Chapter 3: Health, Wellness, and Disparities

Stage 3: Assuming the dependent role

Patient accepts the doctors diagnosis and follows a treatment plan. The pt might have trouble making changes if they are asked and may require assistance

Stage 4: Achieving recovery and rehabilitation

Patient gives up the dependent role and resumes regular activities. This usually occurs at home and may also be at a hospital or rehab center

What are some examples of an acute illness?

Pneumonia, influenza, appendicitis, common cold, and diarrhea.

Stages of change model

Precontemplation, contemplation, and determination

The nursing student who has diarrhea before every test and clinical understands that this is not a healthy behavior. This student is aware that this negative effect can impact overall health. The nurse recognizes that this student needs to focus on which of the following dimensions of health? A. sociocultural B. emotional C. intellectual D. physical

B. emotional dimension Rationale: emotional is how the mind affects the body and influences health. Intellectual dimension encompasses cognitive abilities, physical dimension includes genetics and sex, and sociocultural dimension relates to economic level lifestyle family and culture

The nurse is giving a talk to a local community on the harms of smoking. The nurse tells the group that a risk factor increases a person's chance for illness and injury. What type of risk factor is smoking? A. non modifiable B. modifiable C. primary D. secondary

B. modifiable Rationale: these things are subject to change based on the patients wants and needs. Non- modifiable things are those that can be changed like family history, age, and genetics

Which definition best describes acute illness? A. a medical condition that is life threatening and requires surgery B. the rapid onset of symptoms tasing a relatively short time C. the leading health problem in the world D. a condition that causes a permanent change and a long period of care

B. the rapid onset of symptoms lasting a relatively short time Rationale: acute illnesses are not always life threatening

Which is an example of the sociocultural dimension influencing a person's health-illness status? A. a teen in an automobile accident is worried his scars will cause him to lose friends B. a family lives in an environment where pollution levels are high C. a father who is a Jehovah's Witness refuses a blood transfusion for his son D. a single mom of two applies for food stamps to feed her family

D. a mom applies for foodstamps Rationale: A is the emotional dimension, B is the environmental dimension, and C is the spiritual dimension

An exacerbation refers to the reactivation of a disease. Which condition is associated with exacerbation? A. heredity illness B. congenital illness C. acute illness D. chronic illness

D. chronic illness

A nurse incorporates concepts from current models of health when providing health promotion classes for patients. What is a key concept of both 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 continuously changing state

D. health is a continuously changing state

The nurse's community outreach class is giving a presentation on seat belts and child safety every weekend in October. What level of health promotion is this an example of? A. secondary B. medical C. tertiary D. primary

D. primary

Which is an example of tertiary health promotion? A. family counseling B. Pap test C. water treatment D. rehabilitation

D. rehab Rationale: family counseling and Pap tests are secondary promotions, and water treatment is a primary promotion

The nurse is educating a client with diabetes on how to better control blood sugar levels and recognize symptoms of hypoglycemia and hyperglycemia. The client is frequently admitted to the hospital due to elevated blood surges. This education is an example of which level of health promotion? A. primary B. secondary C. chronic D. tertiary

D. tertiary Rationale: tertiary begins after the client is diagnosed and treated with the goal of reducing disability and helping rehabilitate them

What are some examples of a chronic illness?

Diabetes mellitus, lung disease, arthritis, COPD, lupus, and hypertension

True or False? A person who is experiencing a productive cough and fever takes a sick day to recuperate and decide whether to make an appointment with the doctor. This person is said to be in stage 3 of illness behavior: assuming a dependent role.

False Rationale: This person is actually in stage 2 which is assuming a sick role

True or False? A person who keeps in touch with neighbors in an attempt to foster a "community feeling" is promoting ones human dimension.

False Rationale: they are actually promoting one's sociocultural human dimension

A group of students is reviewing the various levels of illness prevention. The students demonstrate understanding when they identify which of the following as the goal of tertiary prevention of illness? A. providing prompt treatment B. preventing illness or disease C. minimizing complications D. improving general well-being

Rationale: the tertiary prevention of illness focuses on rehabilitation and to minimize complications and maximize function. Preventing illness and improving general well-being of a client is the goal of primary prevention. Providing prompt treatment is the goal of secondary prevention.

