Chapter 3: Health Education and Health Promotion

ANS: A Rationale: EHRs enable clear communication among care team members and the collection of data for continuous improvement in client care. Electronic documentation is not always easier and most people are not opposed to it. Stating that all hospitals do this does not directly address their reluctance or state the benefits. The use of technology in health care settings is not specifically mandated by legislation. PTS: 1 REF: p. 72 NAT: Client Needs: Safe, Effective Care Environment: Management of Care TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

19. The nurse is performing a dietary assessment with a client who has been admitted to the medical unit with community-acquired pneumonia. The client asks if the nurse is posing so many questions about the client's dietary practices because the client is from another country. What is the nurse's best response to this client? A. "We always try to abide by foreign-born clients' dietary preferences to make them comfortable." B. "We know that some cultural and religious practices include dietary guidelines, and we do not want to violate these." C. "We wouldn't want to feed you anything you only eat on certain holidays." D. "We know that clients who grew up in other countries often have unusual diets, and we want to accommodate this."

ANS: B Rationale: Culture and religious practices together often determine whether certain foods are prohibited and whether certain foods and spices are eaten on certain holidays or at specific family gatherings. A specific focus on holidays, however, does not convey the overall intent of the dietary interview. Dietary planning addresses all clients' needs, not only those who are immigrants. It is inappropriate to characterize a client's diet as "unusual." PTS: 1 REF: p. 73 NAT: Client Needs: Psychosocial Integrity TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Apply NOT: Multiple Choice

20. In the course of performing an admission assessment, the nurse has asked questions about the client's first- and second-order relatives. What is the primary rationale for the nurse's line of questioning? A. To determine how many living relatives the client has B. To identify the family's level of health literacy C. To identify potential sources of social support D. To identify diseases that may be genetic

ANS: D Rationale: To identify diseases that may be genetic, communicable, or possibly environmental in origin, the interviewer asks about the age and health status, or the age and cause of death, of first-order relatives (parents, siblings, spouse, children) and second-order relatives (grandparents, cousins). This is a priority over the number of living relatives, sources of support, or health literacy, though each of these may be relevant. PTS: 1 REF: p. 75 NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice

21. The nurse is completing a family history for a client who is admitted for exacerbation of chronic obstructive pulmonary disease (COPD). The nurse should include questions that address which health problem? Select all that apply. A. Allergies B. Alcohol use disorder C. Fractures D. Hypervitaminosis E. Obesity

ANS: A, B, E Rationale: In general, the following conditions are included in a family history: cancer, hypertension, heart disease, diabetes, epilepsy, mental illness, tuberculosis, kidney disease, arthritis, allergies, asthma, alcohol use disorder, and obesity. Fractures and hypervitaminosis do not have genetic etiologies. PTS: 1 REF: p. 75 NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Response

22. Which action would the nurse perform during the inspection phase of the physical examination? A. Gather as many psychosocial details as possible by questioning the client. B. Pay attention to the details while visually observing the client. C. Document the client's breath sounds. D. Avoid letting the client know that the client is being assessed.

ANS: B Rationale: During inspection, it is essential for the nurse to pay attention to the details while visually observing the client. Gathering psychosocial details by questioning the client would occur during the health history, not during inspection (visual observation) or any other phase of the physical examination. Documenting the client's breath sounds would occur during auscultation (assessment by listening to body sounds with a stethoscope), not during inspection. It is not necessary avoid letting the client know that the client is being assessed. PTS: 1 REF: p. 84 NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

23. During a comprehensive health assessment, which structure can the nurse best assess by palpation? A. Brain B. Heart C. Thyroid gland D. Lungs

ANS: C Rationale: Many structures of the body, although not visible, may be assessed through the techniques of light and deep palpation. Examples include the superficial blood vessels, lymph nodes, thyroid gland, organs of the abdomen and pelvis, and rectum. The brain, encased within the skull, and the heart and lungs, located behind the ribs, are not accessible to palpation and are typically assessed via other methods (i.e., imaging, electroencephalograph, echocardiography). PTS: 1 REF: p. 84 NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice

24. A 51-year-old client's recent reports of fatigue are thought to be caused by iron-deficiency anemia. The client undergoes testing of the transferrin levels. This biochemical assessment would be performed by assessing which type of specimen? A. Urine B. Serum C. Cerebrospinal fluid (CSF) D. Synovial fluid

ANS: B Rationale: Biochemical assessments are made from studies of serum (albumin, transferrin, retinol-binding protein, electrolytes, hemoglobin, vitamin A, carotene, vitamin C, and total lymphocyte count) and studies of urine (creatinine, thiamine, riboflavin, niacin, and iodine). Transferrin is found in serum, not urine, CSF, or synovial fluid. PTS: 1 REF: p. 88 NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice

25. A school nurse at a middle school is planning a health promotion initiative for girls. The nurse has identified a need for nutritional teaching. What problem is most likely to relate to nutritional problems in girls of this age? A. Protein intake in this age group often falls below recommended levels. B. Total calorie intake is often insufficient at this age. C. Calcium intake is above the recommended levels. D. Folate intake is below the recommended levels in this age group.

ANS: D Rationale: Adolescent girls are at particular nutritional risk, because iron, folate, and calcium intakes are below recommended levels, and they are a less physically active group compared to adolescent males. Protein and calorie intakes are most often sufficient. PTS: 1 REF: p. 86 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

26. A team of community health nurses has partnered with the staff at a youth drop-in center to address some of the nutritional needs of adolescents. Which situation most often occurs during the adolescent years? A. Lifelong eating habits are acquired. B. Peer pressure influences growth. C. BMI is determined. D. Culture begins to influence diet.

