Culture Midterm Ch. 4

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What is the Healthy People 2020 goal for health disparities? 1. Achieve health equity, eliminate disparities, and improve the health of all groups. 2. Reduce health disparities among Americans. 3. Eliminate health disparities among Americans. 4. Recognize health disparities among elderly.

Answer: 1 - achieve health equity, eliminate disparities, and improve the health of all groups 1. The Healthy People 2020 goal for health disparity is to achieve health equity, eliminate disparities, and improve the health of all groups. 2. This was the Healthy People 2000 goal for health disparities. 3. This was the Healthy People 2010 goal for health disparities. 4. This is not a Healthy People goal for health disparities.

Since health is viewed from many perspectives, what is essential for a healthcare provider to do for a patient? 1. Be able to understand health from the patient's viewpoint. 2. Allow time for the patient to process what the health care provider is doing. 3. Ensure the patient agrees with the medical plan of care. 4. Be sure the patient understands what the healthcare provider is saying.

Answer: 1 - be able to understand health from the patient's viewpoint 1. Being able to understand health from the patient's viewpoint will lessen the chances of misunderstandings arising between the patient and healthcare provider. 2. Allowing time for the patient to process what the healthcare provider is doing assumes the patient has no understanding of the health care system, which may be erroneous. 3. If treatment is given, the patient needs to agree with the plan of care, but this doesn't always have to be a medical plan of care, which assumes only a given medical regimen has validity. 4. While it is important for the patient to understand what the healthcare provider is saying, it implies that patients cannot understand healthcare language, which may be a misperception on the part of the healthcare provider to the patient.

Which definition of health would the nurse most likely use when assessing a patient's thinking about health? 1. Being in a state of physical, mental, and social well-being 2. Not having any discernible illness or disease 3. Having a harmonious, balanced relationship with nature 4. The ability to get up and go to work each day

Answer: 1 - being in a state of physical, mental, and social well-being 1. The World Health Organization offers the most commonly accepted holistic definition of health: when a person has a state of complete physical, mental, and social well-being, and not merely the absence of disease. 2. No sign of discernible illness or disease does not indicate overall health, but represents a physical definition of health. 3. A harmonious, balanced relationship with nature can occur with health or illness. 4. The ability to get up and go to work is a functional definition of health.

What would be the result of ambivalence during the dependent-patient role stage? 1. Create barriers that interfere with the treatment and willingness to comply. 2. Warrant further confirmation sought from family and friends about what is happening. 3. Have the person become aware that something is wrong. 4. Cause additional burdens to family and friends of the person at this time.

Answer: 1 - create barriers that interfere with the treatment and willingness to comply 1. Ambivalence during the dependent-patient stage can create a barrier that could interfere with treatment, and with the patient's willingness to comply with the treatment regimen. 2. Further confirmation sought from family and friends is part of the assumption of the sick role stage, where ambivalence is not a factor. 3. Becoming aware that something is wrong is the symptom experience stage. 4. Ambivalence would not cause additional burdens to family and friends, as this is an issue for the patient.

Which statement exemplifies how a nursing student views health? 1. Entered the health care profession with a culturally based concept of health 2. Forces patients to accept the medical definitions of health 3. Accepts the prevailing definition of health and applies it to individual patients 4. Must share the patient's views of health and illness

Answer: 1 - entered the health care profession with a culturally based concept of health 1. All people entering a healthcare profession do so with a personal or culturally based concept of health that will probably change during their education. It is important to consider this when working with patients. 2. Forcing patients to accept a medical definition of health is contrary to providing culturally appropriate care. 3. Accepting a prevailing definition of health, and applying it to patients, is not giving culturally appropriate care. 4. It is not necessary to share patients' views of health and illness, but to understand them to provide appropriate care.

For many people, health and illness are opposites which can make them view health as which of the following? 1. Freedom from evil that causes illness 2. A state of physical fitness 3. A state of emotional ambiguity 4. The reward for a productive life

Answer: 1 - freedom from evil that causes illness 1. Many people associate health and illness as opposites, such that health is good and illness is evil. Therefore, viewing health from this perspective sees health as the freedom from and absence of evil that causes illness. 2. Physical fitness is a functional definition of health, and being physically fit is healthy. 3. Emotional wholeness can be considered health if viewed as the opposite of illness, and therefore ambiguity would not be health. 4. Health as a reward for a productive life infers that a person cannot be productive if he or she is ill, which is not always true.

Why would healthcare providers refer to Healthy People 2020 when providing public health/community health patient care? 1. It provides a plan to continue to improve the health of everyone in the United States. 2. It supports policies which provide monetary incentives to states who reach the benchmark goals. 3. It serves as a monitoring system that evaluates the health of all citizens. 4. It is mandated legislation that will result in a healthier population by 2020.

