Health Promotion Exam 3
Which techniques should the nurse use to draw the patient's attention away from a painful wound debridement and dressing change? Select all that apply. A. Yoga B. Acupuncture C. Therapeutic touch D. Breathing techniques E. Relaxation techniques
C. Therapeutic touch D. Breathing techniques E. Relaxation techniques Therapeutic touch and breathing and relaxation techniques are alternative methods of physical and mental health promotion. The nurse's therapeutic touch gives the patient a sense of comfort and support. Breathing techniques divert the patient's attention away from the dressing and promote oxygenation of the wound site. Relaxation techniques such as mindfulness, visualization, and meditation help the patient to relax during the painful procedure of debriding the wound and changing the dressing. Yoga is not a viable technique for the patient as the patient may be in pain during a dressing change and unable to do yoga. Acupuncture involves stimulation of specific points in the body to control pain. This stimulation is accompanied with application of heat, cool, laser, or penetration of thin needles. These stimulation techniques are not helpful during wound debridement and dressing change.
A couple approaches a nurse for counseling. The body mass index (BMI) of the husband is 32. The BMI of the wife is 13. Both are unemployed and need financial support. On interviewing, the nurse finds that the husband snores loudly, which disturbs the wife during sleep. What is the internal variable that has an influence on the woman's sleep? 1. BMI of 32 2. Snoring 3. Employment status 4. BMI of 13
Correct 4. BMI of 13 The BMI of 13 shows that the woman is underweight. It shows her poor nutritional status. It is an internal variable that can have an influence on her health and sleep. The BMI of 32 is her husband's health indicator, so it comes under external variables. Other external variables are snoring and employment status.
The nurse is caring for a patient with an illness. Arrange the stages of illness in the order described by Suchman. 1. Perceived recovery 2. Medical care contact 3. Symptom experience 4. Assumption of the sick role 5. Dependent patient role
Correct 1. Symptom experience 2. Assumption of the sick role 3. Medical care contact 4. Dependent patient role 5.Perceived recovery The Stages of Illness Model by Suchman describes illness behavior and how individuals arrive at coping mechanisms necessary to manage these conditions. Stage I is symptom experience, during which a person experiences clinical manifestations of the disease. The person acknowledges that something is wrong and seeks treatment. Stage II is assumption of the sick role. The person decides that the illness is genuine and care is necessary. The person is temporarily excused from typical social and personal obligations. Stage III is the medical care contact. The person seeks professional advice from health care providers, and the health care providers identify, validate, and legitimize the sick role. Stage IV is the dependent patient role. During this stage, the person is designated as a patient and is dependent on others for treatment. Stage V is perceived recovery. The person is well and abandons the sick role to resume usual tasks and roles to the greatest degree possible.
The nurse identifies a patient whose health status is affected by attitudes, values, and cultural practices. Which health model would be the best to identify the relationship between the patient's cultural practices and health status? 1. Health Belief Model (HBM) 2. Holistic Health Model (HHM) 3. Health Promotion Model (HPM) 4. Basic Human Needs Model (BHNM)
Correct 1. Health Belief Model (HBM) The Health Belief Model identifies the impact of patient's attitudes and beliefs on the patient's susceptibility to illness, the severity of the illness, barriers to adopting a healthy lifestyle, and self-care during an illness. The nurse provides culturally competent and congruent care to the patient based on the Health Belief Model. The Holistic Health Model deals with promotion of natural healing methods and collaborative care. The Health Promotion Model deals with providing preventive care. The nurse follows the Basic Human Needs Model to categorize the areas of patient need.
During a visit to a family clinic, the nurse teaches a mother about immunizations, car seat use, and home safety for an infant and toddler. Which type of nursing interventions are these? 1. Health promotion activities 2. Acute care activities 3. Restorative care activities 4. Growth and development-care activities
Correct 1. Health promotion activities Health promotion activities focus on interventions designed to maintain the physical, social, emotional, and spiritual health of the family unit. They can include information about specific health behaviors, family coping techniques, and growth and development.
