Fundamentals of Success Theory-Based Nursing Care
A nurse is caring for an immobilized client who was admitted to the hospital with a pressure ulcer. Which type of stressor precipitated the pressure ulcer? A. Microbiological B. Physiological C. Chemical D. Physical
Answer: D Rationale: A. Pressure is not a microbiological stressor. Microbiological stressors precipitate infection. B. Pressure is not a physiological stressor. Physiological stressors are disturbances in structure or function of any tissue, organ, system, or body part. C. Pressure is not a chemical stressor. Chemical stressors are drugs, poisons, and toxins. D. The force of pressure is a physical stressor. Pressure is the continuous force of a body part on a surface as a result of gravity; compression of tissue occurs between a bony prominence and the surface on which the body part is resting. This force is external to the body. The pressure ulcer, which is the response, becomes a secondary stressor that is then physiological in nature.
Which statement does the nurse understand is most related to adaptations associated with the General Adaptation Syndrome? A. Adaptations depend on the nature of the stressor. B. Adaptations can be conscious or unconscious. C. Adaptations become secondary stressors. D. Adaptations are maladaptive responses.
Answer: B Rationale: A. The General and Local Adaptation Syndromes involve automatic nonspecific responses that are not dependent on specific stressors. The body automatically responds in the same way physiologically regardless of the nature of the stressor. B. Reactions to stress are both conscious and unconscious. In the General and Local Adaptation Syndromes, automatic physiological responses are not under conscious control. Adaptations, such as behavioral responses, are often under conscious control. C. Although an adaptation may become a secondary stressor, many do not. D. Adaptations can be maladaptive and fail to help a person achieve or maintain balance, or they can be positive and help a person achieve or maintain balance.
According to Maslow, which characteristic is least associated with a person who is self-actualized? A. Is autonomous B. Is able to see the good in others C. Has the ability to problem-solve D. Has an external locus of control
Answer: D Rationale: A. Self-actualized people are autonomous, independent, self-directed, and governed from within. B. Self-actualized people are friendly and loving. They respect themselves and others and seek out the good in others. C. Self-actualized people are accurate in predicting future events, highly creative, and open to new ideas and have superior perception. All these qualities contribute to problem-solving abilities. D. An external locus of control least describes self-actualized people. People with an external locus of control respond to a reward or recognition that comes from outside the self. People who are self-actualized strive to develop their maximum potential based on motivation from within.
The Kubler-Ross Stages of Grieving theory reflects a process that progresses through several stages to final acceptance. List these client statements in order according to the Kubler-Ross Stages of Grieving. 1. "I am going to get a second opinion." 2. "I find it so hard to think about the face that I don't have long to live." 3. "I've never smoked in my life. I shouldn't be the one with lung cancer." 4. "I'll have the chemotherapy because I want to see my children grow up." 5. "I don't want a big funeral because I want people to remember me and be happy."
Answer: 1, 3, 4, 2, 5 Rationale: 1. This statement reflects "doctor shopping," which is a form of denial, the first stage of the Kubler-Ross Stages of Grieving theory. The client is experiencing shock and disbelief. 2. This statement reflects depression, the fourth stage of the Kubler-Ross Stages of Grieving theory. The client is grieving over what is happening and what will never be. 3. This statement reflects the anger stage, the second stage of the Kubler Ross Stages of Grieving theory. The client is aware of the reality of the situation and is resentful and angry. 4. This statement characterizes the bargaining stage, the third stage of the Kubler-Ross Stages of Grieving theory. The client is negotiating for more time. 5. This statement characterizes acceptance, the fifth stage of the Kubler-Ross Stages of Grieving theory. The client has accepted the inevitable and is looking toward the future.
A nurse educator is conducting a class about child development for nurses. The nurse reviews the Stages of Moral Development Theory by Lawrence Kohlberg, emphasizing the reason an individual makes a moral decision in each of six stages. Place the following client statements in the order that reflects the motives for moral decisions as an individual progresses from stage one to stage six. 1. "I was following the rules." 2. "I did not want to get punished." 3. "I expected to receive a reward." 4. "I thought it was the right thing to do." 5. "I wanted others to see me as a good person." 6. "I was doing what is acceptable in our community."