ANS: A Rationale: Adolescence is a time of critical growth and acquisition of lifelong eating habits; therefore, nutritional assessment, analysis, and intervention are critical. Peer pressure does not influence growth. Cultural influences tend to become less important during the teen years; they do not emerge for the first time at this age. BMI can be assessed at any age. PTS: 1 REF: p. 86 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice

27. A nurse who has practiced in the hospital setting for several years will now transition to a new role in the community. How does a physical assessment in the community compare with that in the hospital? A. It consists of largely the same techniques. B. It does not require privacy. C. It is less comfortable for the client. D. It is less structured.

ANS: A Rationale: The physical assessment in the community and home consists of the same techniques used in the hospital, outpatient clinic, or office setting. Privacy is provided, and the person is made as comfortable as possible. The importance of comfort, privacy, and structure is similar in both settings. PTS: 1 REF: p. 73 NAT: Client Needs: Physiological Integrity: Basic Care and Comfort TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice

28. The nurse is conducting an assessment of a client in the client's home. The client is 91 years old, lives alone, and has no family members living close by. What should the nurse be aware of to aid in providing care to this client? A. Where the closest relative lives B. What resources are available to the client C. What the client's financial status is D. How many children the client has

ANS: B Rationale: The nurse must be aware of resources available in the community and methods of obtaining those resources for the client. The other data would be nice to know, but are not prerequisites to providing care to this client. PTS: 1 REF: p. 73 NAT: Client Needs: Physiological Integrity: Basic Care and Comfort TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

29. What is the nurse's rationale for prioritizing biochemical assessment when appraising a client's nutritional status? A. It identifies abnormalities in the chemical structure of nutrients. B. It predicts abnormal utilization of nutrients. C. It reflects the tissue level of a given nutrient. D. It predicts metabolic abnormalities in nutritional intake.

ANS: C Rationale: Biochemical assessment reflects both the tissue level of a given nutrient and any abnormality of metabolism in the utilization of nutrients. It does not focus on abnormalities in the chemical structure of nutrients. Biochemical assessment is not predictive. PTS: 1 REF: p. 88 NAT: Client Needs: Physiological Integrity: Reduction of Risk Potential TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

30. The nurse is providing care for a client who has several missing teeth. What is the most likely nutritional consequence the nurse should anticipate for this client? A. Inadequate intake of high-fiber foods B. Inadequate caloric intake C. Loss of fluid D. Malabsorption of nutrients

ANS: A Rationale: The most likely nutritional consequence for a client with several missing teeth is inadequate intake of high-fiber foods. Inadequate caloric intake, loss of fluid, and malabsorption would be less likely consequences. PTS: 1 REF: p. 92 NAT: Client Needs: Physiological Integrity: Basic Care and Comfort TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice

31. When caring for a client who predominantly identifies with another culture than the nurse, how can the nurse best demonstrate an awareness of culturally congruent care? A. Maintain eye contact at all times. B. Try to speak the client's primary language. C. Use touch when communicating. D. Establish effective communication.

ANS: D Rationale: Establishment of an environment of culturally congruent care and respect begins with effective communication, which occurs not only through words, but also through body language and other cues, such as voice, tone, and loudness. Not all cultures are comfortable with eye contact. Unless the nurse is fluent in the client's primary language, trying to communicate in that language would not be effective communication. Not all cultures incorporate touch while communicating. PTS: 1 REF: p. 94 NAT: Client Needs: Safe, Effective Care Environment: Management of Care TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Apply NOT: Multiple Choice

32. The nurse is preparing a discharge teaching session with a client to evaluate the client's ability to change a dressing. The client speaks and understands the dominant language only minimally. What would be the best way to promote understanding during the teaching session? A. Ask the client to repeat the instructions carefully. B. Write the procedure out for the client in simple language. C. Use an interpreter during the teaching session. D. Have the client demonstrate the dressing change.

ANS: C Rationale: Policies that promote culturally competent care provide translation services for clients with minimal ability in the dominant language. Writing instructions and asking the client to repeat instructions do not adequately compensate for the communication barrier that exists. Having the client demonstrate the procedure would demonstrate competency but does not address promoting understanding during a teaching session. PTS: 1 REF: p. 81 NAT: Client Needs: Safe, Effective Care Environment: Management of Care TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Apply NOT: Multiple Choice

33. The nurse is admitting a client with uncontrolled hypertension and type 1 diabetes to the unit. During the initial assessment, the client reports seeking assistance and care from the shaman in the client's community. What is the nurse's best response to the client's indication that the care provider is a shaman? A. "Thank you for providing the information about the shaman, but we will keep that information and approach separate from your current hospitalization." B. "It seems that the care provided by your shaman is not adequately managing your hypertension and diabetes, so we will try researched medical approaches." C. "Don't worry about insulting your shaman; the health care provider will explain to the shaman that the shaman's approach to your hypertension and diabetes was not working." D. "I understand that you value the care provided by the shaman, but we would like you to consider medications and dietary changes that may lower your blood pressure and blood sugar levels."

