NUR 313 Health, Wellness, and Health Disparities

What is a dynamic state in which a person constantly adapts to changes in the internal and external environment? A. Health B. Wellness C. Holism D. Infirmity

A. Health Health is a dynamic state in which a person constantly adapts to changes in the internal and external environment. Wellness is a dynamic and conscious process of making choices that help achieve one's fullest potential. Holism is care that addresses all dimensions of a person, mind, body, and spirit. Infirmity refers to a state of disability due to an illness.

A client has been admitted to the hospital for the treatment of diabetic ketoacidosis, with a random blood glucose reading of 575 mg/dL (31.91 mmol/L), vomiting, and shortness of breath. This client has experienced which phenomenon? A. Exacerbation B. Morbidity C. Infection D. Risk factor

A. Exacerbation This client has experienced a significant exacerbation of a chronic disease (diabetes mellitus), which has manifested as an acute threat to the client's health. Morbidity is an epidemiological statistic of the frequency of a disease. The client's problem does not have an infectious etiology. A risk factor is any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or injury.

Which are characteristics of chronic conditions? (Select all that apply.) A. Resolve spontaneously B. Are rarely curable C. Have a rapid onset D. Require lifelong management E. Have a prolonged course

B. Are rarely curable D. Require lifelong management E. Have a prolonged course Chronic conditions typically have a slower onset and prolonged course, do not resolve spontaneously, are rarely curable, and require lifelong management. Acute conditions typically have a rapid onset and short course and resolve spontaneously or are curable.

Nurses from hospital in a low-income area of the city are developing educational materials and programs focused on health care for vulnerable populations. When planning community outreach, which members of the community will the nurses include? Select all that apply. A. White male diagnosed with HIV B. Black teenager who is 6 months pregnant C. Hispanic male who has type 2 diabetes D. Low-income family living in rural America E. Middle-class teacher living in a large city F. White infant born with cerebral palsy

B. Black teenager who is 6 months pregnant C. Hispanic male who has type 2 diabetes D. Low-income family living in rural America F. White infant born with cerebral palsy National trends in the prevention of health disparities are focused on vulnerable populations, such as racial and ethnic minorities, those living in poverty, women, children, older adults, residents of rural areas and lower-income areas of cities, and people with disabilities and special health care needs.

The nurse practitioner is discussing health promotion with a group of senior nursing students. What would be the best example of secondary health promotion? A. Weight loss program B. Family counseling C. Immunizations D. Workplace health and safety seminar

B. Family counseling Secondary health promotion and illness prevention focus on screening for early detection of disease, with prompt diagnosis and treatment of those found; this includes emotional issues, making family counseling the correct answer. Workplace health and safety would be considered a primary health promotion activity, as would a weight loss clinic and an immunization clinic.

Risk factors for illness are divided into six categories. Working with carcinogenic chemicals is an example of which type of risk factor? A. Environmental risk factor B. Physiologic risk factor C. Health habits risk factor D. Lifestyle risk factor

A. Environmental risk factor Working and living environments may contribute to disease. Working with cancer-causing chemicals is an example of an environmental risk factor for illness. Physiologic risk factors are those relating to an individual's body or biology. Lifestyle risk factors are habits or behaviors people choose to engage in. A health habit risk factor is any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or injury.

An older adult client has been recently diagnosed with vascular dementia. Because the client lives alone and has poorly controlled hypertension, the client has begun to receive home healthcare. This new aspect of the client's care is characteristic of which stage of illness? A. Assuming a dependent role B. Assuming the sick role C. Experiencing the symptoms D. Achieving recovery and rehabilitation

A. Assuming a dependent role The stage of assuming a dependent role often requires assistance in carrying out activities of daily living. As well, the client often requires care, which may be provided in the home. Experiencing symptoms and assuming a sick role may precede (or accompany) this process. Recovery and rehabilitation are not evident in the client's present circumstances.

When chronic illnesses and disabilities are present, individuals benefit most from activities that: A. help them eat well. B. help them maintain independence. C. preserve their social interactions. D. accomplish financial stability.