Answer: 2, 3, 5, 1, 6, 4 Rationale: 1. The fourth stage of moral development is Maintaining Social Order. The motivation for behavior is based on following the rules to uphold the law. 2. The first stage of moral development is Obedience and Punishment. The motivation for behavior is fear of negative consequences (e.g., punishment, disapproval). 3. The second stage of moral development is Individualism and Exchange. The motivation for behavior is the desire for a positive consequence (e.g., reward, good result). 4. The sixth stage of moral development is Universal Principles. Motivation for behavior is based on abstract reasoning, universal ethical principles, and principles of justice. 5. The third stage of moral development is Interpersonal Relationships. The motivation for behavior is based on pleasing others because it is what others expect. 6. The fifth stage of moral development is Social Contract and Individual Rights. The motivation for behavior is based on differing beliefs and values but adheres to standards agreed upon by society.
A nurse is assessing a child in relation to the stages of Jean Piaget's Theory of Cognitive Development. Which behavior indicates that the child has reached the Formal Operations stage of cognitive development according to Piaget? A. Utilizes deductive reasoning when examining alternatives B. Uses logical thought to organize collected information C. Investigates objects by placing them in the mouth D. Employs language to communicate with others
Answer: A Rationale: A. Utilizing deductive reasoning to examine alternatives reflects the Formal Operations stage of cognitive development. These individuals use symbols related to abstract concepts and are capable of hypothetical and deductive reasoning. B. Using logical thought to organize information reflects the Concrete Operations stage of cognitive development. These individuals use logical thought to organize information and solve concrete problems. Also, they are less egocentric than when in previous stages. C. Investigating objects by placing them in the mouth reflects the Sensorimotor stage of cognitive development. These individuals process information on the physical or emotional level primarily through the senses. D. Employing language to communicate with others reflects the Preoperational stage of cognitive development. these individuals demonstrate an increasing ability to connect cognitively through language and actions.
Freedom from which situation demonstrates a safety and security need in Maslow's Hierarchy of Human Needs? A. Pain B. Hunger C. Ridicule D. Loneliness
Answer: A Rationale: A. According to Maslow's Hierarchy of Needs, freedom from pain is considered a safety and security need. Confusion sometimes occurs because other theorists, such as R. A. Kalish, believe that pain should be categorized along with adequate air, food, water, rest/sleep, shelter, elimination, and temperature regulation as a first-level physiological need. B. According to Maslow's Hierarchy of Needs, freedom from hunger is considered a first-level physiological need, not a safety and security need. C. According to Maslow's Hierarchy of Needs, freedom from ridicule is associated with self-esteem needs, not safety and security needs. D. According to Maslow's Hierarchy of Needs, freedom from loneliness is associated with the need to feel loved and to belong, not to feel safe and secure.
A nurse is analyzing information about a client. Which of the following does Maslow's Hierarchy of Needs theory help the nurse to identify? A. Client's problem that has top priority B. Developmental level of the client C. Coping patterns of the client D. Client's health beliefs
Answer: A Rationale: A. Client problems/needs can be ranked in order of ascending importance according to how essential they are for survival using Maslow's Hierarchy of Needs as a framework. Maslow identifies five levels of human needs. A person must meet lower-level needs before addressing higher-level needs. Physiological needs are first-level needs: air, food, water, sleep, shelter, etc.; safety and security needs are second; love and belonging needs are third; self-esteem needs are fourth; and self-actualization is the fifth-level need. B. Erikson's Developmental Theory is designed to identify a client's developmental level, not Maslow's Hierarchy of Needs. C. Maslow's Hierarchy of Needs is not designed to identify a person's coping patterns in response to stress. D. Rosenstock's and Becker's Health Belief Models, not Maslow's Hierarchy of Needs, identify the relationship between health beliefs and the use of preventive actions to promote health.
