fundamentals of nursing 203 chp 6

Which statement by a patient supports the nurse's conclusion that the patient follows a holistic approach of healing? 1. "I am implementing changes in my behavior for better health." 2. "I am following a perfect regimen of diet and exercise every day." 3. "I am also using guided imagery and relaxation therapy for treatment." 4. "I am following prescribed medical therapies to lower the risk of heart attack."

"I am also using guided imagery and relaxation therapy for treatment." A patient who follows a holistic approach to healing recognizes the natural healing abilities of the body and may prefer guided imagery and relaxation therapy. Traditional methods of healing may also be used. A patient who follows health promotion will practice healthy food habits and exercise to maintain proper health. A patient who follows the transtheoretical model of change will practice proper behavior habits to promote healing. Patients who follow the health belief model have their own perceptions about illness and try to take actions related to lifestyle changes to prevent the risk of illness.

A patient comes to the local health clinic and states, "I've noticed how many people are out walking in my neighborhood. Is walking good for you?" Which is the best response to help the patient through the stages of change for exercise? 1. "Walking is okay, but I really think running is better because it burns more calories." 2. "Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" 3. "Yes, I want you to begin walking. Walk for 30 minutes every day and eat more fruits and vegetables." 4. "They probably aren't walking fast enough or far enough. You need to spend at least 45 minutes if you are going to do any good."

"Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" The patient's response indicates that the patient is in the contemplative state, possibly intending to make a behavior change within the next 6 months. The nurse's statement reinforces the behavior and provides a specific goal for the patient to begin a walking plan.

The nurse is teaching a group of student nurses about health belief models. Which components of the health belief model address the relationship between a person's beliefs and behaviors? Select all that apply. 1 Individual's perception of susceptibility to an illness 2 Individual's perception of duration of an illness 3 Individual's perception of management of an illness 4 Likelihood that a person will take preventive action against a disease 5 Individual's perception of the seriousness of an illness

1 Individual's perception of susceptibility to an illness 4 Likelihood that a person will take preventive action against a disease 5 Individual's perception of the seriousness of an illness The first component of the health belief model involves an individual's perception of susceptibility to an illness. Once individuals understand that they may be susceptible to a disease, they may be able to perceive the seriousness of the problem. The second component is an individual's perception of the seriousness of the illness. The third component is the likelihood that a person will take preventive action. Perception of duration and management of illness are not part of this model.

A 76-year-old patient has come to a clinic for a regular check-up. During the assessment the nurse finds that the patient is a chronic smoker. The patient is not alcoholic but is allergic to milk and seafood. Considering the patient's age, screening tests for colon cancer are performed, and the patient is advised to begin a high-fiber diet. The patient complains of pain in the legs. The Doppler study of the lower extremities reveals peripheral vascular disease (PVD). The patient is advised to exercise regularly. Which suggested interventions are included in primary prevention? Select all that apply. 1 Counseling for smoking cessation 2 Prescribing narcotic drugs for pain relief 3 Encouraging the patient to exercise regularly 4 Advising the patient to avoid milk products 5 Advising a high-fiber diet to prevent colon cancer

1 Counseling for smoking cessation 4 Advising the patient to avoid milk products 5 Advising a high-fiber diet to prevent colon cancer In primary prevention, measures are taken before the occurrence of disease or dysfunction. In this case, activities for primary prevention include counseling for smoking cessation, advising the patient to avoid milk products, and advising a high-fiber diet. Prescription of narcotics for pain relief is a secondary prevention, which is done after diagnosis. Encouraging the patient to exercise is a tertiary prevention against complications and disabilities related to peripheral vascular disease.

A male patient has been laid off from his construction job and has many unpaid bills. He is going through a divorce after 15 years of marriage and has been seeing his pastor to help him through this difficult time. He does not have a primary health care provider because he has never really been sick and his parents never took him to the physician when he was a child. Which external variables influence this patient's health practices? Select all that apply. 1 Difficulty paying bills 2 Seeing his pastor as a means of support 3 Family practice of not routinely seeing a health care provider 4 Stress from the divorce and the loss of a job 5 Family practice associated with the emotional aspects of seeing a health care provider

1 Difficulty paying bills 3 Family practice of not routinely seeing a health care provider External factors impacting health practices include family beliefs and economic impact. How a patient's family uses health care services generally affects the patient's own health practices. Their perceptions of the serious nature of diseases and their history of preventive care behaviors (or lack of them) influence how patients will think about health. Economic variables may affect a patient's level of health by increasing the risk for disease and influencing how or at what point the patient enters the health care system.