What is the first step in health promotion, wellness education, and illness prevention? 1. Identifying risk factors. 2. Identifying vulnerable people. 3. Helping the patient improve health status. 4. Emphasizing wellness strategies.
Correct 1. Identifying risk factors. When caring for a patient, the nurse has to identify the risk factors and discuss health issues following a comprehensive nursing assessment. Assessment is followed by identification of vulnerable groups. Following this, the nurse can help patients decide if they want to maintain or improve their health status by taking risk-reducing efforts. Based on the assessment and the patient's needs, the nurse can emphasize wellness strategies.
A nurse has conducted an immunization program for physically challenged children in a rehabilitation center. Pneumonia vaccine was administered to the children as a part of the program. What level of prevention is this called? 1. Primary prevention 2. Tertiary prevention 3. Secondary prevention 4. Early diagnosis
Correct 1. Primary prevention Primary prevention includes measures taken before the occurrence of a medical problem. For example, vaccinations are given to children or adults to prevent a disease from occurring, which comes under the realm of primary prevention. Tertiary prevention is required when there is a permanent disability. Secondary prevention includes early diagnosis, treatment, and disability limitation.
In planning nursing care for an 85-year-old male patient, the most important basic need that must be met is: 1. Assurance of sexual intimacy. 2. Preservation of self-esteem. 3. Expanded socialization. 4. Increase in monthly income.
Correct 2. Preservation of self-esteem. Self-esteem is essential for physical and psychological health across the life span. Nurses should also consider that applying a fixed hierarchical order is not always the most accurate method for predicting patient behavior or actions concerning optimal health. Areas of need categorized above basic physiologic function, such as self-esteem and love, often override essential physiologic needs when a patient is confronted with certain circumstances.
The nurse is conducting a home visit with an older adult couple. She assesses that the lighting in the home is poor and there are throw rugs throughout the home and a low footstool in the living room. She discusses removing the rugs and footstool and improving the lighting with the couple. The nurse is addressing which level of need according to Maslow? 1. Physiological 2. Safety and security 3. Love and belonging 4. Self-actualization
Correct 2. Safety and security The teaching addresses the need for safety and security. The throw rugs, low lighting, and low stool are hazards that can cause falls in the elderly. Preventing falls is a priority safety issue for older adults.
A patient diagnosed with major depressive disorder has a nursing diagnosis of chronic low self-esteem related to negative view of self. Which would be the most appropriate cognitive intervention by the nurse? 1. Promote active socialization with other patients. 2. Role play to increase assertiveness skills. 3. Focus on identifying strengths and accomplishments. 4. Encourage journaling of underlying feelings.
Correct 3. Focus on identifying strengths and accomplishments. A humanistic approach to healthcare focuses on strengths of individuals rather than weaknesses or illness (i.e., physiologic disease or mental disorder). Focusing on strengths and accomplishments to minimize the emphasis on failures assists the patient to alter distorted and negative thinking. The other interventions are important, but they are not designed to impact thoughts.
The nurse is teaching the parents of toddlers about the use of seat belts and vehicle safety. What is the nurse's goal behind this teaching? 1. Rehabilitation 2. Early detection 3. Health promotion 4. Specific protection
Correct 4. Specific protection Specific protection activities help to prevent a specific disease or a potential injury. Teaching safety measures to parents helps to prevent injury and accidents in toddlers. Rehabilitation or restoration of health refers to attaining the possible level of recovery from the illness. Use of seat belts and safety measures do not help in rehabilitation. Diagnostic tests are performed to detect a disease at an early stage; however, teaching safety measures does not help in detection of diseases. Health promotion activities include general measures to prevent illness and promote health. It includes activities such as lifestyle modifications, nutritional counseling, and modification of the environment.