Which concept about health do nurses need to appreciate? A. Perceptions of health vary among cultures. B. To be considered healthy, a person needs to be productive. C. There must be an absence of illness for a person to be considered healthy. D. Underlying consensus exists among theorists about the definition of health.
Answer: A Rationale: A. Every individual is influenced by family, ethnic, and cultural beliefs and values. These beliefs and values influence a person's lifestyle through how one perceives, experiences, and cops with health, illness, and disability. The nurse must assess the impact of these influences on the client's health and health practices. B. Only in the Role-Performance Model of Health is productivity or performance of one's role a necessary component to be considered healthy. Although it is important to understand, it is a narrow definition of health and fails to include the multitude of other factors that impact on a definition of health. C. Absence of disease or injury is the foundation of the Clinical Model of Health and fails to include the multitude of other factors that have an impact on a definition of health. D. Health cannot be easily measured or defined in common terms. There is no consensus on a definition of health, because health is unique to each individual and is based on personal expectations and values.
A nurse is considering the Faith Development Theory by James Fowler while assessing several clients. Which clients does the nurse expect to assume responsibility for their own beliefs about faith? A. Older adolescents B. Young adolescents C. Older school-age children D. Young school-age children
Answer: A Rationale: A. Older adolescents and young adults assume responsibility for their own commitments, beliefs, and attitudes about faith. This reflects the individuative-reflective stage of faith development. B. Young adolescents begin to examine life-guiding beliefs, values, and attitudes about faith. This reflects the synthetic-conventional stage of faith development. C. Older school-age children may accept the concept of God and appreciate the perceptions of others. This reflects the mythic-literal stage of faith development. D. Children between 3 and 7 years of age imitate parental behaviors without thorough understanding. This reflects the intuitive-projective stage of faith development.
A nurse gives a client in a nursing home a choice about which color shirt to wear. Which level need, according to Maslow's Hierarchy of Needs, has the nurse just met? A. Self-esteem B. Physiological C. Safety and Security D. Love and Belonging
Answer: A Rationale: A. Choosing which color shirt to wear provides a person with the opportunity to make a choice and supports feelings of independence, competence, and self-respect, which all contribute to a positive self-esteem. B. Providing choices does not meet needs on the physiological level of Maslow's Hierarchy of Needs. Physiological needs are related to having adequate air, food, water, rest, shelter, and the ability to eliminate and regulate body temperature. C. Providing choices does not meet needs on the safety and security level of Maslow's Hierarchy of Needs. Safety and security needs are related to being and feeling protected in the physiological and interpersonal realms. D. Providing choices does not meet needs on the love and belonging level of Maslow's Hierarchy of Needs. Love and belonging needs are related to giving and receiving affection, attempting to avoid loneliness and isolation, and wanting to feel as though one belongs.
A nurse is differentiating between primary and secondary stressors. Which stressor is an example of a secondary stressor? Select all that apply. A. Pain B. Tachycardia C. Death of a spouse D. Shortness of breath E. Ingested microorganisms F. Increased blood pressure
Answer: A, B, D, F Rationale: A. Pain initially is a response to some previous primary stressor, threat, or stimulus. However, when pain stimulates additional responses in an effort to manage the pain, the pain becomes a secondary stressor. B. Tachycardia is a response to a primary stressor, such as trauma or a cardiac problem. Tachycardia then becomes a secondary stressor precipitating further adaptations in the individual. C. Death of a spouse is a primary psychosocial stressor, not a response to some previous stressor. D. Shortness of breath is a response to a primary stressor, such as cancer of the lung or a respiratory tract infection. Shortness of breath then becomes a secondary stressor precipitating further adaptations in the individual. E. Ingested microorganisms are a primary microbiological stressor, not a response to some previous stressor. F. An increase in blood pressure. It is a response to a primary stressor, such as a systemic infection or fear of the unknown. Then the increased blood pressure may become a secondary stressor.