The nurse understands that there are many variables that affect the health beliefs and practices of an individual. Which are examples of external variables? Select all that apply. 1 Family practices 2 Socioeconomic factors 3 Developmental stages 4 Cultural beliefs 5 Spiritual factors

1 Family practices 2 Socioeconomic factors 4 Cultural beliefs Family practices, socioeconomic factors, and cultural beliefs are all external variables. Family health practices have a huge impact on how a person thinks and acts. An individual tends to follow the same health practices that the family members follow. An individual usually seeks support and approval for the health practices and beliefs from social support systems. This social system includes spouse, neighbors, and peers. Cultural beliefs influence the way an individual seeks medical care and affect the personal health practices. Developmental stages and spiritual factors are internal variables, which influence a person's health and health care beliefs and practices.

A 76-year-old patient with peripheral vascular disease (PVD) developed gangrene of the left foot and underwent an amputation. After the amputation, the patient was given crutches, and an occupational therapist assisted the patient to walk with crutches. The patient is depressed due to the loss of the foot and has been prescribed antidepressants. Which tertiary preventive measures should be advised for this patient? Select all that apply. 1 Implanting a prosthetic foot in the left leg 2 Referring the patient for vocational retraining 3 Referring the patient to social support groups 4 Advising the patient about measures to prevent accidents 5 Prescribing antidepressant medications to the patient

1 Implanting a prosthetic foot in the left leg 2 Referring the patient for vocational retraining 3 Referring the patient to social support groups Tertiary measures are taken after permanent, irreversible disability and focus on rehabilitation. The tertiary preventive measures in this case would include implantation of a prosthetic foot, referring the patient for vocational retraining, and referring the patient to social support groups. Advising the patient about measures to prevent accidents is a primary prevention activity. Prescription of antidepressants is a secondary prevention activity.

The nurse is learning about the holistic health model of nursing. Which statements are true about this model? Select all that apply. 1 It attempts to create conditions for optimal health. 2 It recognizes the natural healing abilities of the body. 3 It incorporates complementary and alternative therapies into nursing care. 4 It is used to understand the relationships of basic human needs. 5 It is based on the belief that certain human needs are more basic than others.

1 It attempts to create conditions for optimal health. 2 It recognizes the natural healing abilities of the body. 3 It incorporates complementary and alternative therapies into nursing care. The holistic health model attempts to create conditions for optimal health. It recognizes that the human body possesses a natural healing ability. These abilities can be used in patient care by incorporating complementary and alternative therapies such as music therapy and relaxation therapy. Maslow's hierarchy model helps to understand the relationships of basic human needs. It is based on the belief that certain human needs are more basic and need to be met before others.

Which risk factors for cerebrovascular disease are considered modifiable? Select all that apply. 1 Smoking five times a day 2 A sedentary lifestyle 3 A history of insulin dependent diabetes 4 Thromboembolic disease. 5 Eating pizza for dinner every night

1 Smoking five times a day 2 A sedentary lifestyle 5 Eating pizza for dinner every night Modifiable risk factors for a disease are in the patient's ability to control and/or change. Tobacco use, which increases the risk of cardiovascular disease, is modifiable. A sedentary lifestyle also increases the risk for cerebrovascular disease, and it is modifiable. Eating foods with poor nutritional value frequently increases risk for cerebrovascular disease, and it is modifiable. Although a patient with a history of insulin dependent diabetes will have an increased risk for cerebrovascular disease due to abnormal glucose regulation that affects the cerebrovascular system, this is a genetic and physiological factor, so is non-modifiable. Likewise, a patient with thromboembolic disease will have inadequate blood circulation, which may cause cerebrovascular disease, but this is a physiological factor responsible for cerebrovascular disease, not a modifiable risk.

A 45-year-old diabetic non-English-speaking woman whose husband died 12 years ago was found unconscious at home. Her neighbors brought her to the hospital 38 miles away. The patient was diagnosed with diabetic ketoacidosis (DKA). After initial interventions, the patient regained consciousness. She refuses to take insulin because it is against her religion. She is very upset and asks to see a chaplain. What should the nurse do to ensure the best care for the patient? Select all that apply. 1 Try to arrange a chaplain per the patient's request. 2 Give insulin, because only this can improve the patient's blood sugar level. 3 Inform the patient about the advantages and disadvantages of insulin. 4 Withhold insulin at this time, because it is against the patient's religious belief. 5 Arrange a language interpreter for better communication.

1 Try to arrange a chaplain per the patient's request. 3 Inform the patient about the advantages and disadvantages of insulin. 4 Withhold insulin at this time, because it is against the patient's religious belief. 5 Arrange a language interpreter for better communication.

A 45-year-old diabetic non-English-speaking woman whose husband died 12 years ago was found unconscious at home. Her neighbors brought her to the hospital 38 miles away. The patient was diagnosed with diabetic ketoacidosis (DKA). After initial interventions, the patient regained consciousness. She refuses to take insulin because it is against her religion. She is very upset and asks to see a chaplain. What should the nurse do to ensure the best care for the patient? Select all that apply. 1 Try to arrange a chaplain per the patient's request. 2 Give insulin, because only this can improve the patient's blood sugar level. 3 Inform the patient about the advantages and disadvantages of insulin. 4 Withhold insulin at this time, because it is against the patient's religious belief. 5 Arrange a language interpreter for better communication.