B. help them maintain independence. Although their chronic illnesses and disabilities cannot be eliminated, adults can benefit most from activities that help them maintain independence and achieve an optimal level of health. The other answers, while beneficial, are not as helpful.

A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). The nurse explains to the client that COPD is a chronic disease. Why is COPD considered a chronic disease? A. It persists for a long time. B. It is a sequela of acute illness. C. It takes a long time to cure. D. It has a gradual onset and lasts for a long time.

D. It has a gradual onset and lasts for a long time. Chronic illness has a gradual onset and lasts for a long time. It is usually seen in old age. It may or may not be due to acute illness. Chronic diseases are a major cause of morbidity in the population.

The nurse in a free clinic caring for clients uses the Health Belief Model, which is based on three components. What is the main focus for this model? A. How people interact with their environments B. How health is a constantly changing state C. What people believe to be true about their health D. Factors that predispose a person to infectious diseases

C. What people believe to be true about their health The Health Belief Model focuses on what people perceive or believe to be true about themselves in relation to their health. The Health Promotion Model focuses on how people interact with their environments, as they pursue health. The Health-Illness Continuum Model focuses on health as a constantly changing state, whereas The Agent-Host-Environment Model explains how certain factors place a person at risk for an infectious disease.

To be an effective change agent for wellness, the nurse must: A. skip breakfast to reduce calories. B. drink caffeinated beverages. C. lead a sedentary lifestyle. D. consume a healthy diet.

D. consume a healthy diet. Nurses focused on wellness advocate the use of lifestyle modification skills that alleviate stress and promote a state less susceptible to disease, such as eating a healthy diet. Skipping breakfast, drinking caffeinated beverages, and being sedentary are not associated with improved health or wellness.

A community health nurse is developing a support group for patients coping with chronic health problems. What chronic health conditions does the nurse anticipate group members might want to discuss? Select all that apply. A. Diabetes mellitus B. Bronchial pneumonia C. Rheumatoid arthritis D. Ulcerative colitis E. Fractured hip F. Otitis media

A. Diabetes mellitus C. Rheumatoid arthritis D. Ulcerative colitis Diabetes, arthritis, and ulcerative colitis are chronic diseases causing permanent, irreversible alterations in normal anatomy and/or physiology. They require a lengthy period of care, support, and patient education. Pneumonia, fractures, and otitis media are acute illnesses, characterized by a rapid onset and typically short duration.

When admitting an adolescent to the hospital, the nurse anticipates that the client will respond to questions about their health beliefs based primarily on the basis of what factors? A. Age and developmental stage B. Gender and medical history C. Peer influence and education D. Health promotion activities

A. Age and developmental stage Age and developmental stage are important considerations in the health belief model. Other factors are influential, but age and developmental stage are paramount within this model.

Which nursing intervention is an example of tertiary preventive care? A. Assisting with speech therapy a client with a traumatic brain injury B. Administration of immunizations to a 6-month-old child C. Blood pressure screenings at a senior center D. Teaching stress reduction classes at a wellness center

A. Assisting with speech therapy a client with a traumatic brain injury Tertiary prevention begins after the illness and is used to help rehabilitate clients. Speech therapy is an example of tertiary preventive care. The administration of immunizations and teaching stress reduction classes are examples of primary preventive care. Blood pressure screening is an example of secondary preventive care.

A public health nurse is planning interventions for a community and plans to determine the frequency of diseases in the area. What information will best guide the nurse? A. Morbidity table B. Disease eradication statistics C. Mortality rates D. Annual hospital admissions

A. Morbidity table Morbidity refers to how frequently a disease occurs; mortality is the number of deaths resulting from a disease. These statistics may be placed in tables as a reference for others.

The client tells the nurse she has never "gotten over" the loss of her husband 2 years ago. The client states she is drinking alcohol to excess every day and has started smoking, saying both help her cope. What is the best response by the nurse? A. "You need to decrease your alcohol consumption and stop smoking for your overall health." B. "It may be time for you to consider a comprehensive treatment program." C. "As you learn to better cope, you will see a decrease in your need for these substances." D. "This is the way you are coping with the stress. Everyone copes in their own way."