ANS: D Rationale: Some clients may seek assistance from a shaman or medicine man or woman. The nurse's best approach is not to disregard the client's belief in these healers or try to undermine trust in these healers. Nurses should make an effort to accommodate the client's beliefs while also advocating the treatment proposed by health science. The nurse's best response in incorporating these strategies is, "I understand that you value the care provided by the shaman, but we would like you to consider medications and dietary changes that may improve your blood pressure and blood sugar levels." PTS: 1 REF: p. 93 NAT: Client Needs: Psychosocial Integrity TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Apply NOT: Multiple Choice

34. The nurse is performing a cultural nursing assessment of a newly admitted client. What should the nurse include in the assessment? Select all that apply. A. Family structure B. Subgroups C. Cultural beliefs D. Health practices E. Values

ANS: A, C, D, E Rationale: Cultural nursing assessment refers to a systematic appraisal or examination of individuals, families, groups, and communities in terms of their cultural beliefs, values, and practices. Subgroups are not a specific focus of this assessment. PTS: 1 REF: p. 91 NAT: Client Needs: Psychosocial Integrity TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Remember NOT: Multiple Response

35. The quality improvement team at the hospital has recognized the need to better integrate the principles of transcultural nursing into client care. When explaining the concept of transcultural nursing to uninitiated nurses, how should the team members describe it? A. The comparative analysis of the health benefits and risks of recognizable ethnic groups B. Research-focused practice that focuses on client-centered, culturally competent nursing C. A systematic and evidence-based effort to improve health outcomes in clients who are immigrants D. Interventions that seek to address language barriers in nursing practice

ANS: B Rationale: Transcultural nursing, a term sometimes used interchangeably with cross-cultural, intercultural, or multicultural nursing, refers to research-focused practice that focuses on client-centered, culturally competent nursing. It is not limited to language barriers and foreign-born clients. It does not focus solely on health risks and benefits in ethnic groups. PTS: 1 REF: p. 72 NAT: Client Needs: Safe, Effective Care Environment: Management of Care TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Understand NOT: Multiple Choice

36. During an orientation class, the medical unit's nursing educator is presenting education on transcultural nursing to a group of newly licensed nurses. What should the staff educator identify as the underlying focus of transcultural nursing? A. To enhance the cultural environment of institutions B. To promote the health of communities C. To provide culture-specific and culture-universal care D. To promote the well-being of discrete, marginalized groups

ANS: C Rationale: The underlying focus of transcultural nursing is to provide culture-specific and culture-universal care that promotes the well-being or health of individuals, families, groups, communities, and institutions. It includes, but is not limited to, institutions, communities, or marginalized groups. PTS: 1 REF: p. 72 NAT: Client Needs: Safe, Effective Care Environment: Management of Care | Client Needs: Physiological Integrity: Basic Care and Comfort TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Understand NOT: Multiple Choice

37. The future of transcultural nursing care lies in finding ways to promote cultural competence in nursing students. How can this goal be best accomplished? A. By offering multicultural health studies in nursing curricula B. By enhancing the content of community nursing classes C. By requiring students to care primarily for clients from other ethnic groups D. By screening applicants according to their cultural competence ANS: A Rationale: Nursing programs are exploring creative ways to promote cultural competence and humanistic care in nursing students, including offering multicultural health studies in their curricula. Enhancing the content of community nursing classes would not necessarily achieve this goal. Matching students to clients from other cultures is often impractical, and applicants are not screened by their cultural competence. PTS: 1 REF: p. 73 NAT: Client Needs: Psychosocial Integrity | Client Needs: Physiological Integrity: Basic Care and Comfort TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Apply NOT: Multiple Choice

20. A public health nurse is planning educational interventions that are based on Becker's Health Belief Model. When identifying the variables that affect local residents' health promotion behaviors, what question should the nurse seek to answer? A. "Do residents believe that they have ready access to health promotion resources?" B. "Why have previous attempts at health promotion failed?" C. "How much funding is available for health promotion in the community?" D. "Who is available to provide health promotion education in the local area?"

ANS: A Rationale: Barriers, Becker's second variable, are defined as factors leading to unavailability or difficulty in gaining access to a specific health promotion alternative. The other listed questions do not directly relate to the four variables that Becker specified. PTS: 1 REF: p. 64 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

28. A nurse recognizes that individuals of different ages have specific health promotion needs. When planning to promote health among young adults, what subject is most likely to meet the learning needs of the demographic group? A. Family planning B. Management of risky behaviors C. Chronic illness management D. Relationship skills training

ANS: A Rationale: Because of the nationwide emphasis on health during the reproductive years, young adults actively seek programs that address prenatal health, parenting, family planning, and women's health issues. The other options are incorrect because they are not health promotion classes typically sought out by young adults. PTS: 1 REF: p. 67 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning | Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

8. Based on current knowledge of health promotion, what factor should the nurse prioritize in an effort to promote health, longevity, and weight control in clients? A. Good nutrition B. Stress reduction C. Use of vitamins D. Screening for health risks

ANS: A Rationale: It has been suggested that good nutrition is the single most significant factor in determining health status, longevity, and weight control. A balanced diet that uses few artificial ingredients and is low in fat, caffeine, and sodium constitutes a healthy diet. Stress reduction and screening for health risks are correct answers, just not the most significant factors. Vitamin use is not normally necessary when an individual eats a healthy diet, except in specific circumstances. PTS: 1 REF: p. 63 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

10. The nurse is teaching a local community group about the importance of disease prevention. Why is the nurse justified in emphasizing disease prevention as a component of health promotion? A. Prevention is emphasized as the link between personal behavior and health. B. Most individuals die of preventable causes. C. International organizations emphasize prevention as the main criterion of health care. D. The external environment affects the outcome of most disease processes.

