Final Review Questions for NR222 Health & Wellness

The nurse is asked how essential oils may be used as part of aromatherapy. The nurse responds: A. "They may be mixed with carrier oils and used during massage." B. "They may be swallowed in small amounts for stomach distress." C. "They may be applied during pregnancy to prevent stretch marks." D. "They may be placed on herpes lesions on the eye."

A. "They may be mixed with carrier oils and used during massage." Essential oils may be used in the following ways: • They may be added to the bath or used in a douche. • They may be mixed with carrier oils and used during massage. • They may be applied directly to minor injuries to speed healing. • They may be placed on cloth and applied as a compress. • They may be inhaled after vaporization. Precautions should be considered when using essential oils, including: • They are for external use only. • The oils should be diluted in carrier oil before direct application to the skin. • Avoid application to the eyes and mucous membranes. • Many of the oils are contraindicated for use during pregnancy. • Essential oils should be used with caution in epilepsy, hypertension, and estrogen-dependent tumors.

Which of the following statements accurately describe poverty in the United States according to the 2010 U.S. Census? (select all that apply) A. 15.1% of the population lived below poverty level. B. Hispanics have the highest rates of poverty. C. Poverty is higher in the West. D. Growth in income has not increased equally for all households. E. 25% of people living in poverty are older Americans.

A. 15.1% of the population lived below poverty level. D. Growth in income has not increased equally for all households. E. 25% of people living in poverty are older Americans. For most people in the United States, income has risen over time. However, growth in income has not increased equally for all households. According to the 2010 U.S. Census, 15.1% of the population lived below the poverty level. Of those people, about 35.5% were children, people with disabilities comprised 28%, and older Americans were at 25%. Regionally, poverty is concentrated in the South, followed by the West, Midwest, and Northeast. It also appears higher in cities than rural areas. In 2010, groups with high poverty rates included Hispanics at 20.6% and African Americans at 24.3%.

The nurse is explaining services provided in assisted living to a couple considering a move to long-term housing for older adults. The nurse explains that assisted living includes: A. 24-hour protective oversight. B. medications administered by staff personnel. C. client responsibility for preparation of own medications. D. expectation that clients are independent in all care areas.

A. 24-hour protective oversight. Assisted living includes 24-hour oversight for clients. The clients must be mobile; they may require some assistance. All meals and snacks are provided. They may request assistance with bathing and hygiene. Housekeeping and laundry services are provided. They may require occasional assistance with dressing. The client should self-administer medication or may receive personal monitoring of medication administration.

Which activity represents secondary prevention? A. A home health care nurse visits a patient's home to change a wound dressing. B. A 50-year-old woman with no history of disease attends the local health fair and has her blood pressure checked. C. The school health nurse provides a program to the first-year students on healthy eating. D. The patient attends cardiac rehabilitation sessions weekly.

A. A home health care nurse visits a patient's home to change a wound dressing. Secondary prevention focuses on individuals who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions. The home health nurse changing the wound dressing is an activity that is focused on preventing complications. Much of the nursing care related to secondary prevention is delivered in homes, hospitals, or skilled nursing facilities.

Which of the following statements best supports the ethical principle of justice? A. Access to health care should be provided for all people. B. Dialysis should be available for clients who adhere to their prescribed dietary regimes. C. Transplant organs should be allocated based on ability to pay for hospital costs. D. Health-promotion interventions should be provided to those who agree to pay more for health services.

A. Access to health care should be provided for all people. Justice is a major ethical principle of importance in health-promotion settings. Justice is involved with the fair distribution of "goods" such as health, education, food, and shelter. Justice is the equalizing of benefits across society regardless of merit. Evaluating the four options above, it is apparent that the first statement supports justice related to provision of health care to all people, without regard to ability for payment. The other options place conditions on receiving care and interventions based on ability to pay or maintain medical regimes, which does not support the concept of justice.