B. "It may be time for you to consider a comprehensive treatment program." People exhibiting stress and altered coping through substance use or overeating require a comprehensive treatment program to address their coping and adaptation problems. Simply telling the client to cut down or abstain is unlikely to cause change. After two years, spontaneous resolution of the behavior is unlikely. The nurse should affirm the client but not their maladaptive behavior.

Which nursing activity reflects secondary prevention? A. Promoting the use of seat belts B. Making a referral for a mammogram C. Discussing the use of drugs and alcohol D. Promoting the use of helmets while riding motorcycles or bicycles

B. Making a referral for a mammogram econdary prevention involves screening for early detection of disease, such as a mammogram. Discussions about wearing helmets, using seat belts, and drugs and alcohol are all examples of primary prevention, which focuses on promoting health and preventing disease.

Which is the most accurate definition of health? A. Health is a state of maximal wellness. B. Health is a lack of disease. C. Health is a state of complete physical, mental, and social well-being. D. Health is a reflection of wellness and requires a conscious and deliberate effort to maintain.

C. Health is a state of complete physical, mental, and social well-being Health is viewed as a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity. The other options would not be the best definition of health.

A client comes to the health center for a routine visit. During the visit, the client tells the nurse, "I'm motivated to do things now to make sure I'm the healthiest I can be." When planning this client's care, the nurse should focus on which area? A. Health promotion B. Illness prevention C. Self-concept D. Diagnosis of disease

A. Health promotion. Health promotion is the behavior of a person who is motivated by a personal desire to increase well-being and health potential. In contrast, illness/disease prevention, also called health protection, is behavior motivated by a desire to avoid or detect disease or to maintain functioning within the constraints of an illness or disability. Self-concept incorporates both how people feel about themselves (self-esteem) and the way they perceive their physical self (body image). Diagnosis of disease involves a medical aspect such that a disease is traditionally diagnosed—and treatment is prescribed—by a health care provider or advanced practice nurse, whereas nurses focus on the person with an illness.

Which of the oncology nurse's interventions best demonstrates primary health promotion? A. Teaching clients how they can manage their exposure to known carcinogens B. Teaching a client about the expected adverse effects of chemtherapy C. Working with a client whose body image has been affected by a recent mastectomy D. Encouraging women to obtain screening mammograms according to recommendations

A. Teaching clients how they can manage their exposure to known carcinogens Primary prevention refers to health promotion and illness prevention, such as educating clients how to lower their risk of a disease. Secondary prevention includes screening for those at risk to develop illness. Tertiary prevention refers to rehabilitation or prevention of complications after diagnosis with a disease, such as chemotherapy or surgery.

A nurse observes that a client who has pneumonia is in the recovery and rehabilitation stage of the illness. Which statement describes the client response that the nurse would expect at this stage of the illness? A. The client gives up the dependent role. B. The client assumes a dependent role. C. The client seeks medical attention. D. The client recognizes symptoms of illness.

A. The client gives up the dependent role. In the recovery and rehabilitation stage, known as Stage 4, the person gives up the dependent role and resumes normal activities and responsibilities. The client would not seek medical attention, assume a dependent role, or recognize symptoms of illness in this stage. Stage 1 is when the client would recognize symptoms of the illness. Stage 2 is when the client would seek medical attention. Stage 3 is when the client would assume a dependent role.

A nurse is assessing a client for potential variables that influence the client's health. When assessing the client's self-concept, which area should the nurse include? Select all that apply. A. The client's feelings about self as a person B. The client's view of self physically C. The client's educational level D. The client's cultural background E. The client's degree of interaction with family members

A. The client's feelings about self as a person B. The client's view of self physically Self-concept incorporates both how people feel about themselves (self-esteem) and the way they perceive their physical self (body image). Educational level, culture, and family interaction are not components of self-concept.