1 Try to arrange a chaplain per the patient's request. 3 Inform the patient about the advantages and disadvantages of insulin. 4 Withhold insulin at this time, because it is against the patient's religious belief. 5 Arrange a language interpreter for better communication. The nurse should take measures to address the internal variables of the patient to ensure she receives the best care. The nurse should arrange for a chaplain to visit to give the patient emotional and spiritual support. The nurse should explain the advantages and the disadvantages of insulin to the patient. This information will help the patient reconsider her decision. A language interpreter would improve communication and help the nurse better understand the patient's needs. The nurse should not decide whether or not to administer insulin without the patient's consent. However, insulin is needed to manage the patient's blood sugar level, so the nurse should explain the consequences of not taking insulin.

Stroke is a lifestyle disease. Which lifestyle factors may increase the risk of developing a stroke? Select all that apply. 1 Unhealthy diet 2 Physical inactivity 3 Excessive sun exposure 4 Tobacco use 5 Lack of immunizations

1 Unhealthy diet 2 Physical inactivity 4 Tobacco use An unhealthy diet, physical inactivity, and use of tobacco all could increase the risk of stroke. High fat content foods increase the risk of atherosclerosis, which in turn leads to stroke. Physical inactivity may lead to obesity, which again promotes deposition of fats in the blood vessels, thus increasing the risk of stroke. Tobacco use accelerates the process of atherosclerosis and also contributes to increasing the risk of stroke. Excessive sun exposure can cause cancer. A lack of immunizations may leave one susceptible to diseases such as influenza and hepatitis.

The nurse is providing information to a group of adolescents about contraception and the risk of human immunodeficiency virus (HIV) infection. What is the nurse teaching in this instance? 1 primary prevention 2 Secondary prevention 3 The health belief model 4 The holistic approach mo

1 primary prevention The nurse is teaching the adolescents the measures that should be taken to prevent human immunodeficiency virus (HIV) infection and unplanned pregnancy; therefore, the nurse is providing primary prevention. When providing secondary prevention, the nurse educates the patient about screening techniques available for specific diseases. The nurse respects the patient's cultural practices while following the health belief model of treatment. The nurse provides a traditional method of healing while providing a holistic approach to treatment. However, neither the health belief model nor the holistic approach are considered preventive care.

A patient has a cold with mild fever and is advised to rest for 3 days. Which patient statements would be classified under illness behavior? Select all that apply. 1. "I shouldn't cook dinner for my husband. I don't want him to get sick, too." 2. "I feel fine; I should go shopping." 3. "It's really bad; I have to stay at home, and it's boring." 4 "Maybe I can catch up on a few of my favorite movies." 5 "Praying may help me feel better.

1. "I shouldn't cook dinner for my husband. I don't want him to get sick, too." 3. "It's really bad; I have to stay at home, and it's boring." 4 "Maybe I can catch up on a few of my favorite movies." 5 "Praying may help me feel better. Illness behavior may include the disease and its effect on the well-being and level of functioning of the patient. Illness behavior includes the way people react to their diagnoses, interpret their symptoms, make decisions to cope, and use resources in the health care system. Exemption from cooking due to illness is an illness behavior. Feeling disappointed about staying home due to illness is an example of illness behavior. Planning to watch movies due to illness is an illness behavior. Planning to pray without fail to help treat the illness is also an illness behavior. Stating that one feels fine is not an illness behavior.

Which activity represents secondary prevention? 1. A home health care nurse visits a patient's home to change a wound dressing. 2. A 50-year-old patient with no history of disease attends the local health fair and has blood pressure checked. 3. The school health nurse provides a program to the first-year students on healthy eating. 4. A patient attends cardiac rehabilitation sessions weekly

1. A home health care nurse visits a patient's home to change a wound dressing. Secondary prevention focuses on individuals who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions. The home health nurse changing the wound dressing is an activity that is focused on preventing complications. Much of the nursing care related to secondary prevention is delivered in homes, hospitals, or skilled nursing facilities. Educational programs and cardiac rehabilitation sessions are examples of primary preventive measures.

The nurse understands that levels of preventive care include primary, secondary, and tertiary prevention. Which activities are included in primary prevention? Select all that apply. 1. Health education programs 2. Immunizations 3. Physical fitness activities 4. Diagnostic tests 5. Drug therapy

1. Health education programs 2. Immunizations 3. Physical fitness activities Health education programs, immunizations, and physical fitness activities aim at preventing illness and promoting health. These primary prevention activities are targeted towards physically and emotionally healthy people. Diagnostic tests and drug therapy are secondary levels of care and are performed when disease is already present.