A nurse is assessing a client who is experiencing prolonged stress. For which most serious complication should the nurse monitor the client? A. Altered sleeping B. Impaired immunity C. Increased muscle tension D. Decreased intestinal peristalsis
Answer: B Rationale: A. Difficulty sleeping is a common response to stress, but it is not life-threatening. Although it can contribute to fatigue, it is not as serious a concern as one of the other options presented. B. Impaired immunity is a serious threat caused by prolonged periods of stress. Stressors elevate blood cortisone levels, which decrease anti-inflammatory responses, deplete energy stores, lead to a state of exhaustion, and decrease resistance to disease. C. Increased muscle tension is a physiological indicator of stress. However, it is not as serious a concern as one of the other options presented. D. When stressed, the client's parasympathetic nervous system precipitates a decrease in intestinal peristalsis. Constipation is a concern, but it is not as serious as one of the other options presented.
Th Health Belief Model attempts to explain and predict health behaviors and focuses on which of the following? A. One's ability to fulfill one's assigned roles B. Constructs associated with perceived threat and net benefit C. Locus of control being important in one making choices about health behaviors D. People moving along a continuum from health on one end to illness on the other end
Answer: B Rationale: A. Fulfilling one's roles is the focus of the Role-Performance Model of Health and Wellness. This model states that health is defined in terms of a person's ability to fulfill societal roles; if roles are met, people perceive themselves as healthy even if they have an illness. B. The Health Belief Model focuses on perceived threats, severity, benefits, barriers, cues to action, and self-efficacy, which all influence a person's "readiness to act" in response to a health threat; Rosenstock first proposed this model during the 1950s. C. Locus of control is the focus of the Health Locus of Control Model. If the nurse knows that a client is motivated by either internal or external forces, then the nurse can plan internal or external reinforcement to motivate a client toward better health. D. This is the focus of the Health-Illness Continuum Model of health and wellness. This model focuses on health being on one end of the continuum and illness being on the other end. People move back and forth along the continuum based on their own perceptions, with no distinct boundary between health and illness.
A prospective nurse is being interviewed for a job by the nurse manager in an urgent care center. The nurse manager states that the facility adheres to a clinical model of health/illness. Which should the nurse anticipate will be expected of the nurses within this facility? A. Consider clients as holistic human beings. B. Make assessment of clients in the physiological domain. C. Identify the relationship between clients' beliefs and actions. D. Recognize if clients are able to perform their role within the family.
Answer: B Rationale: A. Holistic health care involves viewing all dimensions of the person, including emotional, mental, spiritual, and physical. This is a broad approach when compared with the clinical model. B. The clinical model, also known as the medical model, is concerned with the presence or absence of signs and symptoms of illness, disease, or injury. It is a narrow interpretation of health/illness because the focus is on the identification and treatment of a defect or dysfunction. Urgent care centers are concerned with meeting acute health-care needs. C. Identifying the relationship between clients' beliefs and actions is a component of the Health Belief Model of Health Behavior. It is unrelated to the clinical model of health/illness. D. Performing societal roles (e.g., parent, spouse, friend, and employee) is related to the Role Performance Model of Health. It is a narrow interpretation of health and is unrelated to the clinical model of health/illness.
Which person is considered healthy when referring to the Role-Performance Model of Health? A. Coal miner who retires after acquiring black lung disease B. Coach who continues to coach after becoming a paraplegic C. Brick layer who takes a leave of absence while recovering from hernia surgery D. Police officer who sells alarm systems after leaving the force because of being shot while on duty
Answer: B Rationale: A. If a person retires because of illness, the person has not met society's expectation in terms of role performance and, therefore, is considered unhealthy in light of the Role-Performance Model of Health. B. According to the Role-Performance Model of Health, as long as a person can perform work associated with societal roles, even if a person is limited physically, the person is considered healthy. A coach who continues coaching even though ill or disabled is considered healthy in light of the Role-Performance Model of Health. C. According to the Role-Performance Model of Health, a person who cannot fulfill responsibilities associated with one's job is considered sick. Therefore, a person who takes a leave of absence from work to recover is someone who is considered unhealthy in this model. D. A strict interpretation of the Role-Performance Model of Health will most likely describe a police officer who changes jobs because of a physical or emotional inability to continue the first job as unhealthy. even though the former police officer is still a wage earner, it is not in the same job.