Answer: 1 - it provides a plan to continue to improve the health of everyone in the U.S. 1. Healthy People 2020 is a government plan to improve the health for everyone in the United States. 2. Monetary incentives are not part of the benchmark goal achievement for Healthy People 2020. 3. Healthy People 2020 is not a monitoring system, though data is collected and evaluated to determine objective achievement. 4. Healthy People 2020 is not mandated legislation but a health program for the US people.

Besides being important public health issues and motivating people to action, what purpose do the Healthy People 2020 objectives serve? 1. Measure the impact of prevention activities. 2. Provide monetary worth to the nation. 3. Replace other tools. 4. Identify people needing secondary health services.

Answer: 1 - measure the impact of prevention activities 1. The Healthy People series provides science-based 10-year national objectives for improving the health of all Americans. Over the decades, Healthy People has established benchmarks and monitored progress in order to measure the impact of prevention activities. 2. The Healthy People 2020 objectives do not provide monetary worth to the nation. 3. Evaluation tools can be designed to measure progress. However, the Healthy People 2020 objectives were not designed to replace other tools. 4. The Healthy People 2020 objectives do not identify people needing secondary health services.

A patient is experiencing symptoms of an illness. In which stage of the illness experience would this patient seek a scientific diagnosis for the problem? 1. Medical care contact 2. Dependent-patient role 3. Symptom experience 4. Assuming the sick role stage

Answer: 1 - medical care contact 1. Seeking scientific answers to what is going on, rather than asking family and friends, is the medical care contact stage. 2. In the dependent-patient role stage, the patient is under the control of the physician, and is expected to accept and comply with prescribed treatment. 3. In the symptom experience stage, the person is both physically and cognitively aware that something is wrong, and responds emotionally. 4. When assuming the sick role stage, the patient seeks help and shares the problem with family and friends.

A patient comes to a healthcare provider concerned about a family history of diabetes. The provider addresses the patient's concerns and suggests interventions to diminish the patient's chances of developing the disease. What is this action considered? 1. Perceived benefits 2. Demographic variables 3. Perceived seriousness 4. Sociopsychological variables

Answer: 1 - perceived benefits 1. From a healthcare provider viewpoint, a protocol is followed when they are consulted about a potential or actual problem. Suggesting a course of action for a patient concerned about a family history of a disease is considered a perceived benefit when action is taken to prevent or mitigate the disease. 2. Demographic variables include race and ethnicity, which may or may not influence a family history of disease. This is a patient's view, not a provider's. 3. Perceived seriousness addresses the perception of the degree of a problem from the patient's own viewpoint, not the provider's. 4. Sociopsychological variables include social class, peer group, etc. that influence a patient's view, not a provider's view.

Which is an obligation of a person who is assuming the sick role? 1. Seek help and following it to promote recovery. 2. Stay away from others to prevent them from becoming ill. 3. Follow health orders without question. 4. Appear to be sick.

Answer: 1 - seek help and following it to promote recovery 1. While the sick person is not responsible for recovery, it is the responsibility of the sick person to seek help, then follow the advice given concerning the illness in order to recover. 2. Staying away from others to prevent them from becoming ill is not an obligation of the person in the sick role, but if the person has a contagious illness, it would be common sense to limit interactions with others. 3. Following health orders to recover is among the expectations of the sick role, but following them blindly without asking questions is not. 4. Appearing sick is not an obligatory role of the sick.

A patient does not understand what the healthcare provider is describing about a health problem. What is this discrepancy considered? 1. Structural variable 2. Demographic variable 3. Sociopsychological variable 4. Perceived susceptibility

Answer: 1 - structural variable 1. Structural variables differ when the provider and the patient see the problem from different angles. 2. Demographic variables address age, race, and ethnicity, which do not influence an individual determining cause of illness. 3. Sociopsychological variables come into play when a patient and health care provider differ about a cause of illness in terms whether the belief of the illness is traditional or modern. 4. Perceived susceptibility is the individual's own view of the seriousness of an illness, not its cause.

Which phases would a person experience during an illness trajectory? 1. Symptoms, diagnosis, treatment, rehabilitation 2. Symptoms, diagnosis, rehabilitation, treatment 3. Rehabilitation, treatment, recovery, symptoms 4. Diagnosis, treatment, symptoms, rehabilitation

Answer: 1 - symptoms, diagnosis, treatment, rehabilitation 1. Symptoms are often the first sign, followed by diagnosis, then treatment and lastly, rehabilitation. 2. A logical progression of phases during an illness trajectory may include presentation of the symptoms, followed by diagnosis of the symptoms, treatment, and recovery. 3. Rehabilitation is considered a later step in the illness trajectory that follows symptoms, treatment and recovery. 4. Diagnosis occurs after symptoms appear, followed by treatment and rehabilitation.