What statements made by the patient indicate that the patient's self-concept is improving following treatment? Select all that apply. A. "I am pretty comfortable with my crutches." B. "It is easier to administer insulin than I had imagined." C. "The prosthesis hurts; I cannot endure it." D. "Physical therapy is going well. I'm going to be on my feet soon." E. "I don't find the social gathering very interesting."
Correct A. "I am pretty comfortable with my crutches." B. "It is easier to administer insulin than I had imagined." D. "Physical therapy is going well. I'm going to be on my feet soon." Acceptance of the use of assistive devices and understanding teaching, such as how to administer insulin, suggest good progress. Positive attitudes toward returning to previous levels of functioning also indicate good progress. Not wanting to put additional efforts into rehabilitation and not wanting to socialize indicate negative self-concept.
A nurse is learning about the holistic health model of nursing. Which statements are true about this model? Select all that apply. A. It attempts to create conditions for optimal health. B. It recognizes the natural healing abilities of the body. C. It incorporates complementary and alternative therapies into nursing care. D. It is used to understand the relationships of basic human needs. E. It believes that certain human needs are more basic than others.
Correct A. It attempts to create conditions for optimal health. B. It recognizes the natural healing abilities of the body. C. It incorporates complementary and alternative therapies into nursing care. Holistic Health Model attempts to create conditions for optimal health. It believes that the human body possesses a natural healing ability. These abilities can be used in the patient care by incorporating complementary and alternative therapies like music therapy and relaxation therapy. The Maslow's Hierarchy Model helps to understand the relationships of basic human needs. It also believes that certain human needs are more basic and need to be met before others.
What factors should the nurse identify as barriers to health maintenance habits and routines during health promotion campaigns in urban areas? Select all that apply. A. Poor air quality B. Increased crowds C. Cramped working conditions D. Limited access to healthful food E. Limited access to specialized health care systems
Correct A. Poor air quality B. Increased crowds C. Cramped working conditions D. Limited access to healthful food Urban communities often face challenges such as poor air quality, crowded living, and overcrowded working conditions. Poor air quality is due to overcrowding, industrialization, and a greater number of vehicles. People tend to migrate to urban areas for better employment prospects, which leads to overcrowding. Urban areas often have highly specialized health care institutions though they may lack primary and preventive health care centers. Urban areas do not necessarily lack access to healthful foods, although some poorer neighborhoods may have more limited access
Which concepts provide a useful framework for implementing the nursing process as explained in the Health Belief Model (HBM)? A. Self-efficacy B. Cues to action C. Perceived benefits D. Physical limitations E. Perceived susceptibility
Correct A. Self-efficacy B. Cues to action C. Perceived benefits E. Perceived susceptibility The HBM suggests that individuals are motivated to act if they have certain beliefs or experiences, as explained in the six concepts of the model. The first concept is self-efficacy, which is the individual's confidence in the ability to take action. The nurse provides training and guidance in performing action. Another concept is cues to action, which are factors that activate readiness to change. The nurse promotes awareness to bring about the change. The third concept is perceived benefits. The nurse explains how, where, and when to take action and describes the likely positive results. The nurse also has to determine the patient's perceived susceptibility. The nurse helps the individual identify the chances of acquiring a condition or disease. The patient's physical limitations are not included in the HBM. Instead, physical limitations impact their activities of daily living.
Which body image stressors would likely damage the self-concept of an individual? Select all that apply. A. A new haircut B. Alopecia due to chemotherapy C. Amputation of the foot D. Knee replacement surgery E. Rhinoplasty
Correct B. Alopecia due to chemotherapy C. Amputation of the foot Body image involves an individual's attitude about his or her physical appearance, structure, and bodily function. Various stressors influence body image. Loss of hair due to chemotherapy and loss of a foot due to amputation influence a person's body image. A new haircut would not act as a stressor because it is transient and may improve physical appearance. Knee replacement surgery and plastic surgery would enhance the physical appearance or functioning of the body and so would not be stressors.
