Community Chapter 5 Health Promotion

A 34 yr old client is recovering from a BKA secondary to a MVA. The nurse meets with the client to update his care plan, and cleint states that he knows that he will walk again. He asks for PT schedules and timelines for prosthetics on the basis of his healing process. On the basis of knowledge of the theory of reasoned action, the client's behavior reflects:

An enhanced ability to meet his goals on the basis of his intention and behaviors

The nurse identifies the specific indicators and focal areas needed to establish immunization and well-child clinics in a low-income neighborhood. What actions are needed to meet the health outcomes of the project?

Develop a plan to meet the costs and promote the benefits of the project

Absenteeism due to illness has increased recently in the local middle school. The increase is noted to be related to exacerbation of asthma symptoms in the student population. Which would be the most effective approach in decreasing absenteeism among this population?

Develop an asthma education and surveillance program that addresses students, families, and faculty members.

An immigrant form Guatemala, age 47, is admitted to the coronary care unit with CHF. This is the 4th admission for this client, and the physician believes the client's inability to adhere to his diet and RX regimen is the reason for his frequent admissions. The physician refers the client to the local community health nurse, on discharge from the hospital. Which would be most appropriate for the nurse to include in this client's place of care?

Developing culturally relevant and gender sensitive interventions

The nurse conducts a class on the basics of nutrition to a group of obese adults. The nurse counsels the audience, telling them that they need to change their behaviors. By the end of the class, the nurse has lost the audience. To enhance audience participation and learning in the next class, the nurse should:

Encourage the group to participate in the decision making

The nurse decided to use a learning model based on Skinner with a client with diabetes to improve compliance with dietary and blood glucose assessment requirements. Which would be the best way to implement this program?

Give rewards for a lower blood sugar level and food diary that reflects moderate dietary compliance

A 32 yr old African American client is diagnosed with HIV. She is at her 6mth appt. following diagnosis and treatment. The client states that she has not revealed her diagnosis to her BF b/c she is afraid that he will leave. She expresses feelings of anger b/c she must put her feelings and illness aside or be abandoned. The client's behavior reflect:

Inability to advocate for herself

Multiple family units in an underserved neighborhood have children who have not been vaccinated per health guidelines. The nurse researches the problem and establishes a well-child clinic within walking distance to the neighborhood. The clinic is poorly attended. Which would be the nurse's best action to revise the program and improve attendance to the clinic?

Interview members of the neighborhood to determine why they do not use the clinic

A 47-year-old client and three members of his neighborhood have had their homes robbed and belongings scattered. The client contacts the police and, with their assistance, develops a neighborhood watch. The watch is organized and 24 families have been recruited to participate. The watch will be active throughout vacation months and as needed. This organization is representative of:

Relapse prevention model

The nurse works at community clinic that provides various types of health screenings for members of the community. One day, the nurse provides tuberculin tests for a group of new hospital employees. Which type of screening procedure is this?

Selective screening

Using the tenets of secondary prevention, the committee seeks to establish an HIV/AIDS clinic. The nurse states that it is important for the location of the clinic to be associated with the local hospital. The committee states that the cost of the clinic associated with the hospital is higher than one that is free standing. Which presents the best rationale for the nurse's suggestion?

The hospital can more easily implement programs of care for the clients

A woman arrives at the clinic for a routine appointment. She has been HIV positive for3 years and states she is doing well. She currently is involved in a relationship with a man who is HIV positive. She states that she is not consistent with safe sex practices due to her significant other's preferences and feels uncomfortable asking him to wear a condom. Which is the nurse's best response to promote the client's health?

"You will not be protected against other strains of HIV or STIs"

Health People 2020 (HP 2020) is a guidepost for nurses and interdisciplinary teams in community and public health. New focal areas for HP 2020 include: (Select all that apply.)

1. Adolescent Health 2. Genomics 3. Social determinants of Health

A 27 yr old client comes from a background of physical and sexual abuse. Violence victimization continued with her partners until recently. She is currently in a support group for victims of abuse. The client's social background places her at risk for: SATA

1. Decreased safe sex behaviors 2. Increased risk for HIV/AIDS 3. Increased risk of depression

A 19-year-old client is diagnosed as HIV positive. Which behaviors might be indicators of noncompliance with her drug regimen and require further assessment? (Select all that apply.)

1. Depression 2. Indifference of self-advocacy in sexual relationships 3. Client's expression of concern regarding the ability to pay for her medications

Secondary HIV prevention or positive prevention is used when caring for African-American women living with HIV by addressing which behavioral risks? (Select all that apply.)

1. Interpersonal mistrust 2. Poor adherence to TX 3. Compromised self-advocacy in sexual relationships.

The nurse works in a facility that provides hospice care for clients with cancer DX's. The nurse recognizes that the care provided in this facility is tertiary in nature. The nurse develops a plan for the clients that would include the tenets of tertiary prevention. The plan would include: SATA

1. Palliative care 2. Pain control 3. Supportive spiritual development

The nurse decides to use the health belief model for a wellness walking program for older adults. The walk is to begin each day at 8 PM. Each day a different participant is to start a chain of phone calls to other participants to remind all to attend. The nurse informs the clients in the clinic that walking will improve their overall health and well-being. Two older adults show up the first night and none the second. Which information should the nurse gather to explain the failure of the program? (Select all that apply.)

1. The severity of the physical challenge related to the client population 2. What stands in the way of taking action toward the goal of health promotion 3. The presence or absence of cues needed for the program to achieve success

The local clinic is dedicated to the well adult and child. It has evening hours and offers varied programs for the community. The programs include immunizations and classes on fire safety, health education, and care safety, to name a few. How would the nurse explain the level of prevention used in this setting to your colleagues?

Primary

The committee has established the need for a sick child clinic in an impoverished neighborhood. The demographic data have been collected, and the committee is ready to meet with a group of local businesspeople who are willing to support the project financially. The plan is for the committee and group to combine to facilitate the establishment of the clinic. Using a transtheoretical model, which level of readiness has the committee achieved?

Preparation

A 43-year-old African-American client is HIV positive. She has a personal history of abuse, which ended when her husband died 2 years ago. When counseling the client about adherence to her treatment plan, the nurse finds her intelligent and goal oriented. In addition to her need for education and follow-up regarding her HIV diagnosis and treatment, which associated condition should the nurse most consider when caring for this client?

PTSD