A client with terminal cancer is willing to try new therapies. Which stage of Kubler-Ross Stages of Grieving does the nurse identify that the client is experiencing? A. Denial B. Depression C. Bargaining D. Acceptance
Answer: C Rationale: A. A client in the denial stage of grieving refuses to believe that the event is happening and is unable to deal with practical problems, such as trying new therapies. B. A client in the depression stage of grieving usually will acknowledge the reality and inevitability of the impending loss, will grieve the loss of present relationships and future experiences, and may stop all but palliative therapy. C. A client in the bargaining stage of grieving seeks to avoid the loss and will try new therapies to gain more time. D. A client in the acceptance stage of grieving comes to terms with the loss. The client begins to detach from surroundings and supportive people and generally no longer has the emotional or physical energy to try new therapies.
A nurse is caring for a newly admitted client. The nurse collects data and reviews that client's clinical record. Which level need is the priority for this client according to Maslow's Hierarchy of Needs? CLIENT'S CLINICAL RECORD Vitals Signs - Temperature: 99.8F, temporal - Pulse: 110 beats per minute - Respirations: 24 breaths per minute Pain Assessment - Reports a part level of 9 on a scale of 0 to 10 - "Sharp, piercing pain" - Located in lower left abdomen - Pain started 3 days ago and became progressively worse Social History - 65-year-old female - Smokes one pack of cigarettes daily for 45 years - Drinks alcohol socially on weekends - Husband of 45 years died of colon cancer 1 year ago - States that she "misses him a lot" - Daughter wants her to move in with her, but client states she wants to remain independent because she is able to take care of herself - Participates in a sewing group at her church, making pillowcases for hospitalized children A. Physiologic B. Self-esteem C. Safety and security D. Love and belonging
Answer: C Rationale: A. A need in the physiologic level is not the priority. Although the pulse and respiratory rates are slightly higher than the expected (normal) ranges, they most likely are a response to the pain experienced by the client. B. There are no data to support the conclusion that a need in the self-esteem level exists. The client reports that she wants to remain independent and is able to care for herself. C. Pain is a safety and security level need based on Maslow's Hierarchy of Needs. Pain relief is the client's priority need. D. A need in the love and belonging level is not the priority. The client's daughter appears to be concerned about the client's wellbeing. However, the client disagrees with moving in with her daughter.
A nurse is assessing a client who experienced an emotional stress. Which most common response should the nurse anticipate the client will exhibit? A. Anger B. Denial C. Anxiety D. Depression
Answer: C Rationale: A. Although anger may be identified as a reaction to stress, it is not the most common response to stress. Anger is more classically seen in the Kubler-Ross second stage of dying/grieving. B. Denial is more commonly seen in the Kubler-Ross first stage of dying/grieving, not as the most common response to stress. C. Anxiety is the most common response to all new experiences that serve as an emotional threat. D. Depression is an extreme response to prolonged stress and is not the most common human response to stress.
A nurse is caring for a group of clients. A client experiencing which of the following situations does the nurse anticipate will have the hardest time coping? A. Scheduled for a biopsy B. Unable to control the course of illness C. Challenged by a multiplicity of stressors D. Having to relocate to an assisted-living facility
Answer: C Rationale: A. Although waiting for the results of a biopsy is stressful, it is not as stressful as one of the other options presented. B. Although being unable to control the course of illness is stressful, it is not as stressful as one of the other options presented. C. As the multiplicity of stressors increases, it becomes harder for a person to cope. As each stress is added, the accumulated impact is greater than just the sum of each individual stressor. D. relocation is stressful whether it is voluntary or involuntary. However, it is not as stressful as one of the other options presented.
Which statement best reflects a principle common to all theories of health, wellness, and illness? A. A sense of well-being is synonymous with health. B. People are able to control factors that affect health. C. Many variables influence a person's perception of health. D. A person who is able to meet the demands of one's role is necessary for health.
