tell him?

"You have done well in this program. However, it is important to continue in the program to learn how to maintain weight loss. Otherwise, you are likely to return to your previous lifestyle."

The nurse conducts an assessment of a 38-year-old patient's fitness using the step test. At the end of the test, which heart rate would indicate the patient is in very poor physical condition?

134 beats/min

The nurse is caring for a patient with a nursing diagnosis of Activity Intolerance secondary to cardiac disease that causes the patient to produce less energy than is expended with activity. Which theory of health and wellness would support this nursing diagnosis?

Betty Neuman

The nurse is admitting an elderly resident to an assisted living facility. In order to determine the resident's level of physical fitness upon admission, which of the following components should be included in the assessment?

Cardiorespiratory fitness Muscular fitness Flexibility

A group of nursing students have been discussing the benefits of forming a study group. They realize that reviewing disease processes and treatments together may be more helpful in retaining new information and applying it to the clinical setting than if they continued to study individually. According to Prochaska and DiClemente's Transtheoretical Model of Change, which stage of behavior change are they exemplifying?

Contemplation

The nurse is implementing a wellness program based on data gathered from a group of low-income seniors living in a housing project. He is using the Wheels of Wellness as a model for his planned interventions. Which of the following interventions would be appropriate based on this model? Select all that apply.

Creating a weekly discussion group focused on contemporary news Facilitating a relationship between local pastors and residents of subsidized housing Coordinating a senior tutorial program for local children at the housing center Establishing an on-site healthcare clinic operating 1 day per week

Goals for Healthy People 2020 include which of the following? Select all that apply.

Eliminate health disparities among various groups. Increase the quality and years of healthy life.

A mother of three young children is newly diagnosed with breast cancer. She is intensely committed to fighting the cancer. She believes she can control her cancer to some degree with a positive attitude and feelings of inner strength. Which of the following traits is she demonstrating that is linked to health and healing?

Hardiness

Identify interventions that would be effective when assisting a client in making behavior changes that would reduce his health risk factors. Select all that apply.

Have the client identify two or three goals for change. Help the client to understand the benefits of change. Allow the client to identify available support and resources within the community.

The nurse, working in a substance abuse rehabilitation facility, is talking with a resident who says, "I'm just here to avoid going to jail. I'm not addicted to alcohol. I just enjoy it, but I'm going to quit to avoid getting arrested again." Which of Pender's Health Promotion Model assumptions is this resident demonstrating? Select all that apply.

Health professionals are part of the person's interpersonal environment. The person values positive growth and attempts to balance change and stability. The person seeks to actively regulate his own behavior.

A client informs the nurse that he has quit smoking because his father died of lung cancer 3 months ago. Based on his motivation, smoking cessation should be recognized as an example of which of the following?

Health protection

The nurse is teaching a class for diabetics and tells them, "Maintaining your blood glucose within normal limits helps reduce the risk for complications of diabetes." What type of activity does this class represent?

Health protection

The nurse is working with a client who is obese and reports having a sedentary lifestyle. What is the nurse's first action to promote this client's health?

Help the client identify goals for promoting health.

What teaching points will the nurse develop to address Healthy People 2020 goals? Select all that apply.

How to file for Medicaid How to maintaining a safe home and neighborhood How to develop and maintain a healthy lifestyle

According to Pender's Health Promotion Model, which variables must be considered when planning a health promotion program for a client? Select all that apply.

Individual characteristics and experiences Behavioral outcomes Behavior-specific cognition and affect

Which type of health promotion programs seeks to raise the level of knowledge and awareness of individuals and groups about health habits?

Information dissemination

The nurse is planning a health promotion class for young adult women. What topic would be most important for the nurse to include for this group?

Papanicolaou (Pap) test every 2 or 3 years

The new mother who just gave birth tells the nurse, "I don't know anything about babies, so I want you to teach me everything you can to help me be a good mother." What nursing diagnosis would be most appropriate for this patient? Readiness for Enhanced:

Parenting

The nurse working in an ambulatory care program asks questions about the client's locus of control as a part of his assessment because of which of the following? Select all that apply.

People who feel in charge of their own health are the easiest to motivate toward change. People who feel powerless about preventing illness are least likely to engage in health promotion activities. People who respond to direction from respected authorities often prefer a health promotion program supervised by a health provider.

The school nurse at a local elementary school is performing physical fitness assessments on the third grade children. When assessing students' cardiorespiratory fitness, the most appropriate test is to have the students:

Run a mile without stopping, if they can

The nurse teaches a class for the community discussing routine screening tests for different types of cancer. What level of health prevention would the nurse classify this activity?

Secondary

The nurse is planning a health promotion class for adolescents. The presentation is too long. Which topic would be least important and therefore appropriate for the nurse to delete?

Stranger danger

Which would be an appropriate topic for the elementary school nurse to include in health promotion activities for students?

Stranger danger

The nurse working in an acute care setting provides what level of health prevention most often?

Tertiary

A 55-year-old man suffered a myocardial infarction (heart attack) 3 months ago. During his hospitalization, he had stents inserted in two sites in the coronary arteries. He was also placed on a cholesterol-lowering agent and two antihypertensives. What type of care is he receiving?

Tertiary prevention