ANS: A Rationale: Most deaths are not classified as being preventable. HMO priorities do not underlie this emphasis. The external environment affects many disease processes, but the course of illness is primarily determined by factors intrinsic to the client. PTS: 1 REF: p. 63 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice

24. The nurse is assessing the nutritional awareness of a client who is overweight. What outcome most clearly demonstrates that the client possesses nutritional awareness? A. The client avoids processed foods. B. The client uses vitamins and supplements to meet daily nutritional requirements. C. The client consumes store-bought, low-calorie cakes for snacks. D. The client chooses foods high in trans fat.

ANS: A Rationale: Nutritional awareness involves an understanding of the importance of a healthy diet that supplies nutrients through unprocessed foods. With healthy eating, vitamins and supplements should not be necessary to meet daily nutritional needs. Store-bought cakes, even low-calorie ones, are processed and refined and should be avoided. The client with nutritional awareness would choose a healthier unsaturated fat food rather than one with trans fats. PTS: 1 REF: p. 65 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

18. The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who has just received a new diagnosis of diabetes. Which client behavior demonstrates to the nurse the client's emotional readiness to learn? A. The client is asking questions about diabetes management. B. The client is no longer experiencing shortness of breath. C. The client describes a sibling with well-controlled diabetes. D. The client successfully follows a complex COPD regimen.

ANS: A Rationale: Seeking information about diabetes shows an emotional readiness and motivation to learn. No longer experiencing shortness of breath is an example of physical readiness to learn. Experiential readiness relates to previous experiences that may influence an individual's ability to learn. Having a sibling with well-controlled diabetes and being able to follow a complex regimen for COPD are examples of experiential readiness. PTS: 1 REF: p. 59 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Analyze NOT: Multiple Choice

33. Which of the following factors has most influenced the growing emphasis on health promotion in nursing? A. A changing definition of health B. An awareness that wellness exists C. An expanded definition of chronic illness D. A belief that disease is preventable

ANS: A Rationale: The concept of health promotion has evolved because of a changing definition of health and an awareness that wellness exists at many levels of functioning. The other options are incorrect because health promotion has not evolved because we know that wellness exists or a belief that disease is preventable. No expanded definition of chronic illness has caused the concept of health promotion to evolve. PTS: 1 REF: p. 64 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice

19. A nurse is planning an educational event for a local group of citizens who live with a variety of physical and cognitive disabilities. What variable should the nurse prioritize when planning this event? A. Health-promotion needs of the group B. Relationships between participants and caregivers C. Wellness state of each individual D. Learning needs of caregivers

ANS: A Rationale: The nurse must be aware of the participants' specific health promotion needs when teaching specific groups of people with physical and mental disabilities. This is a priority over the relationships between participants and caregivers, each person's wellness state, or caregivers' learning needs. PTS: 1 REF: p. 57 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

3. A gerontologic nurse has observed that clients often fail to adhere to their therapeutic regimen. What strategy should the nurse adopt to best assist an older adult in adhering to a therapeutic regimen involving wound care? A. Demonstrate a dressing change and allow the client to practice. B. Provide a detailed pamphlet on a dressing change. C. Verbally instruct how to change a dressing and check for comprehension. D. Delegate the dressing change to a trusted family member.

ANS: A Rationale: The nurse must consider that older adults may have deficits in the ability to draw inferences, apply information, or understand major teaching points. Demonstration and practice are essential in meeting their learning needs. The other options are incorrect because providing written instructions is not a substitute for a comprehensive teaching plan. Verbally teaching how to change a dressing and then checking for comprehension of the teaching is not as effective as demonstrating a dressing change and observing the client practicing the dressing change. Having a family member change the dressing when the client is capable of doing it impedes self-care and independence. PTS: 1 REF: p. 58 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

37. The nurse is working with a 15-year-old client who has diabetes and who is struggling with the necessary behavioral changes. Which of the following motivators is most likely to be effective? A. A learning contract B. A star chart C. A point system D. A food reward system

ANS: A Rationale: Using a learning contract or agreement can also be a motivator for learning. Such a contract is based on assessment of client needs; health care data; and specific, measurable goals. Young adults would not respond well to the use of star charts, point systems, or food as reward for behavioral change. These types of motivators would work better with children. PTS: 1 REF: p. 58 NAT: Client Needs: Safe, Effective Care Environment: Management of Care TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

29. Middle-aged adults are part of an age group that is known to be interested in health and health promotion, and the nurse is planning health promotion activities accordingly. To what suggestions do members of this age group usually respond with enthusiasm? Select all that apply. A. Lifestyle practices that can improve health B. Healthier eating practices C. Life benefits of exercise D. Strategies for adhering to prescribed therapy E. Exercise for the aging

ANS: A, B, C Rationale: Young and middle-aged adults represent an age group that not only expresses an interest in health and health promotion but also responds enthusiastically to suggestions that show how lifestyle practices can improve health; these lifestyle practices include nutrition and exercise. Middle-aged adults may not respond positively to teaching aimed at "the aging." Adherence is not noted to be a desired focus in this age group. PTS: 1 REF: p. 67 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Response

22. A parish nurse is describing the relationship between health and physical fitness to a group of older adults who all attend the same church. What potential benefits of a regular exercise program should the nurse describe? Select all that apply. A. Decreased cholesterol levels B. Delayed degenerative changes C. Improved sensory function D. Improved overall muscle strength E. Increased blood sugar levels

ANS: A, B, D Rationale: Clinicians and researchers who have examined the relationship between health and physical fitness have found that a regular exercise program can promote health in the following ways: by decreasing cholesterol and low-density lipoprotein levels; delaying degenerative changes, such as osteoporosis; and improving flexibility and overall muscle strength and endurance. Physical fitness does not directly improve the senses, and it tends to decrease blood sugar. PTS: 1 REF: p. 65 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Response

36. The nurse is providing client education to a client who was diagnosed 6 months ago with type 1 diabetes. The client's hemoglobin A1c results suggest the client has not been adhering to the prescribed treatment regimen. To help this client better adhere to the treatment regimen, the nurse should assess variables that affect the client's ability to perform which tasks? Select all that apply. A. Obtain resources. B. Teach friends about diabetes. C. Cure the disease. D. Maintain a healthy social environment. E. Adopt specific behaviors.