Answer: C Rationale: A. Not all models of health agree with this view of health. For example, the Clinical Model has a narrow interpretation that views health as the absence of signs and symptoms of disease or injury. Well-being is a subjective perception of energy and vigor. A person able to carry out daily tasks, interact successfully with others, manage stress and emotions, and strive for continued growth and who has meaning or purpose in life ha a sense of well-being, regardless of the severity of disease or infirmity. B. Not all definitions of health identify that a person is able to control factors that affect health. The Adaptive Model is one of the few that addresses a person's ability to use purposeful adaptive responses and processes in response to internal and external stimuli to achieve health. C. There is a little consensus about any one definition of health, wellness, and illness. However, all definitions of health, wellness, and illness address the fact that there are a number of factors that influence health. D. Not all definitions of health define health in terms of an individual's ability to fulfill societal roles. For example, the Clinical Model views people from the perspective of a physiological system with related functions with health being the absence of disease or injury.
A nurse is caring for a client who was exposed to a stressful event. Which statement about the General Adaptation Syndrome should the nurse consider when caring for this client? A. A stressful event is an iatrogenic stress. B. An individual exposed to a stressful events will adapt in a unique way. C. A stressful event will precipitate an autonomic nervous system response. D. An individual exposed to a stressful even eventually will achieve homeostasis.
Answer: C Rationale: A. Not all stressful events are iatrogenic stresses. An iatrogenic stress is a stimulus caused by a treatment or diagnostic procedure. B. The General Adaptation Syndrome is a common physiological response to stress that follows a uniform, not unique, pattern in everyone. C. Stressors precipitate the General Adaptation Syndrome, which is a neuroendocrine response and part of the autonomic nervous system. D. Not everyone achieves homeostasis. Some individuals reach the stage of exhaustion.
A nurse is caring for a client recently diagnosed with advanced cancer. Which client statement reflects the Kubler-Ross stage of denial in the grief process? Select all that apply. A. "Why did this have to happen to me now?" B. "How could this happen when I quit smoking cigarettes?" C. "Maybe they mixed up my records with someone else's records." D. "I probably will not live long enough to see my children married." E. "What's the point in doing anything? They tell me I am going to die soon anyway."
Answer: C Rationale: A. This statement characterizes the anger, not denial, stage in the grieving process. During the anger stage, the person may vent hostile feelings or displace these feelings on others through acting-out behaviors. B. This statement characterizes the anger, not denial, stage of the grieving process. During the anger stage, the person may question, "Why me, when I did everything right?" C. This statement characterizes the denial stage of the grieving process. When in denial, a client may identify reasons why the diagnosis is not possible. D. This statement characterizes the depression stage of the grieving process. During the depression stage, the client realizes the full impact of the situation and grieves future losses. E. This statement characterizes the depression stage of the grieving process. During the depression stage, the client realizes the full impact of the situation and grieves future losses.
A nurse is teaching a course about death and dying to a community group. Which is most important for the nurse to teach parents about preparing a child for the death of a grandparent? A. Wait until the child asks a question about the situation. B. Have the child participate in mourning rituals. C. Begin at the child's level of understanding. D. Praise the child for being strong.
Answer: C Rationale: A. Waiting until the child asks a question is not an effective way to deal with childhood grieving. Children are perceptive and capable of recognizing that something is wrong but may not know what questions to ask. Avoiding discussing the loss with the child may make the child feel afraid, lonely, or even abandoned. B. The child's age, level of understanding, feelings, and fears will determine how much the child should engage in mourning rituals. Children should not be forced to attend mourning rituals, nor should they be pushed aside in an attempt to protect them from pain, because this can lead to feelings of abandonment, fear, or loneliness. C. Beginning at the child's level of understanding is essential when preparing a child for the death of a grandparent. Because there is such a difference regarding how children of different ages view the concept of death, it is important first to assess the child's level of understanding. D. No one should be told how to feel or behave when it comes to reacting to loss. Expression of diverse feelings is essential if a child is to cope with the loss of the grandparent or develop positive coping strategies to deal with loss later as an adult.