A patient became disfigured in a car accident. Arrange the five phases of adjustment to the change in body image in correct order. 1. Acknowledgment 2. Acceptance 3. Withdrawal 4. Rehabilitation 5. Shock

1. Shock 2. Withdrawal 3. Acknowledgment 4. Acceptance 5. Rehabilitation When a change in body image occurs, patients go through different phases in adjusting to the change. The five phases include shock, withdrawal, acknowledgment, acceptance, and rehabilitation. The shock stage involves disbelief and an initial response to the change. The withdrawal stage is characterized by being isolated from others and having negative feelings. Acknowledgment is the recognition of the change, followed by acceptance. The last stage is rehabilitation, which is characterized by adjustments to resume a near-normal level of functioning.

The nurse is developing a health promotion program on healthy eating and exercise for high school students using the health belief model as a framework. Which statement is related to the perception of susceptibility to an illness? 1 "I don't have time to exercise because I have to work after school every night." 2 "I'm worried about becoming overweight and getting diabetes because my father has diabetes." 3 "The statistics of how many teenagers are overweight is scary." 4 "I've decided to start a walking club at school for interested students."

2 "I'm worried about becoming overweight and getting diabetes because my father has diabetes." The statement "I'm worried about becoming overweight and getting diabetes because my father has diabetes" indicates that the individual is concerned about developing diabetes and believes that there is a risk or susceptibility based on recognition of a familial link for the disease. Once this link is recognized, the individual may perceive the personal risk for diabetes. None of the other options recognizes a risk factor or susceptibility.

The nurse has been assigned to care for a 35-year-old patient who has developed new moles all over the body. On examination the nurse finds that the moles are different sizes and vary in color from brown to black. They are more commonly found on body parts exposed to sun. The nurse finds that the patient is a journalist. The patient's father died of melanoma many years back. What are the risk factors of melanoma in the patient? Select all that apply. 1 Age 2 Exposure to sunlight 3 Lifestyle 4 Genetic factor 5 Stressful workplace

2 Exposure to sunlight 4 Genetic factor Excessive exposure to sun rays increases the likelihood of developing skin cancers such as melanoma. Genetic factors are an important cause of cancer, which increase the patient's susceptibility to the disease. Age is not a risk factor for cancer. Lifestyle factors such as stress in the workplace do not predispose a person to cancer.

The nurse is conducting a health fair in a rural area to teach the importance of health promotion and illness prevention. Which topics and objectives should the nurse include in this session, according to Healthy People 2020? Select all that apply. 1 Dental hygiene 2 Sexually transmitted diseases 3 Injury and violence prevention 4 Mental health and mental disorders 5 Immunization and infectious disease

2 Sexually transmitted diseases 3 Injury and violence prevention 4 Mental health and mental disorders 5 Immunization and infectious disease Healthy People 2020 identifies goals set by the U.S. Department of Health and Human Services (USDHHS) to achieve a high quality of health for all and to create a safe environment. The initiative focuses on health topics and objectives that the nurse should include in the session. These include sexually transmitted diseases, injury and violence prevention, mental health and mental disorders, and immunization and infectious disease. The list also includes adolescent health, tobacco use, substance abuse, environmental health, and access to health care. Dental hygiene is not included in this list.

A patient comes to a rheumatology clinic with acute osteoarthritis, managed with maintenance medication. The patient's height is 167 cm (5 ft 5 in) and weight is 75kg (165 lb). The patient's body mass index (BMI) exceeds the average level. Which tertiary prevention interventions should the nurse suggest to the patient? Select all that apply. 1 Immunizations 2 Weight reduction 3 Continuing medication 4 Physical exercise 5 Diagnostic tests

2 Weight reduction 3 Continuing medication 4 Physical exercise The goal of tertiary prevention is to minimize the impact of an ongoing illness or injury that has lasting effects. Tertiary prevention for this patient includes weight reduction (prevents excess pressure on the affected joints), continuation of maintenance medication (reduces the pain of osteoarthritis and prevents progression of the disease), and physical exercise (maintains movement of joints, because stiffness of joints is a common problem in patients with osteoarthritis). Immunizations are considered primary prevention. Diagnostic tests are secondary prevention.

The nurse assesses the following risk factors for coronary artery disease (CAD) in a male patient. Which factors are classified as genetic or physiological? Select all that apply. 1. Sedentary lifestyle 2. Father died from CAD at age 50 3. History of hypertension 4. Diet high in sodium 5. Elevated cholesterol level 6. Age of 44 years

2. Father died from CAD at age 50 3. History of hypertension 5. Elevated cholesterol level Genetic risk factors are related to heredity and the genetic predisposition to an illness; physiological factors involve the physical functioning of the body. Certain physical conditions such as being pregnant or overweight place increased stress on physiological systems (e.g., the circulatory system), increasing susceptibility to illness in these areas. A person with a family history of coronary artery disease is at risk for developing the disease later in life because of a hereditary and genetic predisposition to the disease. Age, diet and lifestyle are not genetic or physiological risk factors.