ANS: A, D, E Rationale: Nurses' success with health education is determined by ongoing assessment of the variables that affect a client's ability to adopt specific behaviors, obtain resources, and maintain a healthy social environment. The client's ability to teach friends about the condition is not a variable that the nurse would likely assess when educating the client about the treatment regimen. Type 1 diabetes is not curable. PTS: 1 REF: p. 57 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Response

38. A nurse working in a gerontology clinic as a member of a health care team recognizes that some older adults do not adhere to therapeutic regimens because of chronic illnesses that require long-term treatment by several health care providers. Which responsibility of the nurse is most important in this situation? A. Knowing all the dietary supplements the client is taking B. Working collaboratively with other team members to provide coordinated care C. Identifying all potential side effects of a medication the client is taking D. Having a peer witness their interactions with the client

ANS: B Rationale: Above all, health care professionals must work together to provide continuous, coordinated care; otherwise, the efforts of one health care professional may be negated by those of another. Interactions do not necessarily need to be witnessed. The care team should be aware of the client's use of supplements and familiar with potential side effects of a medication the client is taking, but these are not priority principles that guide overall care. PTS: 1 REF: p. 60 NAT: Client Needs: Safe, Effective Care Environment: Management of Care TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

30. A community health nurse has been asked to participate in a health fair that is being sponsored by the local senior center. Which principle of health promotion for older adults should the nurse use when developing educational activities? A. Older adults are not likely to perform health promotion activities. B. Older adults benefit from practices that help them maintain independence. C. Older adults with chronic illnesses are not likely to benefit from health promotion activities. D. Older adults are no longer in need of health promotion activities.

ANS: B Rationale: Although their chronic illnesses and disabilities cannot be eliminated, the older adult can benefit from activities that help them maintain independence and achieve an optimal level of health. Moreover, older adults, even those with chronic illness, are health conscious, view their health positively, and are likely to engage in health promotion activities. PTS: 1 REF: p. 68 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

13. The occupational health nurse is preparing health promotion programs for the workplace. Which program is the occupational health nurse most likely to develop to promote wellness? A. Self-care for diabetes B. Cholesterol screening C. Body-building D. Working efficiently

ANS: B Rationale: Health promotion includes health screenings, counseling, immunizations, and preventative medications. Health promotion programs in the workplace typically offer health screenings, such as cholesterol screenings. While a health promotion program may screen for glucose levels, workplace programs are typically not focused on self-care for a particular disease. Health promotion programs may also offer physical fitness programs to improve and maintain health; however, bodybuilding is not part of physical fitness for health promotion in the workplace. Working more efficiently may help to reduce stress, but this type of program is not likely to be developed by the occupational health nurse. PTS: 1 REF: p. 68 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

17. A team of public health nurses is doing a strategic plan and discussing health promotion activities for the next year. What initiative best demonstrates the principles of health promotion? A. A seminar on antiterrorism B. A family planning clinic at a community center C. An immunization clinic at the largest local mall D. A meeting about leadership styles

ANS: B Rationale: Health promotion may be defined as those activities that assist people in developing resources that maintain or enhance well-being and improve their quality of life. A family planning clinic meets these criteria most closely. An anti-terrorism seminar is not about health improvement. The immunization clinic will fall under the category of primary and secondary prevention. A leadership styles meeting is informational, but not about health promotion. PTS: 1 REF: p. 64 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

34. A nurse is working with a client who has recently received a diagnosis of human immunodeficiency virus (HIV). When performing client education during discharge planning, what goal should the nurse prioritize? A. Encourage the client to exercise within the client's limitations. B. Encourage the client to adhere to the client's therapeutic regimen. C. Appraise the client's level of nutritional awareness. D. Encourage a disease-free state.

ANS: B Rationale: One of the goals of client education is to encourage people to adhere to the therapeutic regimen. This is a very important goal because it is necessary if clients are to attain their optimal level of wellness. In this client's circumstances, this is likely a priority over exercise or nutrition, though these are important considerations. A disease-free state is not obtainable. PTS: 1 REF: p. 57 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

2. An 82-year-old client has come to the clinic for a scheduled follow-up appointment. The nurse learns from the client's child that the client is not following the instructions the client received upon discharge from the hospital last month. What is the most likely factor causing the client not to adhere to the therapeutic regimen? A. Ethnic background of health care provider B. Costs of the prescribed regimen C. Presence of a learning disability D. Personality of the primary provider

ANS: B Rationale: Variables that appear to influence the degree of adherence to a prescribed therapeutic regimen include gender, race, education, illness, complexity of the regimen, and the cost of treatments. The ethnic background and personality of the health care provider and the personality of the health care provider are not considered variables that appear to influence the degree of adherence to a prescribed therapeutic regimen. PTS: 1 REF: p. 57 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Remember NOT: Multiple Choice