A patient has a family history of cardiac disease and has maintained lifestyle changes as a preventive measure. Within the overall perspective of perceived susceptibility, what is this patient demonstrating? 1. Taking action 2. Perceived seriousness 3. Perceived benefits 4. Changing modifying factors.

Answer: 1 - taking action 1. Taking action includes the changes a person makes when he or she feels susceptible in terms of illness or disease. Maintaining lifestyle changes would indicate the patient perceives the seriousness of the threat, and has taken steps to mitigate the danger or prevent it from occurring. 2. Perceived seriousness is the degree of seriousness with which the patient treats the issue. While the patient perceives the seriousness, the seriousness is not resolved until the action is taken. 3. Perceived benefits are achieved when the action is taken to prevent the cardiac disease, but won't occur until the action is taken. 4. Maintaining lifestyle changes is a modifying factor. Modifying factors include race, gender, and other sociopsychological variables.

A group of healthcare providers are attempting to define health. What can occur during this discussion? 1. Terms and meanings may be challenged. 2. Categories of health will be listed. 3. Ambiguity will be resolved. 4. Achieves a full acceptance by all parties

Answer: 1 - terms and meanings may be challenged 1. Defining health can yield many different explanations, all of which can be challenged by others, making it difficult to achieve one definition. 2. Listing categories of health gives physical components, but does not give a definition. 3. Discussion of health definitions doesn't clear up ambiguity, but opens up further ambiguity as to what health is. 4. It is essentially impossible for all to achieve acceptance of one definition of health.

The nurse determines that a patient is in the onset stage of an illness. What did the nurse observe in the patient? 1. The first symptoms of a given problem are experienced. 2. There is a gradual resumption of normal roles and activities. 3. The sick role becomes that of being a patient. 4. The disease is identified and socially sanctioned.

Answer: 1 - the first symptoms of a given problem are experienced 1. Alksen defines four stages of the illness experience. The onset stage is when the person experiences the first symptoms of a given problem. 2. Recovery is where a gradual resumption of normal roles and activities occurs. 3. Assuming a sick role that becomes being a patient is the stage of patient status. 4. Where the disease is identified and socially sanctioned is the diagnosis stage.

While reviewing the Healthy People 2020 document, the nurse identifies what as being the main objectives of the program?Select all that apply: 1. Address the relationship between health status and biology, behavior, services, social factors, and policies. 2. Emphasize an ecological approach to disease prevention and health promotion. 3. Ensuring all Americans have health insurance 4. Eliminating childhood diseases 5. Ensuring all Americans have one physical each year

Answer: 1,2 - address the relationship between health status and biology, behavior, services, social factors, and policies 1. Healthy People 2020 has an objective that addresses the relationship between health status and biology, individual behavior, health services, social factors, and policies. 2. Healthy People 2020 has an objective that emphasizes an ecological approach to disease prevention and health promotion. 3. Health insurance coverage for all Americans is not an objective of Healthy People 2020. 4. The elimination of childhood diseases is not an objective of Healthy People 2020. 5. Ensuring that Americans have an annual physical each year is not an objective of Healthy People 2020.

How would the definition of health differ between a beginning nursing student and a graduate nursing student? Select all that apply: 1. Health for the graduate nurse is more technical. 2. Health for the graduate student is more abstract. 3. Health becomes more tangible for the graduate nurse. 4. Health for the beginning nurse is a complex integration of parts. 5. Health becomes easier to define for the graduate nurse.

Answer: 1,2 - health for the graduate nurse is more technical, health for the graduate nurse is more abstract 1. The definition of health becomes more technical as the student advances in the educational program. 2. The definition of health becomes more abstract as the student advances in the educational program. 3. Tangible evidence of health is seen within the healthcare consumer and not the beginning or graduate nurse. 4. Health being viewed as a complex integration of parts would be applicable to the graduate nurse, since this definition is abstract and technical. 5. For the graduate nurse, the concept of health becomes more abstract and technical. There is no way of knowing if defining health becomes easier for the graduate nurse.

Why would the nurse review health status determinants when assessing a patient? Select all that apply: 1. Learn the patient's lifestyle. 2. Understand the patient's environment. 3. Identify how to measure progress. 4. Ability to motivate action 5. Identify ways to reduce health care costs.