The nurse is explaining the health belief model to a group of student nurses. Which statements are true about this model? Select all that apply. 1. It was proposed by Pender in 1982 and revised in 1996. 2. It addresses the relationship between a person's beliefs and behaviors. 3. An individual's perception of susceptibility to an illness affects behavior. 4. An individual's perception of the seriousness of the illness affects actions. 5. The access to health care facilities determines whether an individual will take preventive action.

2. It addresses the relationship between a person's beliefs and behaviors. 3. An individual's perception of susceptibility to an illness affects behavior. 4. An individual's perception of the seriousness of the illness affects actions. The health belief model addresses the relationship between a person's beliefs and behaviors and the impact of those beliefs on health. The individual's perception of susceptibility to an illness affects behavior towards the illness. An individual who perceives an increased susceptibility to an illness may take preventive action against the illness. An individual who perceives that the illness is serious may seek medical advice. The health belief model was proposed by Rosenstoch and Becker and Maiman. The access to health care facilities may affect the types of health care received but does not affect the preventive measures taken by the individual.

A patient approaches the nurse to learn about complementary and alternative interventions for a headache. Which complementary and alternative interventions should the nurse suggest to the patient to help attain a good outcome? Select all that apply. 1. Drug therapy 2. Music therapy 3. Therapeutic touch 4. Relaxation therapy 5. Radiation therapy

2. Music therapy 3. Therapeutic touch 4. Relaxation therapy Complementary and alternative therapies can be incorporated into the nursing care model for providing holistic care. These therapies promote the natural healing abilities of the body. Music therapy helps to provide a soothing environment. Therapeutic touch helps in relieving anxiety. Relaxation therapy helps to relax the body and mind. Drug therapy and radiation therapy are not alternative interventions.

he nurse is teaching a group of student nurses about the three levels of prevention. Which activities are included in the secondary prevention of diseases? Select all that apply. 1 Use of specific immunizations 2 Use of environmental sanitation 3 Individual and mass screening activities 4 Selective examinations to cure and prevent disease process 5 Provision of facilities to limit disability and prevent death

3 Individual and mass screening activities 4 Selective examinations to cure and prevent disease process 5 Provision of facilities to limit disability and prevent death The activities of secondary prevention are aimed at early diagnosis, prompt treatment, and disability limitation. The activities include individual and mass screening and selective examination to diagnose diseases in early stages and provide timely treatment. Secondary prevention also includes provision of facilities to limit disabilities and prevent death. Use of specific immunizations and use of environmental sanitation are included in primary prevention.

Which behavior would lead the nurse to anticipate that patients are in the contemplation stage of change? 1 They have integrated changes into their lifestyle. 2 They are actively involved in changing their behavior. 3 They have started developing a change in their behavior. 4 They are defensive when confronted about their behavior

3 They have started developing a change in their behavior. Patients in the contemplative stage will start to consider changing their behavior. Patients in the management stage will have successfully integrated the changes into their lifestyle. Patients in the action stage of health behavior changes will be actively involved in changing behavior. Patients in the precontemplation stage may become defensive about their behavior and refuse to change it.

Based on the transtheoretical model of change, which is the most appropriate response to a patient who states, "Me, exercise? I haven't done that since junior high gym class, and I hated it then!" 1. "That's fine. I don't exercise either because I hate it, too, and I don't think it's helpful." 2. "OI want you to walk 3 miles four times a week, and I'll see you in 1 month." 3. "I understand. Can you think of one reason why being more active would be helpful for you?" 4. "I'd like you to ride your bike three times this week and eat at least four fruits and vegetables every day.

3. "I understand. Can you think of one reason why being more active would be helpful for you?" The patient's response indicates that the patient is in the precontemplation stageand does not intend to change behavior in the next 6 months. In this stage the patient is not interested in information about the behavior and may be defensive when confronted with it. Asking an open-ended question may stimulate the patient to identify a reason to change behavior. Nurses are challenged to motivate and facilitate change in health behavior when working with individuals.

The head nurse is teaching student nurses about internal and external variables related to the development of a disease. Which factors are considered external variables? Select all that apply. 1. Emotional factors 2. Spiritual factors 3. Cultural background 4. Employment status 5.Family practices

3. Cultural background 4. Employment status 5.Family practices Both internal and external variables influence a person's health. External variables that affect the health of a person include socioeconomic factors such as cultural background, employment status, and family practices. Internal variables include developmental stage, intellectual background, emotional factors, and spiritual factors.

The nurse is caring for a patient who is quadriplegic. According to Maslow's hierarchy of needs, which patient needs should be given priority over others? Select all that apply. 1. Reassuring the patient 2. Allowing the family members to visit 3. Feeding the patient 4. Ensuring adequate fluid intake 5. Assisting with bladder or bowel elimination

3. Feeding the patient 4. Ensuring adequate fluid intake 5. Assisting with bladder or bowel elimination According to Maslow's hierarchy of needs, some human needs are more basic than other needs and should be met before other needs are met. Food, water, and elimination are basic needs and should be given priority over others. Reassurance helps to make the patient emotionally secure. A visit by family members makes the patient feel loved.