14. A nurse is teaching a community program about the association between stress levels and negative health outcomes. The nurse should include the cause-and-effect relationship that stress has with which type of condition? A. Congenital defects B. Infectious diseases C. Traumatic injuries D. Chronic illnesses E. Genetic disorders

ANS: B, C, D Rationale: Studies suggest the negative effects of stress on health and a cause-and-effect relationship between stress and infectious diseases, traumatic injuries (e.g., motor vehicle crashes), and some chronic illnesses. Congenital defects, such as spina bifida and cleft lip, occur during pregnancy or birth due to hereditary conditions or environmental factors and are not linked to stress. Genetic disorders likewise typically result from genetic mutations due to inherited disorders or environmental factors occurring before birth, and are not associated with stress. PTS: 1 REF: p. 65 NAT: Client Needs: Psychosocial Integrity TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Understand NOT: Multiple Response

12. The nurse is planning to teach tracheostomy care to a client who will be discharged home following a spinal cord injury. When preparing to teach, which component of the teaching plan should the nurse prioritize? A. Citing the evidence that underlies each of the teaching points B. Alleviating the client's guilt associated with not knowing appropriate self-care C. Determining the client's readiness to learn new information D. Including several nursing colleagues in the planning process

ANS: C Rationale: Assessment in the teaching-learning process is directed toward the systematic collection of data about the person and family's learning needs and readiness to learn. Client readiness is critical to accepting and integrating new information. Unless the client is ready to accept new information, client teaching will be ineffective. Citing the evidence base will not likely enhance learning. Client guilt cannot be alleviated until the client understands the intricacies of the condition and their physiologic response to the disease. Inclusion of colleagues can be beneficial, but this does not determine the success or failure of teaching. PTS: 1 REF: p. 59 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

16. A nurse is working with a client who was recently diagnosed with asthma. During the current session, the nurse taught the client how to administer the bronchodilator by metered-dose inhaler. How should the nurse best evaluate the teaching-learning process? A. Ask the client specific questions about the medication. B. Ask whether the client now understands how to use the inhaler. C. Directly observe the client using the inhaler to self-administer a dose. D. Assess the client's respiratory health at the next scheduled visit.

ANS: C Rationale: Demonstration and practice are essential ingredients of a teaching program, especially when teaching skills. It is best to demonstrate the skill and then give the learner ample opportunity for practice. By observing the client using the inhaler, the nurse may identify what learning needs to be enhanced or reinforced. Asking questions is not an accurate gauge of learning. Respiratory assessment is a relevant, but indirect, indicator of learning. Delaying the appraisal of the client's technique until a later clinic visit is inappropriate because health problems could occur in the interval. PTS: 1 REF: p. 63 NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

26. Positive client outcomes are the ultimate goal of nurse-client interactions, regardless of the particular setting. Which of the following factors has the most direct influence on positive health outcomes? A. Client's age B. Client's ethnic heritage C. Health education D. Outcome evaluation

ANS: C Rationale: Health education is an influential factor directly related to positive client care outcomes. The other options are incorrect because ethnicity, the client's age, and outcome evaluation are less influential factors related to positive client care outcomes, though each factor should be considered when planning care. Outcomes should be evaluated, but this does not cause them to be successful, but rather identifies if they were achieved. PTS: 1 REF: p. 56 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Understand NOT: Multiple Choice

21. How should the nurse best define health? A. Health is the effort to systematically maximize wellness. B. Health is a state that is characterized by a lack of disease. C. Health is a condition that enables people to function at their optimal potential. D. Health is a deliberate attempt to mitigate the effects of disease.

ANS: C Rationale: Health is viewed as a dynamic, ever-changing condition that enables people to function at an optimal potential at any given time. Health does not necessarily denote the absence of disease, an effort to maximize wellness, or mitigate the effects of disease. PTS: 1 REF: p. 64 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Communication and Documentation BLM: Cognitive Level: Understand NOT: Multiple Choice

7. A class of nursing students has been asked to break into groups of four and complete a health-promotion teaching project and present a report to their fellow students. What project most clearly demonstrates the principles of health promotion teaching? A. Demonstrating an injection technique to a client for anticoagulant therapy B. Explaining the side effects of a medication to an adult client C. Discussing prevention of sexually transmitted infections (STI) to high school students D. Instructing an adolescent client how to avoid hypoglycemic episodes

ANS: C Rationale: Health promotion encourages people to live a healthy lifestyle and to achieve a high level of wellness. Discussing the importance of STI prevention to a group of high school students is the best example of a health promotion teaching project. Teaching a client an injection technique, side effects of medication, and how to avoid hypoglycemia are interventions to treat disease or illness and not examples of health promotion. PTS: 1 REF: p. 63 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

31. Which concept should the nurse use when performing health teaching? A. The primary goal of health teaching is to prevent illness. B. Health teaching requires a prescription from the client's primary care provider. C. Health teaching is an independent nursing function. D. The nurse must provide health teaching, even if the client refuses.