Effects of illness on the family

Role change of family members, stress on the patient and family, frequent hospitalizations, economic impact, and decrease in social interactions

Health-illness continuum

views health as constantly changing state with a high level wellness and death on opposite sides of a continuum. this illustrates the dynamic and every changing state of health

Agent-host environmental model

views interaction between an external agent, a susceptible host, and the environment as causes of a disease in a person

Stage 2: Assuming the sick role

The person now sees themselves as "sick". They may try and take OTC meds, try alternative methods, and may seek diagnosis and treatment.

Stage 1: Experiencing symptoms

This is when we first realize something is wrong and display symptoms we don't normally have. If the symptoms are treated and then go away, the process usually stops here but if they continue, they move to stage 2

True or False? The more risk factors you have, the more at risk you are to contract an illness?

True

Health disparity

a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage

Precontemplation stage

a stage of change in which there is no intention of changing behavior

Health

a state of complete physical, mental, and social well-being, but not merely the absence of disease or infirmity

Intellectual human dimension

cognitive abilities, educational background, past experiences which affect health behaviors and how someone responds to health teaching

Determination stage

commitment to action where one intends to take action and beings preparing (I need to do something like look into diets and go to the gym)

Health Belief Model

concerned with what people perceive to be true about themselves in relation to their health and is based on perceived susceptibility to a disease (I believe ill get it or I believe I won't), perceived seriousness of a disease (what threat does this disease pose to my health), and perceived benefit of action (how effective do I believe these preventative actions will be to prevent illness?)

If one's needs are met they are considered to be...

healthy

Environmental human dimension

housing, sanitation, climate, overcrowding, and pollution

Self-concept

how one thinks and feels about his/her body and self greatly influences how one takes care of themselves and their body

Emotional human dimension

how the mind affects body functions and responds to body conditions also influences heath; the effects of stress and anxiety on the body and how that effect one's health

If one or more of someone's needs are not met there are at a greater risk for...

illness

Risk factor

increases a person's chances for illness or injury

Disease

medical term referring to pathologic changes in structure or function of body or mind

Examples of vulnerable populations

racial and ethical minorities, those living in poverty, women, children, older adults, those in rural areas and inner cities, and those with disabilities and other special health needs

Contemplation stage

realizing a problem exists but there is no commitment to action (maybe I am overweight)

If activity produces a positive response, this behavior will likely be...

repeated

Spiritual human dimension

spiritual beliefs and values that can influence one's health beliefs and their practices (we as nurses must respect these beliefs and understand their importance)

Illness

the unique response of a person to a disease; an abnormal process involving changed level of functioning

Wellness

an active state of being healthy by living a lifestyle promoting good physical, mental, and emotional health

4 Stages of illness

1. Experiencing symptoms 2. Assuming the sick role 3. Assuming a dependent role 4. Achieving recovery and rehabilitation

The 6 human dimensions

1. Physical 2. Emotional 3. Intellectual 4. Environmental 5. Sociocultural 6. Spiritual

A nurse working in a hospital setting cares for patients with acute and chronic illnesses. Which disease states are chronic illnesses? (select all that apply) A. diabetes mellitus B. bronchial pneumonia C. rheumatoid arthrits D. cystic fibrosis E. fractured hip F. otitis media

A, C, D,

The definition of chronic conditions can be complex. Which factors would a nurse expect to be included in the definition of a chronic condition? (select all that apply) A. diseases that don't resolve spontaneously B. diseases that have a short course C. diseases that have a prolonged course D. diseases that resolve spontaneously E. diseases where complete cures are rare

A, C, E

A nurse working in a long-term care facility personally follows accepted guidelines for a healthy lifestyle. How does this nurse promote health in the facility? A. being a role model for healthy behaviors B. not taking sick days from work C. never exposing others to any type of illness D. budgeting time and resources efficiently

A. being a role model for healthy behaviors

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. lifestyle risk factor C. physiologic risk factor D. health habits risk factor

A. environmental risk factor Rationale: working and living environments may contribute to disease

What is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity? A. health B. holism C. wellness D. host

A. health Rationale:

The health belief model is useful when educating individuals about health and illness. Why would this be? A. it allows us to asses the client's beliefs and structure goals so he can meet health needs B. promotes interactions with clients focused on the cause of a disability C. it fosters dependency D. encourages the provision of care that is based on a disability

A. it allows us to asses the client's beliefs and structure goals so they can meet health needs Rationale: it does not foster dependency or promote actions with the client that are focused on the cause of disability

When providing client care, a nurse determines that a client adhere to the health belief model. What would the nurse need to assess as a factor possibly affecting the client's response to illness. A. personality characteristics B. nutritional awareness C. stress management D. environmental sensitivity

A. personality characteristics Rationale: the health belief model provides insight into the connection between the way a person sees one's own state of health. Personality characteristics affect a person's response to illness according to this model

What level of prevention is noted when the nurse educates a group of mothers of school-age children on self breast examinations? A. primary prevention B. educational prevention C. secondary prevention D. tertiary prevention

A. primary prevention Rationale: primary prevention focuses on the health of the person with the goal of preventing disease or illness. Self examination education is primary prevention.