A patient suffering from chronic obstructive pulmonary disease (COPD) refuses to meet anyone, including family members. Which impact of the illness is the patient showing? Select all that apply. 1 Illness symptom 2 Coping 3 Health prevention 4 Changed self-concept 5 Impact on family role

4 Changed self-concept 5 Impact on family role The patient is experiencing an impact of illness on self-concept. A patient who refuses to interact with family members is also experiencing an illness reaction, which impacts the family role. Illness behaviors are a patient's reaction to the disease and a way of coping with the disease and its adversities. Behaviors are generally influenced by the way the patient perceives the illness to be, and adverse reactions are based on those perceptions. Refusing to meet anyone is not a symptom of chronic obstructive pulmonary disease (COPD). Health prevention is a way of preventing health problems from occurring.

A patient has joined a fitness club and attends aerobics class three nights a week. The patient is in what stage of behavioral change? 1. Precontemplation 2. Contemplation 3. Preparation 4. Action

4. Action The patient is in the action stage of behavioral change because the patient is actively engaged in strategies to change behavior. In precontemplation, the patient is not considering a change in behavior within the next 6 months. In contemplation, the patient is considering a change in 6 months, and in preparation, the patient makes small changes in anticipation of change that will occur in the next month.

Health

A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO, 1947) Different meanings for: Individual clients Different cultures values, personality and lifestyle

acute illness

A sudden illness from which a person is expected to recover

Which intervention comes under active strategies of health promotion? 1. Fortification of milk with vitamin D 2. Fluoridation of municipal drinking water 3. A weight reduction program for obese people 4. Fortification of cereals with vitamin A

A weight reduction program for obese people Active strategies of health promotion require a person to be actively involved in the measures taken to improve a condition and reduce the risk of disease. Therefore, a weight reduction program for obese people is an active strategy. In passive strategies of health promotion, individuals gain from the activities of others without acting themselves. Interventions such as fortification of milk with vitamin D, fluoridation of municipal drinking water, and fortification of cereals with vitamin A are classified as passive strategies.

Health Belief Model

Addresses the relationship between a person's beliefs and behaviors Perception of susceptibility to illness Perception of seriousness of illness Both of above determine the likelihood client will take preventative action Helps to plan care to best restore health

Holistic Health Model

Considers physical, emotional and spiritual well-being Incorporates complementary and alternative interventions

A patient wishes to join a relaxation therapy class after going through a period of prolonged stress due to a recent divorce. Initially the patient was reluctant to join the class, but after repeated sessions of counselling, the patient agreed. Arrange the stages of change that the patient experienced in the correct order. 1. Action 2. Preparation 3. Precontemplation 4. Contemplation

Correct 1. Precontemplation 2. Contemplation 3. Preparation 4. Action

The nurse is attending to patients in a postoperative unit. Based on the holistic model of care, which activities should the nurse encourage the patients to perform? Select all that apply. 1 Praying with family 2 Breathing exercises 3 Relaxation therapy 4 Fulfilling psychosocial need 5 Maintaining proper body image

Correct1 Praying with family Correct2 Breathing exercises Correct3 Relaxation therapy In the holistic method, the nurse recognizes the natural healing ability of the body. The nurse combines conventional medicine along with complementary and alternative therapies, which are effective, economical, and noninvasive. Prayers with family members, breathing exercises, and relaxation therapy are techniques that help in healing the patient naturally using the body's own ability. Fulfilling the psychosocial need of the patient comes under Maslow's hierarchy model.

Which is the desired outcome of the health promotion model? 1. Healthy People 2020 2. Encouraging health-promoting behavior 3. Modifying the personality of a person 4. Improving the physical, mental, and social health of all age groups

Encouraging health-promoting behavior Health-promoting behavior is the desired behavioral outcome and the end point in the health promotion model. Healthy People 2020 is a health initiative. Modifying the personality of a person is not a goal of the health promotion model. The health promotion model acknowledges that people are different and each person is unique. Improving the physical, mental, and social health of all age groups is not included in the health promotion model. These are activities included in the primary level of preventive care.

The nurse has conducted a primary prevention program for school children less than 10 years of age. Which nursing intervention is considered primary prevention? 1. Explaining the importance of a nutritious diet 2. Supplying a nutritious diet to children with malnutrition 3. Teaching disabled children to use their capacities to the fullest 4. Conducting health examinations to identify children with malnutrition

Explaining the importance of a nutritious diet Primary prevention interventions are done before the development of a disease or disorder. Interventions can take the form of health education or nursing interventions such as immunizations. Primary prevention also includes a nutritious diet to maintain health and prevent illness. Teaching disabled children to use their capacities to the fullest would be considered tertiary prevention, because disability has already occurred. Conducting health examinations to identify children with malnutrition and supplying nutritious diets to children with malnutrition would be considered secondary prevention, because these measures are directed toward managing a disease that has already manifested.

health promotion model

Health Promotion Model Directed at increasing a client's level of well-being Health-promoting behavior is the desired behavioral outcome

health beliefs

Health beliefs are a person's ideas, convictions, and attitudes about health and illness. They may be based on factual information or misinformation, common sense or myths, or reality or false expectations.