The nurse is reviewing the care of a client who is experiencing the exhaustion stage. Which sign or symptom does the nurse expect to find? A. higher-than-normal blood glucose levels B. lower-than-normal range sodium levels C. higher-than-normal iron levels D. lower-than-normal magnesium levels

A. higher-than-normal blood glucose levels The higher-than-normal blood glucose level occurs in a response to the prolong level of cortisol, which is produced to inhibit insulin in order to meet the increased need for energy when a person is stressed. Lower-than-normal blood glucose levels would suggest that the pancreas is overproducing insulin in response to stress, which is incorrect. Experiencing stress does not affect the iron levels in the body; therefore the iron level is not expected to increase or decrease.

The nurse instructor has completed a session detailing major factors differentiating exacerbations from remissions. The instructor determines the session is successful when the students point out which factor(s) can contribute to exacerbations? Select all that apply. A. immune system is functioning poorly B. sleep has been disrupted due to family issues C. client is facing a potential eviction D. dietary log shows improvement on food choices E. skin turgor indicates good hydration status

A. immune system is functioning poorly B. sleep has been disrupted due to family issues C. client is facing a potential eviction Exacerbations of illnesses are often related to how poorly the immune system is functioning, the stressors the client is facing and overall health status (e.g., nutrition, sleep, hydration). Remission is the opposite and usually indicates how well the immune system is acting, how well the client is handling stressors, and his or her overall health status. Improving food choices and good hydration status are indications the individual is recovering and showing improvement in his or her health status.

A nurse working in an ambulatory care center provides care for patients experiencing varying levels of health and illness. The nurse bases care on which concepts of health and illness? Select all that apply. A. Health and illness are the same for all people. B. Health and illness are individually defined by each person. C. People with acute illnesses may consider themselves healthy. D. People with chronic illnesses have poor health beliefs. E. Health is more than the absence of illness. F. Illness is the response of a person to a disease.

B. Health and illness are individually defined by each person. C. People with acute illnesses may consider themselves healthy. E. Health is more than the absence of illness. F. Illness is the response of a person to a disease. Each person defines health and illness individually, based on a number of factors. Health is more than just the absence of illness; it is an active process in which a person moves toward their maximum potential. An illness is the response of the person to a disease.

A clinic nurse works with a population experiencing health disparities. Which patient does the nurse identify as having the highest risk for postponing annual breast examinations and mammograms? A. Patient whose best friend had a benign breast lump removed B. Patient who lives in a low-income neighborhood C. Patient who has a family history of breast cancer D. Patient whose family encourages regular physical examinations

B. Patient who lives in a low-income neighborhood Healthy People 2020 defines health disparity as a "particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage." Disparities are influenced by race and ethnicity, poverty, sex assigned at birth, age, mental health, educational level, disabilities, sexual orientation, health insurance, and access to health care.

A community health nurse cares for vulnerable populations. What problem will the nurse prioritize for a patient who is homeless? A. Love and belonging B. Safety C. Self-esteem D. Self-actualization

B. Safety Safety is the most appropriate focus as adults and children experiencing homelessness do not have a regular and appropriate place to sleep; they may be sheltered or unsheltered. After meeting safety needs, the nurse can focus on love and belonging, self-esteem, or self-actualization.

Which needs are being met when a nurse recommends a senior citizen community center for an older client who is living alone? A. Spiritual needs B. Sociocultural needs C. Intellectual needs D. Emotional needs

B. Sociocultural needs Increased social interaction, as would be provided by visiting a senior citizen community center, would primarily address a client's sociocultural needs. Emotional needs address how the mind affects body functions and responds to body conditions. Long-term stress affects body systems, and anxiety affects health habits; conversely, calm acceptance and relaxation can actually change the body's responses to illness. The intellectual dimension encompasses cognitive abilities, educational background, and past experiences. Spiritual beliefs and values are assessed when addressing spiritual needs.