The nurse uses the agent-host-environment model of health and illness to assess diseases in patients. This model is based on what concept? A. risk factors B. demographic variables C. behaviors to promote health D. stages of illness

A. risk factors Rationale: the interaction of the agent, host, and environment creates risk factors that increase the probability of disease

What is a chronic illness?

An illness that encompasses many different physical and mental alterations in health status that usually has a slow onset and may have periods of exacerbation or remission. These illness cause a permanent change in one's body and requires special patient education and rehab which can lead to lifestyle modification

What is an acute illness?

An illness that has a rapid onset of symptoms that last a relatively short time and usually a simple treatment that may or may not require hospitalization

Nurses perform health promotion activities in a primary, secondary, or tertiary level. Which nursing actions are considered tertiary health promotions? (select all that apply) A. runs an immunization clinic B. teaches a patient with an amputation exercises C. provides range of motion exercises for a paralyzed patient D. teaches parents of toddlers how to child-proof homes E. provides screening for scoliosis in schools F. teaches new parents how to chose and use a car seat

B, C, Rationale: A, D, and F are primary health promotion and E is secondary health promotion

Despite a national focus on health promotion, nurses working with patients in inner-city clinics continue to see disparities in health care for vulnerable populations. Which patients would be considered vulnerable populations? Select all that apply. a. A White male diagnosed with HIV b. An African American teenager who is 6 months pregnant c. A Hispanic male who has type II diabetes d. A low-income family living in rural America e. A middle-class teacher living in a large city f. A White baby who was born with cerebral palsy

B, C, D, F Rationale: vulnerable populations include racial and ethnic minorities, those living in poverty, older adults, women, children, rural and inner city residents, and people with disabilities and special health care needs

A nurse working in a primary care facility assesses patients who are experiencing various levels of health and illness. Which statements define these two concepts? (select all that apply) A. health and illness are the same for all people B. health an illness are individually defined by each person C. people with acute illness are actually 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, E, F,

Which model of health and illness views health as a constantly changing state, with high-level wellness and death being on opposite ends of a graduated scale? A. Agent-host-environmetal model B. Health-illness continuum C. Health promotion model D. Health belief model

B. Health illness continuum

What is an example of a nursing activity that promotes secondary prevention as a level of preventative care? A. Conducting a smoking cessation class B. Performing a blood pressure screening at a local mall C. Performing range of motion exercises on a bedridden patient D. Promoting safer sex practices in school settings

B. Performing a blood pressure screening at a local mall Rationale: this prevention focuses on prevention of a disease

A patient in a community health clinic tells the nurse, "I have a high temperature, feel awful, and I am not going to work." What stage of illness is the patient exhibiting? A. Stage 1: Experiencing symptoms B. Stage 2: Assuming a sick role C. Stage 3: Assuming a dependent role D. Stage 4: Achieving recovery and rehabilitation

B. Stage 2: assuming a sick role

Which of the following is an example of a characteristic of State 2 of illness? A. a person visits a physician to receive treatment for symptoms of an infection B. a person tells his family that he is sick and allows them to take care of him C. a person experiences a headache and sore throat and takes an aspirin D. a person begins rehabilitation following a stroke that left him paralyzed on one side

B. a person tells his family he is sick and allows them to take care of him Rationale: Stage 2 of illness is assuming the sick role. A is the 3rd stage which is full stage of illness, C is stage 1 which is experiencing symptoms, and D is stage 4 in which the person is healing and is recovering.