Self-actualization

Highest expression of individual potential

When taking care of patients, the nurse routinely asks them if they take any vitamins or herbal medications, encourages family members to bring in music that the patient likes to help the patient relax, and frequently prays with her patients if that is important to them. Which model of health and illness is the nurse practicing? 1. Holistic 2. Health belief 3. Transtheoretical 4. Health promotion

Holistic The nurse is using a holistic model of care that considers emotional and spiritual well-being and other dimensions of an individual to be important aspects of physical wellness. The holistic health model of nursing attempts to create conditions that promote optimal health. Nurses using the holistic nursing model recognize the natural healing abilities of the body and incorporate complementary and alternative interventions such as music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery because they are effective, economical, noninvasive, nonpharmacological complements to traditional medical care. The health belief model addresses the relationship between a person's beliefs and behaviors. The transtheoretical theory assesses an individual's readiness to change, and the health promotion model is directed at increasing a patient's level of well-being.

An elderly patient is admitted to a hospital for management of depression. The patient asks the nurse for permission to do meditation and breathing exercises for 15 minutes in the evening. The nurse has given the permission to do so. Which health model is reflected in this situation? 1. Health promotion model 2. Health belief model 3. Holistic health model 4. Restoration and rehabilitation model

Holistic health model The holistic health model emphasizes that all dimensions of an individual should be considered, including emotional and spiritual well-being, for the total wellness of an individual. Therefore, the approach used in this case comes under the holistic health model. The health promotion model focuses on individual characteristics and experiences, behavior-specific knowledge and affect, and behavioral outcomes. The health belief model addresses the relationship between a person's beliefs and behavior. Restoration and rehabilitation fall under tertiary prevention.

Which is the first step in health promotion, wellness education, and illness prevention? 1. Identifying risk factors 2. Identifying vulnerable people 3. Helping the patient improve health status 4. Emphasizing wellness strategies

Identifying risk factors When caring for a patient, the nurse must identify the risk factors and discuss health issues following a comprehensive nursing assessment. Assessment is followed by identification of vulnerable groups. Following this, the nurse can help patients decide if they want to maintain or improve their health status by taking risk-reducing efforts. Based on the assessment and the patient's needs, the nurse can emphasize wellness strategies.

illness

Illness Abnormal process in which any aspect of a person's functioning is diminished or impaired compared to client's previous condition Acute: Short duration Severe: Chronic, Last > 6 months

When illness occurs, different attitudes about the illness cause people to react in different ways. What do medical sociologists call this reaction to illness? 1. Health belief 2.Illness behavior 3. Health promotion 4. Illness prevention

Illness behavior Illness behavior involves how people monitor their bodies, define and interpret their symptoms, take remedial actions, and use the resources in the health care system. Personal history, social situations, social norms, and past experiences can affect illness behavior. Health beliefs are a person's ideas, convictions, and attitudes about health and illness. Positive health behaviors are activities related to maintaining, attaining, or regaining good health and preventing illness. Illness prevention motivates people to avoid a decline in health or functional levels.

Basic Human Needs Model

Interrelationship of basic human need

Intellectual Background

Knowledge/lack of knowledge Cognitive factors Developmental Disease process

A 45-year-old diabetic non-English-speaking woman, whose husband died 12 years ago, was found unconscious at her home. Her neighbors brought her to the hospital. The patient was diagnosed with diabetic ketoacidosis (DKA). After initial interventions, the patient regained consciousness. Which internal variables may influence the health of the patient? Select all that apply. 1. Language 2 Help from neighbors 3 Location of the patient 4 Location of the hospital 5 The patient's age and gender

Language The patient's age and gender Internal variables include a person's developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors. These factors may affect the health of a person. In this case the patient's language, age, and gender are internal variables. Factors such as help from neighbors, location of the hospital, and location of the patient are external variables.

While assessing the behavior of a patient with a drug addiction, the nurse observes that the patient has abstained from taking drugs for the past 6 months and has been practicing healthy eating habits. Which stage of behavior change does the patient exhibit? 1. Action 2. Preparation 3. Maintenance 4. Contemplative

Maintenance A patient who has abstained from drug use for the past 6 months and is following a proper health regimen is in the maintenance stage of behavior change. A patient in the action stage of behavior change will actively engage in change. A patient in the preparation stage will begin to change habits. A patient in the contemplative stage will consider making lifestyle changes for the next 6 months.