A nursing student is writing a paper about nurses performing health promotion activities at the tertiary level. Which nursing actions will the student include? Select all that apply. A. Running an immunization clinic in a lower-income area of a city B. Teaching a patient with an amputation how to care for the residual limb C. Providing range-of-motion exercises for a patient who is paralyzed D. Teaching parents of toddlers how to childproof their homes E. Providing screening for scoliosis for school students F. Teaching new parents how to choose and use an infant car seat

B. Teaching a patient with an amputation how to care for the residual limb C. Providing range-of-motion exercises for a patient who is paralyzed Tertiary health promotion and disease prevention begins after an illness is diagnosed and treated to reduce disability and to help rehabilitate patients to a maximum level of functioning. Tertiary interventions include providing ROM exercises and patient teaching for residual limb care. Providing immunizations and teaching parents how to childproof their homes and use an appropriate car seat are primary health promotion activities. Providing screenings is a secondary health promotion activity.

A client has a Staphylococcus infection in a decubitus ulcer. In this case, Staphylococcus is the: A. host. B. agent. C. environment. D. disease.

B. agent. The agent is any factor that leads to illness. The client is the host of the infection. The environment is setting in which the infection occurs. The disease is a pathological process that can result from the infection.

Why are health promotion and illness prevention a key responsibility of nurses? A. Chronic illnesses can cause pain and suffering. B. Treatment of chronic illnesses is very expensive. C. Chronic illnesses are the leading health problem in the world. D. People do not like to be sick and feel bad.

C. Chronic illnesses are the leading health problem in the world. Because chronic illnesses are the leading health problems in the world, health promotion and illness prevention activities are vital to nursing care. By endorsing health promotion and illness prevention, the nurse can assist the client to achieve optimal health even with a chronic illness. It is true that treating chronic illnesses can be expensive, they do cause pain and suffering, and people do not like to be sick, but these are not the most important reasons for promoting health and preventing illnesses.

A nurse has volunteered to give influenza immunizations at a local health clinic. In which level of health promotion and illness prevention is the nurse participating? A. Tertiary B. Secondary C. Primary D. Promotive

C. Primary Giving influenza injections is an example of primary health promotion and illness prevention. Secondary prevention includes early detection of disease with prompt diagnosis and treatment. Tertiary prevention focuses on reducing disability and providing rehabilitation to a maximum level of functioning.

What have the models of health promotion and illness prevention been used for? A. To define a medical framework for the care of people with disabilities. B. To create a forum for improving rehabilitative care. C. To help health care providers understand health-related behaviors. D. To formulate care plans for people with disabilities.

C. To help health care providers understand health-related behaviors. Several models of health promotion and illness prevention have been used to help health care providers understand health-related behaviors and adapt care to people from diverse economic and cultural backgrounds. The models include the health belief model, the health promotion model, the health-illness continuum model, and the agent-host-environment model. These models do not define a medical framework in the care of clients with disabilities; these models do not create a forum for improving rehabilitative care; and these models do not formulate care plans for use with the disabled.

A nurse is caring for a patient who has been managing their chronic spasticity well for 10 years. The patient states having had increasing spasticity and few falls due to unremitting muscle spasms. The nurse, patient, and health care provider discuss the possibility the patient may be experiencing which phase of illness? A. Acute onset of illness B. Permanent complication C. Need for hospice care D. Exacerbation of disease

D. Exacerbation of disease Exacerbation of a chronic illness occurs when the symptoms of a disease reappear after having been absent for a time.

A nurse incorporates concepts from current models of health when providing health promotion classes for patients. What is a key concept of both the health-illness continuum and the high-level wellness models? A. Illness as a fixed point in time B. The importance of family C. Wellness as a passive state D. Health as a dynamic state

D. Health as a dynamic state Both these models view health as a dynamic (constantly changing state).

A nurse is caring for a client who has COPD, a chronic illness of the lungs. The client is in remission. Which statement best describes a period of remission in a client with a chronic illness? A. The symptoms of the illness reappear. B. The disease is no longer present. C. New symptoms occur at this time. D. Symptoms are not experienced.

D. Symptoms are not experienced. Chronic illnesses usually have a slow onset and many have periods of remission (the disease is present but the client does not experience symptoms). Exacerbation is when the symptoms of the disease reappear. Chronic illnesses do not go away; the disease continues to be present.