A 76-year-old patient with peripheral vascular disease (PVD) has developed gangrene of the left foot. The patient looks toxic. What measures would be considered as secondary preventive measures in this case? Select all that apply. A. Referring the patient to an occupational therapist B. Amputating the left foot under sterile environment C. Conducting Doppler studies on the right leg to detect any changes D. Administering antibiotics to prevent septicemia E. Mobilization of the patient in the hospital to prevent bed ulcers
Correct B. Amputating the left foot under sterile environment C. Conducting Doppler studies on the right leg to detect any changes D. Administering antibiotics to prevent septicemia Secondary prevention is aimed at diagnosis, treatment, and disability limitation. The measures are taken once the disease process has started. Secondary prevention should limit further progression of the disease and development of complications. In this case, amputation of the left foot under sterile environment would help prevent progression of the disease. Conducting a Doppler study on the right leg would help detect any changes in the right leg. Administration of antibiotics helps to prevent septicemia. After the development of disability, tertiary preventive measures are required, including referral to an occupational therapist. Mobilization of the patient to prevent bed ulcers comes under primary preventi
The nurse assesses the following risk factors for coronary artery disease (CAD) in a male patient. Which factors are classified as genetic or physiological? Select all that apply. A. Sedentary lifestyle B. Father died from CAD at age 50 C. History of hypertension D. Eats diet high in sodium E. Elevated cholesterol level F. Age is 44 years
Correct B. Father died from CAD at age 50 C. History of hypertension E. Elevated cholesterol level F. Age is 44 years Genetic and physiological risk factors include those related to heredity, genetic predisposition to an illness, or those that involve the physical functioning of the body. Certain physical conditions such as being pregnant or overweight place increased stress on physiological systems (e.g., the circulatory system), increasing susceptibility to illness in these areas. A person with a family history of coronary artery disease is at risk for developing the disease later in life because of a hereditary and genetic predisposition to the disease.
The nurse is participating in a community workshop for prevention of noncommunicable chronic diseases. Which diseases does the nurse educator emphasize while educating the community? Select all that apply. A. Flu B. Stroke C. Tuberculosis D. Childhood obesity E. Cardiovascular disease
Correct B. Stroke D. Childhood obesity E. Cardiovascular disease Noncommunicable chronic diseases are long-term diseases that do not spread from one person to another. These include stroke, childhood obesity, and cardiovascular disease. For the prevention and control of chronic diseases, the nurse should educate the community about preventive measures such as controlling blood pressure, maintaining a desirable weight, and including exercise in their lives. The flu and tuberculosis are examples of communicable diseases. These diseases spread from one person to another.
Which nursing activity is found in a tertiary healthcare environment? 1. Administering influenza immunizations at the senior independent-living facility 2. Providing well-baby care in the clinic run by the local community health department 3. Admitting a patient following open heart surgery to the cardiovascular intensive care unit 4. Working the triage desk in the emergency department
Correct 3 Admitting a patient following open heart surgery to the cardiovascular intensive care unit Tertiary prevention, also known as the treatment or rehabilitation stage of preventive care, is implemented when a condition or illness is permanent and irreversible, as is the case when admitting a patient following open heart surgery to the cardiovascular intensive care unit. The aim of care is to reduce the number and impact of complications and disabilities resulting from a disease or medical condition. The goal for secondary prevention is early detection and diagnosis of health problems before patients exhibit symptoms of disease. Preventive and health-promotion activities are part of primary prevention. Immunizations, such as those for influenza, are also types of primary prevention.