ANS: C Rationale: Health teaching and client education are included in each state's nurse practice act and are essential independent functions of the nurse that do not require a provider's order. Preventing illness is only one goal of health teaching. Other goals include promoting, maintaining, and restoring health, as well as helping clients adapt to illness. Although health teaching is a key responsibility of the nurse, nurses also need to recognize that each client has the right to accept or refuse education. PTS: 1 REF: p. 57 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice

35. A client with a recent diagnosis of which condition would most likely benefit from health education that emphasizes adherence? A. Colonization with methicillin-resistant Staphylococcus aureus (MRSA) B. Small bowel obstruction C. Multiple sclerosis D. A fractured humerus

ANS: C Rationale: Many people do not adhere to their prescribed regimens; rates of adherence are especially low (and thus health education is especially needed) when the regimens are complex or of long duration (e.g., therapy for tuberculosis, multiple sclerosis, and HIV infection, and hemodialysis). On the other hand, clients with more acute, short-term conditions (e.g., MRSA, a bowel obstruction, or an arm fracture), which have treatment regimens that are simpler and of shorter duration, would be less likely to benefit from health education that emphasizes adherence. PTS: 1 REF: p. 57 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

40. The nurse is working with a client who has diagnoses of coronary artery disease and angina pectoris. During a clinic visit, the nurse learns that the client has only been taking the prescribed antiplatelet medication when the client experiences chest pain and fatigue. What nursing diagnosis is most relevant to this assessment finding? A. Acute pain related to myocardial ischemia B. Confusion related to mismanagement of drug regimen C. Ineffective health maintenance related to inappropriate medication use D. Ineffective role performance related to inability to manage medications

ANS: C Rationale: This client's action suggests that by taking medications incorrectly the client is not adequately maintaining their health. Role performance is not directly applicable to the client's actions and confusion suggests a cognitive deficit. Pain is not central to the essence of the problem. PTS: 1 REF: p. 66 NAT: Client Needs: Safe, Effective Care Environment: Management of Care TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

11. The nurse is preparing discharge teaching for an adult client diagnosed with urinary retention secondary to multiple sclerosis. The nurse will teach the client to self-catheterize at home upon discharge. What teaching method is most likely to be effective for this client? A. A list of clear instructions written at a sixth-grade level B. A short video providing useful information and demonstrations C. An audio-recorded version of discharge instructions that can be accessed at home D. A discussion and demonstration between the nurse and the client

ANS: D Rationale: Demonstration and practice are essential ingredients of a teaching program, especially when teaching skills. It is best to demonstrate the skill and then give the learner ample opportunity for practice. When special equipment is involved, such as urinary catheters, it is important to teach with the same equipment that will be used in the home setting. A list of instructions, a video, and an audio recording are effective methods of reinforcing teaching after the discussion and demonstration have taken place. PTS: 1 REF: p. 59 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

6. A nurse is planning care for an older adult who lives with a number of chronic health problems. Which nursing diagnosis would educate the client and be the priority intervention? A. Risk for impaired physical mobility related to joint pain B. Functional urinary incontinence related decreased mobility C. Activity intolerance related to contractures D. Ineffective health maintenance related to nonadherence to therapeutic regimen

ANS: D Rationale: For some nursing diagnoses, such as ineffective health maintenance related to nonadherence to therapeutic regimen, education is a primary nursing intervention leading to a change in behavior and improved adherence. For the other nursing diagnoses listed, client education is important, but it is just one of many other interventions that must be performed to achieve the desired goal. PTS: 1 REF: p. 58 NAT: Client Needs: Safe, Effective Care Environment: Management of Care TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

15. A public health nurse understands that health promotion should continue across the lifespan. When planning health promotion initiatives, when in the lifespan should health promotion begin? A. Adolescence B. School age C. Preschool D. Before birth

ANS: D Rationale: Health promotion should begin prior to birth because the health practices of a mother prior to the birth of her child can be influenced positively or negatively. This makes the other options incorrect. PTS: 1 REF: p. 66 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Understand NOT: Multiple Choice

38. Computed tomography of a 72-year-old client reveals lung cancer with metastasis to the liver. The client's adult child has been adamant that any "bad news" be withheld from the client to protect the client from stress, stating that this is a priority in their family's culture. How should the nurse and the other members of the care team best respond? A. Explain to the adult child the team's ethical obligation to inform the client. B. Refer the family to social work. C. Have a nurse or health care provider from the client's culture make contact with the client and adult child. D. Speak with the child to explore the rationale and attempt to reach a consensus.

ANS: D Rationale: Nurses must promote open dialogue and work with clients, families, health care providers, and other health care providers to reach the culturally appropriate solution for the individual client. A referral to social work is not a sufficient response, and enlisting a caregiver from the same culture may not be ethical or effective. Although the nurse may need to explain to the client's child the team's ethical obligation to inform the client at some point, the best response is to speak further with the adult child to explore the rationale and attempt to reach a consensus. PTS: 1 REF: p. 93 NAT: Client Needs: Safe, Effective Care Environment: Management of Care TOP: Chapter 4: Adult Health and Physical, Nutritional, and Cultural Assessment KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Apply NOT: Multiple Choice

9. The nursing profession and nurses as individuals have a responsibility to promote activities that foster well-being. What factor has most influenced nurses' abilities to play this vital role? A. Nurses are seen as nurturing professionals. B. Nurses possess a baccalaureate degree as the entry to practice. C. Nurses possess an authentic desire to help others. D. Nurses have long-established credibility with the public.