Negative health behaviors

Negative health behaviors include practices actually or potentially harmful to health such as smoking, drug or alcohol abuse, poor diet, and refusal to take necessary medications.

Positive health behavior

Positive health behaviors are activities related to maintaining, attaining, or regaining good health and preventing illness. Common positive health behaviors include immunizations, proper sleep patterns, adequate exercise, stress management, and nutrition.

The nurse has conducted an immunization program for physically challenged children in a rehabilitation center. Pneumonia vaccine was administered to the children as a part of the program. Which level of prevention is this? 1. Primary 2. Tertiary 3. Secondary 4. Early diagnosis

Primary Primary prevention includes measures taken before the occurrence of a medical problem. For example, vaccinations are given to children or adults to prevent a disease from occurring; thus, vaccinations come under the realm of primary prevention. Tertiary prevention is required when there is a permanent disability. Secondary prevention includes early diagnosis, treatment, and disability limitation.

The nurse is participating at a health fair at the local mall giving influenza vaccines to senior citizens. Which level of prevention is the nurse practicing? 1. Primary 2. Secondary 3. Tertiary 4. Quaternary

Primary Primary prevention is aimed at health promotion and includes health-education programs, immunizations, and physical and nutritional fitness activities. It can be provided to an individual and includes activities that focus on maintaining or improving the general health of individuals, families, and communities. It also includes specific protection such as immunization for influenza. Secondary prevention is diagnosing and treating an illness and limiting disabilities. Tertiary prevention includes restoration and rehabilitation. Quaternary prevention doesn't exist.

The nurse is teaching the parents of a school-aged child about the risks of physical and sexual abuse and methods necessary to educate the child about them. Which level of Maslow's hierarchy of needs is the nurse addressing? 1. Self-esteem 2. Safety and security 3. Love and belonging 4. Physiological needs

Safety and security The nurse is instructing the parents to teach the child about physical and sexual abuse to ensure the child's physical and psychological safety. Therefore, the nurse is addressing the safety and security level of Maslow's hierarchy of needs. The nurse addresses the child's need to feel love and belonging when instructing the parents to behave politely and provide protection. The nurse addresses the physiological needs of Maslow's hierarchy when instructing the parents to provide proper nutrition and shelter for their child. The nurse addresses self-esteem when patients are undergoing major psychological setbacks in life or are depressed.

The nurse is conducting a home visit with an older adult couple. She assesses that the lighting in the home is poor and there are throw rugs throughout the home and a low footstool in the living room. She discusses removing the rugs and footstool and improving the lighting with the couple. Which level of need is the nurse addressing, according to Maslow? 1 Physiological 2 Safety and security 3 Love and belonging 4 Self-actualization

Safety and security The teaching addresses the need for safety and security. The throw rugs, low lighting, and low stool are hazards that can cause falls in the elderly. Preventing falls is a priority safety issue for older adults. Physiological needs refer to the need for food, fluid, elimination, and so forth. Love and belonging refers to the need for relationships, and self-actualization is the need to feel fulfilled in life.

In the pyramid of Maslow's hierarchy of needs, which need of the patient is placed at the highest level? 1. Food 2. Love 3. Self-actualization 4. Physical safety

Self-actualization Maslow's model of the hierarchy of needs is used to understand the interrelationships of basic human needs. According to this model, basic needs are at the bottom and self-actualization is at the top. Self-actualization is considered the highest expression of one's individual potential, and it allows for the continual discovery of self. Food is considered a basic need and is thus placed at the bottom. The need for love comes after the need for physical safety.

Maslow's Hierarchy of Needs

Some needs necessary for human survival & health Some needs must be met before others Focus of care on client's needs, not strict adherence to hierarchy e.g Mastectomy client may need psyche care > physical Emergent physiologic need precedes higher level need Self-actualization Highest expression of individual potential

A patient experienced a myocardial infarction 4 weeks ago and is currently participating in the daily cardiac rehabilitation sessions at the local fitness center. In which level of prevention is the patient participating? 1. Primary 2. Secondary 3. Tertiary 4. Quaternary

Tertiary prevention Tertiary prevention involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration following myocardial infarction. Tertiary prevention activities are directed at restoration and rehabilitation. Care at this level aims to help patients achieve as high a level of functioning as possible, despite the limitations caused by illness or impairment. This level of care is called preventive care because it involves preventing further disability or reduced functioning. Primary prevention is aimed at health promotion and includes health-education programs, immunizations, and physical and nutritional fitness activities. Secondary prevention includes diagnosing and treating an illness and limiting disabilities. Tertiary prevention includes restoration and rehabilitation.

Developmental Stage

Thought and behavior patterns change throughout life

influencing variables on health and beliefs practices: internal variables

development stage intellectual background perception and functioning emotional factors spiritual factors

influencing variables in health beliefs and practices: external variables

family practices psychosocial socioeconomic factors cultural background

chronic illness

irreversible illness that causes permanent physical impairment and requires long-term health care