A client comes to the ER with abdominal pain, fever, chills, and nausea. The client is diagnosed with appendicitis. What type of illness does the nurse identify this client to have? A. Chronic B. Acute C. Tertiary D. Contagious

B. acute illness Rationale: rapid onset of symptoms and lasts only a short amount of time

The nurse instructor informs the students that there are many factors that affect a person's health. Which of the following does the educator tell the students that is essential for physiological health and survival? A. educational needs B. basic human needs C. spiritual needs D. monetary needs

B. basic human needs Rationale: these include oxygen, food, water, and shelter and are most essential for health and survival

What is an example of an acute illness? A. Diabetes B. Rheumatoid arthritis C. Pneumonia D. Osteoporosis

C. Pneumonia Rationale: this illness has a rapid onset of action of symptoms and lasts a relatively short time unlike the other illnesses mentioned

Based on the components of the physical human dimension, the nurse would expect which clinic patient to be the most likely to have annual breast examinations? A. Jane whose best friend had a benign breast lump removed B. Sarah who lives in a low-income neighborhood C. Tricia who has a family history of breast cancer D. Nancy whose family encourages regular physical exams

C. Tricia, who has a family history of breast cancer Rationale: the physical dimension includes age, race, ethnic background, biological sex, and genetic inheritance

A rapid onset of symptoms that lasts a relatively short time indicates what health problem? A. actual risk factor B. a chronic illness C. an acute illness D. potential for wellness

C. an acute illness

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

C. family counseling Rationale: secondary promotions focus on screening for diseases and includes emotional issues in which family counseling would be necessary. All of the other options are primary promotions because they prevent diseases

A community health nurse arranges for a dental checkup camp for the local children in the school district. Which of the following would most likely be the nurse's goal for the health camp A. reversal of self-care deficit B. high-level wellness C. health promotion D. illness prevention

C. health promotion Rationale: the education on lifestyle choices is part of the health promotion. The goal of illness prevention is to detect and prevent illness, high-level wellness focuses on maximizing the person's highest potential for functioning

A nurse has volunteered to give influenza immunizations at a local clinic. What level of care is the nurse demonstrating? a. Tertiary b. Secondary c. Primary d. Promotive

C. primary

A woman over the age of 40 has an annual mammogram. What level of prevention does this represent? A. medical prevention B. primary prevention C. secondary prevention D. tertiary prevention

C. secondary prevention Rationale: secondary prevention includes screening for those at risk to develop illness or those who could be diagnosed early and given prompt treatment

Which model is most useful in examining the cause of disease in an individual, based on external factors? A. the health-illness continuum B. the high-level illness model C. the agent-host environment model D. the health belief model

C. the agent-host-environment model

A client arrives at a health care facility complaining of pain in the abdomen and diarrhea. The physician diagnoses the client with colitis, an acute illness. Why is this considered an acute illness? A. it lasts for a long time B. it is difficult to treat C. the onset is sudden D. it is not curable

C. the onset is sudden Rationale: acute illnesses are cured in a short time and are not difficult to treat

Primary health promotion is an integral part of health care. What is the purpose of primary health promotion? A. to teach people how to grow B. to change the environment in ways that enhance cultural expectations C. to promote health and prevent disease or injury D. to teach people how to act

C. to promote health and prevent disease or injury

A nurse has chosen to categorize a new initiative as "wellness promotion" rather than "health promotion" Which statement describes the difference between the concept of wellness and the concept of health?

C. wellness is an active state, whereas health is more of a passive state dependent on the absence of disease

Tertiary health promotion and illness prevention

begins after an illness is diagnosed and treated with the goal of reducing disability and helping rehabilitate patients to a maximum level of functioning Examples include: teaching diabetics to administer insulin, how to manage disease courses at home, referring someone to a support group

Health promotion model

developed to illustrate how people interact with their environment as they pursue health. health related behavior is the outcome of the model and is directed toward attaining positive health outcomes and experiences throughout the lifespan.

What are some behaviors that can be modified?

diet, smoking, lifestyle, drug abuse

Primary health promotion and illness prevention

directed toward promoting health and preventing the development of disease processes or injury Examples include: immunizations, education

Sociocultural human dimension

economic status, lifestyle, family and culture (these strongly influence people's health beliefs and practices; use of alternative healthcare over traditional)

Secondary health promotion and illness prevention

focuses on screening for early detection of disease with prompt diagnosis and treatment of any found, also includes the goal of providing prompt treatment Examples include: blood pressure screening, Pap smears, mammograms, and prostate exams

Physical human dimension

genetics, age, developmental level, race, and gender

What is an example of something that cannot be modified?

genetics, age, gender, developmental level, and environmental conditions