ANS: D Rationale: Nurses, by virtue of their expertise in health and health care and their long-established credibility with consumers, play a vital role in health promotion. Nurses are not necessarily seen as nurturing, and a baccalaureate entry to practice is not in place in all jurisdictions. Not every nurse has a genuine desire to help others. PTS: 1 REF: p. 68 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Caring BLM: Cognitive Level: Understand NOT: Multiple Choice

4. A 20-year-old client newly diagnosed with type 1 diabetes needs to learn how to self-administer insulin. When planning the appropriate educational interventions and considering variables that will affect the client's learning, the nurse should prioritize what factor? A. Client's expected lifespan B. Client's gender C. Client's occupation D. Client's culture

ANS: D Rationale: One of the major variables that influence a client's readiness to learn is the client's culture because it affects how a person learns and what information is learned. Other variables include illness states, values, emotional readiness, and physical readiness. Lifespan, occupation, and gender are variables that are usually less salient. PTS: 1 REF: p. 59 NAT: Client Needs: Psychosocial Integrity TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Understand

27. A school nurse is facilitating a health screening program among middle school students. What purpose of health screening should the nurse prioritize when planning this program? A. To provide education to treat chronic diseases B. To evaluate the treatment of current health problems C. To identify the presence of infectious diseases D. To promote positive health practices

ANS: D Rationale: One purpose of health screening in the adolescent population is to promote positive health practices early in life. The purpose of a health screening is not to provide education to treat chronic illnesses, evaluate how current health problems are being treated, or to detect infectious diseases. PTS: 1 REF: p. 66 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice

1. A nurse has been working with a client whose poorly controlled type 1 diabetes has led to numerous health problems. Over the past several years the client has had several admissions to the hospital medical unit, and the nurse has often carried out health promotion interventions. Who is ultimately responsible for maintaining and promoting this client's health? A. The medical nurse B. The community health nurse who has also worked with the client C. The client's primary care provider D. The client

ANS: D Rationale: Society places a great importance on health and the responsibility that each of us ultimately has to maintain and promote our own health. Even though the medical nurse, community health nurse, and primary care provider all actively participate in promoting the client's health, the client must accept responsibility in order for health promotion to be successful. PTS: 1 REF: p. 65 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Understand NOT: Multiple Choice

5. The nurse is planning to teach a 75-year-old client with coronary artery disease about administering the prescribed antiplatelet medication. How can the nurse best enhance the client's ability to learn? A. Provide links to websites that contain evidence-based information. B. Exclude family members from the session to prevent distraction. C. Use color-coded materials that are succinct and engaging. D. Make the information directly relevant to the client's condition.

ANS: D Rationale: Studies have shown that older adults can learn and remember if the information is paced appropriately, relevant, and followed by appropriate feedback. Family members should be included in health education. The nurse should not assume that the client's color vision is intact or that the client possesses adequate computer skills. PTS: 1 REF: p. 58 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice

23. A nurse is discussing health promotion strategies with a client with elevated lipid levels. Which client response best indicates to the nurse that the client is exhibiting self-responsibility? A. "Teach my spouse about diet since I do not do the cooking." B. "I do not need to exercise since I am on my feet all day at work." C. "My father had high cholesterol levels, and he is in good health." D. "I will need to learn to read food labels when food shopping."

ANS: D Rationale: Taking responsibility for oneself is the key to successful health promotion. By taking the initiative to learn to read food labels, the client is demonstrating self-responsibility. Requesting that the spouse be taught about nutrition is not taking responsibility for one's health. By denying the benefits of regular exercise or that elevated lipids levels can lead to cardiovascular disease, the client is not demonstrating self-responsibility. PTS: 1 REF: p. 65 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

32. A nurse who provides care at the campus medical clinic of a large university puts much effort into health promotion. What purpose of health promotion should guide the nurse's efforts? A. To teach people how to act within the limitations of their health B. To teach people how to grow in a holistic manner C. To change the environment in ways that enhance cultural expectations D. To influence people's behaviors in ways that reduce risks

ANS: D Rationale: The purpose of health promotion is to focus on the person's potential for wellness and to encourage appropriate alterations in personal habits, lifestyle, and environment in ways that reduce risks and enhance health and well-being. The other options are incorrect because the purpose of health promotion is not to teach people how to "grow in a holistic manner," to accommodate their limitations, or to change the environment in ways that enhance cultural expectations. Growth is much broader than health and a focus on limitations does not promote health. PTS: 1 REF: p. 56 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice

25. A nurse has planned a teaching-learning interaction that is aimed at middle-school-aged students. To foster successful health education, the nurse's planning should prioritize what component? A. Pretesting B. Social and cultural patterns C. Client awareness D. Measurable interventions ANS: B

Rationale: A client's social and cultural patterns must be appropriately incorporated into the teaching-learning interaction. Pretesting may or may not be used; client awareness is a phrase that has many meanings, none of which make the teaching- learning interaction successful. Interventions are not measured; goals and outcomes are. PTS: 1 REF: p. 59 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Apply NOT: Multiple Choice

39. A client will be receiving outpatient intravenous antibiotic therapy for the treatment of endocarditis. The nurse is preparing health education to promote the client's adherence to the course of treatment. What cultural consideration should the nurse use when developing a teaching plan for the client? A. Apply general knowledge of the client's culture to the teaching plan. B. Acknowledge that culture does not affect the client's readiness to learn. C. Explain to the client that cultural health practices will interfere with antibiotic therapy. D. Perform an individual cultural assessment with the client. ANS: D

Rationale: Before beginning health teaching, nurses must conduct an individual cultural assessment instead of relying only on generalized assumptions about a particular culture. Consequences of ignoring the effects of a client's cultural practices can lead to misunderstanding, a lack of adherence to treatment, and poor health outcomes. The nurse should assess whether there are any cultural practices that may affect health outcomes and work with the client to develop an acceptable plan. PTS: 1 REF: p. 58 NAT: Client Needs: Health Promotion and Maintenance TOP: Chapter 3: Health Education and Health Promotion KEY: Integrated Process: Culture and Spirituality BLM: Cognitive Level: Apply NOT: Multiple Choice