Which is an example of a response to a physiological stressor? Select all that apply. A. A sunburn after being outside all day B. Diarrhea after eating contaminated food C. Shortness of breath when walking up a hill D. A rapid heart rate during a final examination E. Excess fluid volume as a result of renal disease
Answer: C, E Rationale: A. A sunburn is a response to the ultraviolet rays of the sun, which is a physical, not a physiological stressor. The body's responses to a sunburn, such as pain or inflammation, are secondary physiological stressors. B. Diarrhea after eating contaminated food is a response to a microbiological, not a physiological, stressor. C. Shortness of breath is a response to the physiological stress or walking up a hill. The body is reacting via physiological mechanisms to take in more oxygen to meet the oxygen demand of cells when walking. D. The threat of a final examination is a psychological, not a physiological, stressor. The rapid heart rate during a final examination is a physiological response to a psychological stressor. E. Excess fluid volume is a response to the physiological stress of kidney impairment. Because of impaired kidney function, the body is unable to secrete urine, and excess fluid volume occurs.
Which is an example of a health belief? Select all that apply. A. Eating foods that are low in fat B. Accepting grim results of diagnostic tests C. Engaging in physical exercise twice a week D. Recognizing that smoking can cause lung cancer E. Respecting a client's decision regarding therapeutic treatment
Answer: D Rationale: A. Eating foods low in fat is a behavior, not a health belief. B. Accepting grim results of diagnostic tests reflects a behavior in response to bad news, rather than a behavior reflecting a health belief. C. Engaging in physical exercise twice a week is a behavior, not a health belief. D. This is an example of a health belief. If a person believes that smoking cigarettes can cause lung cancer, then the person may refrain from smoking. D. Respecting a client's decision is not an example of a health belief. It reflects the nurse's acceptance of a client as a unique individual and recognizes the client's right to make personal choices about health care.
A nurse is facilitating a support group for people who are coping with the death of a significant other. Which client behavior reflects complicated grieving? A. Remarrying within 6 months after the death of a wife B. Being continuously angry 3 months after the death of a parent C. Exhibiting indicators of depression 9 months after the death of a husband D. Keeping a child's room unchanged for 4 years after the death of the child
Answer: D Rationale: A. Moving on with one's life is a sign of successful grieving. Mourning periods may be abbreviated if the loss is replaced immediately by another equally respected person or if the person experienced anticipatory grieving, which is grieving experienced before the death. B. Being continuously angry 3 months after the death of a parent is within the realm of expected grieving behavior and is not complicated grieving. If a person is continuously angry after 1 year, it is considered complicated grieving. C. Depression of this length is not uncommon, particularly if the relationship was meaningful or intense or no one was able to fill the role of the deceased. If depression does not resolve within a year after the death, it is considered complicated grieving. D. Keeping a deceased child's room unchanged for years is outside the usual limits of grieving. Often, a person can get stuck in a stage of grieving and is unable to progress to the next stage. Keeping a room unchanged for years reflects an inability to face the reality of the loss or to deal with the feelings associated with the loss.
Which concept identified by the nurse is basic to the health-illness continuum model? A. People can be both healthy and ill at the same time on the continuum. B. Actualization must be achieved to be on the healthy end of the continuum. C. When variables are balanced, people are in the exact center of the continuum. D. There is no distinct boundary between health and illness along the continuum.
Answer: D Rationale: A. Where people place themselves on the health-illness continuum is a self-perception of their status in relation to health and illness. From their perspectives, they cannot be healthy and ill at the same time. B. Only the Eudemonistic Model of Health incorporates the concept of actualization, or realization of a person's potential, as the major component of a definition of health. C. Variables, such as genetic makeup, race, gender, age, lifestyle, risk factors, culture, environment, standard of living, support system, spiritual beliefs, and emotional factors, may be in balance and individuals may view themselves at the extremes of the continuum, or they may be out of balance and people may view themselves in the center of the continuum. D. Health and illness are on opposite ends of the health-illness continuum, and there is no distinct boundary between health and illness. Only a person can place herself or himself somewhere along the health-illness continuum based on his or her own perceptions about what constitutes health and illness.