Which nursing actions are representative of the "self-efficacy concept" of the Health Belief Model? Select all that apply. A. Giving verbal reinforcement to make changes B. Using reminder systems to motivate people C. Specifying the consequences of noncompliance D. Explaining the potential positive results of chang., E. Receiving training and guidance in performing action
Correct A Giving verbal reinforcement to make changes The self-efficacy concept describes confidence in one's ability to take action. The nurse helps the patient to develop self-efficacy by providing verbal reinforcement. This action helps the patient to repeat healthy behaviors and discontinue unhealthy ones. The patient goes through training on health-related practices such as how to make appointments and where to look for health-related information. Using a reminder system helps in providing cues to perform an action. Specifying consequences helps clarify the severity of the disease. The perceived-benefits concept helps explain the effectiveness of taking action to reduce risk and promote positive results.
As the nurse collects data on a patient, the nurse finds that the patient is overweight and has a family history of hypertension and diabetes mellitus. Which interventions should be included in primary preventive care? Select all that apply. A. Instruct the patient to follow a weight-reducing, well-balanced diet. B. Educate the patient on taking prescribed medications for hypertension. C. Assess the patient's weight and height to analyze the body mass index. D. Encourage the patient to do regular exercises and physical activities. E. Encourage the patient join a diabetes mellitus management program.
Correct A Instruct the patient to follow a weight-reducing, well-balanced diet. Correct C Assess the patient's weight and height to analyze the body mass index. Correct D Encourage the patient to do regular exercises and physical activities. Primary prevention is aimed at decreasing risk factors for an illness and promoting lifestyle modifications to delay or prevent the occurrence of a disease. Following a weight-reducing, well-balanced diet helps to keep the patient's blood pressure and blood sugar levels in normal ranges and helps to prevent hypertension and diabetes mellitus. Assessing the body mass index helps to determine the patient's risk for developing chronic illnesses. Regular exercise and physical activity help to maintain a healthy weight and decrease the risk factors for hypertension and diabetes. Taking medication for hypertension is a secondary prevention intervention. Encouraging the patient to participate in a diabetes mellitus management program is a tertiary intervention. It helps diabetic patients adopt measures to decrease complications
A nurse is explaining about levels of prevention to a group of nursing students. Which information should the nurse include? Select all that apply. A. Primary prevention involves immunizations, health education programs, and nutrition and physical activities. B. Secondary prevention involves early diagnosis and prompt treatment. C. Tertiary prevention involves minimizing the effects of long-term illness or disability, including rehabilitation. D. Secondary prevention focuses on people who are experiencing health problems or illnesses. E. Tertiary prevention focuses on people who are at risk for developing complications or worsening conditions
Correct A Primary prevention involves immunizations, health education programs, and nutrition and physical activities. Correct B Secondary prevention involves early diagnosis and prompt treatment. Correct C Tertiary prevention involves minimizing the effects of long-term illness or disability, including rehabilitation. Correct D Secondary prevention focuses on people who are experiencing health problems or illnesses. Primary preventions involve immunizations, health education programs, nutrition, and physical activities. Secondary prevention involves early diagnosis and prompt treatment. Tertiary prevention involves minimizing the effects of long-term illness or disability, including rehabilitation. The secondary prevention focuses on people who are experiencing health problems or illnesses. Secondary prevention also involves people who are at risk for developing complications or worsening conditions.
The nurse interacts with a patient and concludes that the patient is in stage IV of the Stages of an Illness Model. Which characteristics led the nurse to this conclusion? Select all that apply. A. The patient has become dependent on others for care and everyday needs. B. The patient abandons the sick role and resumes normal activities. C. The patient experiences fearful, ambivalent thoughts about care. D. The patient is seeking medical care to relieve signs and symptoms. E. The patient rejects treatment and the health care provider's advice.
Correct A The patient has become dependent on others for care and everyday needs. Correct C The patient experiences fearful, ambivalent thoughts about care. Correct E The patient rejects treatment and the health care provider's advice. According to Suchman's stages of illness model, there are five stages of illness. Each stage is characterized by certain patient behaviors. During stage IV of the illness, the patient has already accepted being sick and has adopted the sick role. The patient accepts treatment for the illness. The characteristic behaviors include being completely dependent on others and having fear and ambivalent thoughts due to painful treatment procedures. As a result, the patient may even reject the treatment and advice of the health care provider. During stage V of an illness, the patient abandons the sick role and assumes his or her usual responsibilities. During the stage III of the illness, the patient seeks medical treatment to relieve signs and symptoms.