Answer: 1,2 - learn the patient's lifestyle, understand the patient's environment 1. Lifestyle is a major determinant in disease prevention and health promotion. 2. Environmental factors are major determinants in disease prevention and health promotion. 3. A specific determinant to measure progress is not identified. 4. The ability for health status determinants to motivate action has not been identified. 5. Health status determinants are not used to identify ways to reduce health care costs.

Why does the nurse have difficulty defining health for a patient? Select all that apply: 1. Needs to use medical jargon 2. Difficult to find correct layperson's terms 3. There are too many definitions to choose from. 4. It cannot be defined. 5. Does not want the patient to believe that illness is because of bad behavior

Answer: 1,2 - needs to use medical jargon, difficult to find correct layperson's terms 1. It is difficult to give a definition of health that makes sense without using some form of medical jargon. 2. It is a challenge to define health in terms that a layperson can understand. 3. There might be many definitions of health; however, this is not the reason why it is difficult for the nurse to define health for a patient. 4. Health can be defined, and definitions can be found through a variety of resources. 5. In one context, illness has been equated with bad behavior. However, this is not the reason why the nurse is having difficulty defining health for the patient.

A patient says, "The doctors say I'm healthy, but I still don't feel well." What can the nurse infer from this statement about the patient's definition of health? Select all that apply: 1. The patient equates being healthy with feeling well. 2. The patient's definition of health includes more than the absence of physical symptoms. 3. Since the patient does not feel well, disease must be present. 4. The patient believes that a disease is still present. 5. The patient is experiencing pain.

Answer: 1,2 - the patient equates being healthy with feeling well, the patient's definition of health includes more than the absence of physical symptoms 1. One definition of health describes health as being symbolic of wellness. 2. Some people equate health as being more than the absence of physical symptoms. 3. One definition of health does include being free from disease. However, the nurse cannot infer this from the patient's statement. 4. One definition of health does include being free from disease. However, the nurse cannot infer this from the patient's statement. 5. A person who is healthy can experience pain. This is not what the nurse will infer from the patient's comment.

A patient is experiencing symptoms of an illness. Which behaviors would the patient demonstrate as part of the sick role? Select all that apply: 1. Calling off sick from work for a few days 2. Taking prescribed medications 3. Changing the diet and resting as prescribed 4. Resumption of normal activities 5. Asking friends and family to help diagnose the problem

Answer: 1,2,3 - calling off sick from work for a few days, taking prescribed medications, changing the diet and resting as prescribed 1. The sick person is exempted from the performance of certain normal social obligations, including work. 2. Being sick is being in need of help. Responsibilities of being a patient include complying with the prescribed medical regimen. 3. Being sick is being in need of help. Responsibilities of being a patient include complying with the prescribed medical regimen. 4. The resumption of normal activities is not a part of the sick role, but a part of the illness experience. 5. Asking friends and family to help diagnose the problem is not a part of the sick role, but a part of the illness experience.

After learning about a health problem, a patient is reluctant to take action. Which barriers could be influencing this patient's decision about taking action? Select all that apply: 1. Cost 2. Availability 3. Time 4. Social class 5. Use of jargon

Answer: 1,2,3 - cost, availability, time , 3 Explanation: 1. Cost is a factor that can act as a barrier to taking action. 2. Availability is a factor that can act as a barrier to taking action. 3. Time is a factor that can act as a barrier to taking action. 4. Social class is considered a modifying factor, and not a barrier to taking action. 5. The use of jargon is considered a structural variable, and is not a barrier to taking action.

Which actions or behaviors exemplify health maintenance? Select all that apply: 1. Having an annual physical with a healthcare provider 2. Complying with immunization schedules 3. Eating balanced meals 4. Regular exercise 5. Having health insurance

Answer: 1,2,3,4 - having an annual physical with a healthcare provider, complying with immunization schedules, eating balanced meals, regular exercise 1. Having an annual physical is a health maintenance practice that is preventive care to help someone maintain their level of health. 2. Logic suggests that in order to maintain health, disease must be prevented. This is accomplished by complying with immunization schedules. 3. Logic suggests that in order to maintain health, disease must be prevented. This is accomplished by eating balanced meals. 4. Logic suggests that in order to maintain health, disease must be prevented. This is accomplished by regular exercise. 5. Having health insurance is not an activity or behavior that exemplifies health maintenance.

Within the Healthy People 2020 document, what characteristics contribute to health disparities in the United States? Select all that apply: 1. Race 2. Religion 3. Gender 4. Age 5. Unemployment/underemployment

Answer: 1,2,3,4,5 - race, religion, gender, age, unemployment/underemployment 1. Health disparities as defined in Healthy People 2020 are those that affect a group of people experiencing obstacles to health based upon race. 2. Health disparities as defined in Healthy People 2020 are those that affect a group of people experiencing obstacles to health based upon religion. 3. Health disparities as defined in Healthy People 2020 are those that affect a group of people experiencing obstacles to health based upon gender. 4. Health disparities as defined in Healthy People 2020 are those that affect a group of people experiencing obstacles to health based upon age. 5. Health disparities as defined in Healthy People 2020 are those that affect a group of people experiencing obstacles to health and are based upon unemployment/underemployment.

A person comes to the Emergency Department seeking medical care for symptoms of an illness. What will legitimize the illness for the patient? Select all that apply 1. The health care professional who diagnoses the illness 2. The insurance company that pays for the illness treatment 3. Society's view of the illness 4. The person having the illness

Answer: 1,3 - the health care professional who diagnoses the illness, society's view of illness 1. The sick role of a person having an illness must be conferred by a healthcare professional who has the authority to make a legitimate diagnosis. 2. The insurance company pays when the legitimization of an illness and sick role is confirmed by a healthcare provider's diagnosis. 3. Society's view of an illness helps to confer the sick role on an individual having that illness, but must first be truly legitimized through confirmation by a health care professional. 4. The person having the illness cannot legitimize the illness and diagnosis by themselves. A healthcare provider must legitimize it with an official diagnosis pronouncement.

According to Suchman, what does assuming the sick role mean to a person? Select all that apply 1. Seeks help and shares the problem with family and friends 2. Goes under the control of a physician who plans a treatment of care 3. Seeks scientific confirmation that something is wrong 4. Becomes aware that something is wrong and responds emotionally

Answer: 1,4 - seeks help and shares the problem with family and friends, becomes aware that something is wrong and responds emotionally 1. During the assumption of the sick role stage, the person seeks help and shares the problem with family and friends to seek lay confirmation of symptoms, and to be temporarily excused from responsibilities such as work, school, and other activities. 2. Going under the control of a physician planning a treatment of care is the dependent-patient role stage. 3. Seeking scientific confirmation that something is wrong is the medical care contact stage, as opposed to the lay diagnosis requested during the assumption of the sick role. 4. Becoming aware that something is wrong, and responding emotionally to this, is the symptom experience stage.

4) Which statement exemplifies Murthy's belief about health as a culture? 1. Seeking medical care evolves in distinct stages. 2. Preventive healthcare must thrive. 3. As people define health for themselves, it becomes clearer. 4. Holistic defining of health remains the best explanation.

Answer: 2 - preventive healthcare must thrive 1. Health is somewhat of an elusive concept, but a person seeking medical care does so in distinct stages that reflect health status but not health. 2. Preventive healthcare is vital to a "culture of health." 3. Health definitions vary among individuals, and for healthcare providers, health becomes clearer through education. 4. Since health is an elusive concept, even holistic definitions may not be applicable to an individual patient.

Which illness trajectory would be seen in a person with acute myeloid leukemia (AML)? 1. Presenting symptoms, followed by diagnosis and treatment 2. Acute illness, unstable status, deterioration, and recovery 3. Diagnosis, treatment, unstable status, death 4. Presenting symptoms, followed by treatment and recovery

Answer: 3 - diagnosis, treatment, unstable status, death 1. Acute myeloid leukemia has presenting symptoms that are diagnosed and treated. Depending on the type diagnosed, treatment and ultimate resolution vary. 2. Not all acute myeloid leukemia variants result in a person being acutely ill, with an unstable status leading to deterioration and ultimately recovery. 3. After acute myeloid leukemia is diagnosed, treatment is given. Many treatments do result in an unstable status or death. The trajectory for AML is dependent upon many other factors. 4. Acute myeloid leukemia has presenting symptoms, but before treatment occurs, the particular type of leukemia must be determined, as treatment is specific to the type of leukemia.

While hospitalized, a patient enters the stage of patient status. What behavior will the nurse observe in this patient? 1. The person shifts into the role as it is determined by society. 2. The illness is now socially recognized and identified. 3. Symptoms are being experienced, leading to a diagnosis. 4. The patient does all that can be done to recover from his or her illness.

Answers: 1 - the person shifts into the role as it is determined by society 1. During the patient status stage, the person adjusts to the social aspects of being ill, and that person is expected to shift into this role as society determines it should be enacted. 2. Diagnosis is where the illness is diagnosed, socially recognized for what it is and identified. 3. The onset stage is where symptoms are first being experienced. 4. Recovery is the time when the patient is recovering and symptoms are disappearing.


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