A 45-year-old diabetic non-English speaking woman, whose husband died 12 years ago, was found unconscious at home. Her neighbors brought her to the hospital, 38 miles away. The patient was diagnosed with diabetic ketoacidosis (DKA). After initial interventions, the patient regained consciousness. She refuses to take insulin as it is against her religion. The woman is very upset and asks to see a chaplain. What should the nurse do to ensure the best care for the patient? Select all that apply. A. Try to arrange a chaplain as per the patient's request. B. Give insulin, because only this can improve her blood sugar level. C. Inform the patient about the advantages and disadvantages of insulin. D. Not give insulin, as it is against the patient's religious belief. E. Arrange a language interpreter for better communication.
Correct A Try to arrange a chaplain as per the patient's request. Correct C Inform the patient about the advantages and disadvantages of insulin. Correct E Arrange a language interpreter for better communication. The nurse should take measures to address the internal variables of the patient to ensure she receives the best care. A chaplain should be arranged for to give her emotional and spiritual support. The nurse should explain the advantages and the disadvantages of insulin to the patient. This information would help the patient reconsider her decision. A language interpreter would improve communication with the patient and help the nurse better understand the patient's needs. The nurse should not decide whether or not to administer insulin without the patient's consent. Insulin is needed to manage the patient's blood sugar level, however; so the nurse should explain the consequences of not taking insulin.
A patient comes to a rheumatology clinic with acute osteoarthritis. The patient's height is 167cm (5 ft. 5 in) and weight is 75kg (165 lb). Her BMI exceeds the average level. The nurse understands that the patient needs a tertiary level of preventive care. What should the nurse suggest to the patient to avoid complications of the disease? Select all that apply. A. Aerobics B. Weight reduction C. Continuing medication D. Physical exercise E. Diagnostic tests
Correct B Weight reduction Correct C Continuing medication Correct D Physical exercise The nurse should suggest the patient reduce weight. This would help to prevent putting more pressure on the affected joints. Continuation of medicine is important as this will reduce the pain of osteoarthritis and prevent progression of disease. Physical exercise helps to maintain movement of joints as stiffness of joints is a common problem experienced by these patients. Patients suffering from osteoarthritis should not do aerobics as this exposes the joints to injury. Diagnostic tests are not required at the tertiary level of prevention, unless a new disease emerges. The disease has already been diagnosed and is being treated.
A patient with cancer appears anxious and fearful and reports severe abdominal pain. Using the Holistic Health Model, which interventions should the nurse perform to help the patient cope with these symptoms? Select all that apply. A. Recommend that the patient practice yoga to relax. B. Address the patient's pain, and then focus on the anxiety. C. Explain the use of guided imagery to the patient. D. Use therapeutic communication with the patient. E. Encourage the patient to begin massage therapy.
Correct C Explain the use of guided imagery to the patient. Correct D Use therapeutic communication with the patient. The nurse uses the Holistic Health Model (HHM) while providing nursing care to patients. This model includes the use of natural healing remedies and complementary therapy to promote health. Guided imagery is a technique in which the patient uses his or her imagination to promote relaxation. This technique may relieve stress, fear, and anxiety. The nurse establishes therapeutic communication to enhance the patient's participation in care-giving activities. Yoga is the practice of controlling the physical, mental, and social state of the body. This technique would not be helpful in relieving abdominal pain. Addressing physiological needs such as physical pain before higher-order psychological needs like fear and anxiety is characteristic of the basic human needs model rather than the Holistic Health Model. Massage therapy may promote comfort, but may not relieve abdominal pain.