Which of the following elements might be utilized with energy movement therapy? (select all that apply) A. Acupressure B. Yoga C. Imagery D. Reflexology E. Hydrotherapy

A. Acupressure B. Yoga D. Reflexology Movement therapies use movement and body work to promote physical, mental, emotional, and spiritual well-being. Yoga uses postures, controlled breathing, and meditation. Acupressure stimulates meridian points by stimulation of the acupuncture points with pressing, knuckling, rubbing, squeezing, and stretching. Reflexology is another method of moving energy by using hand pressure. Rather than to acupuncture points, the reflexologist applies pressure to mapped points on the feet or hands or both. Hydrotherapy is the use of water, ice, steam, and hot and cold temperatures to maintain and restore health and is not considered to be movement related.

Identify behaviors that foster the development of trust. (Select all that apply.) A. Answer the call light promptly. B. Call the patient by first name unless requested otherwise. C. Do all the care as quickly as possible and leave the room so the patient can rest. D. Answer questions honestly. E. Demonstrate competence when doing treatments.

A. Answer the call light promptly. D. Answer questions honestly. E. Demonstrate competence when doing treatments. Consistency, courtesy, competency, and honesty build trust. Rushing and avoiding spending time with the patient may decrease or slow the development of trust.

The nurse at an outpatient clinic asks a patient who is Chinese American with newly diagnosed hypertension if he is limiting his sodium intake as directed. The patient does not make eye contact with the nurse but nods his head. What should the nurse do next? A. Ask the patient how much salt he is consuming each day B. Discuss the health implications of sodium and hypertension C. Remind the patient that many foods such as soy sauce contain "hidden" sodium D. Suggest some low-sodium dietary alternatives

A. Ask the patient how much salt he is consuming each day In an Asian culture spoken messages often have little to do with their meanings. It is important for the nurse to clarify how much salt the patient is consuming in his diet.

Which of the following statements apply to theory generation? (Select all that apply.) A. Builds scientific knowledge base of nursing B. Discovers relationships of phenomena to practice C. Tests specific phenomena D. Identifies observations about a phenomenon

A. Builds scientific knowledge base of nursing. Theory-generating research identifies observations or describes phenomena. It contributes to the scientific knowledge base of nursing. Relationships of the phenomena to practice and testing specific phenomena are part of the theory-testing research activitie

Cognitive-behavioral therapy (CBT ) is a stress management intervention that can be utilized. Which of the following statements are true about CBT? (select all that apply) A. CBT is effective with many stress-related and mental health disorders. B. CBT is a long-term intervention. C. CBT helps people evaluate their thoughts, challenge them, and replace them with more rational cognitive and behavioral responses. D. CBT can be utilized by any therapist. E. Cognitive-behavioral restructuring teaches people that negative thinking often causes emotional distress.

A. CBT is effective with many stress-related and mental health disorders. C. CBT helps people evaluate their thoughts, challenge them, and replace them with more rational cognitive and behavioral responses. E. Cognitive-behavioral restructuring teaches people that negative thinking often causes emotional distress. Cognitive-behavioral therapy (CBT) is a conceptually based short-term intervention to modify negative or catastrophic thinking and related behaviors, and thereby reduce stress. It is a technique or series of strategies that help people evaluate their thoughts, challenge them, and replace them with more rational cognitive and behavioral responses. Although advanced training is needed, nurses can safely and effectively use basic strategies. Cognitive-behavioral restructuring teaches people that negative thinking often causes emotional distress. This recognition will alter the negative thinking and reduce the negative consequences of stress.

Priority nursing assessments of Asian Americans/Pacific Islanders should be on which disease process? A. COPD B. Hypertension C. Diabetes mellitus D. Breast cancer

A. COPD Asian Americans have a high prevalence and risk factors of chronic obstructive pulmonary disease, hepatitis B, HIV/AIDS, smoking, tuberculosis, and liver disease. Asian American/Pacific Islander women are less likely to die of breast cancer, and infant mortality rates are lower compared with other ethnic groups. They have lower rates of being overweight, lower rates of hypertension, and are less likely to be cigarette smokers.

Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) A. Caregiver B. Autonomy and accountability C. Patient advocate D. Health promotion E. Lobbyist

A. Caregiver B. Autonomy and accountability C. Patient advocate Each of these roles includes activities for the professional nurse. Each of these is used in direct care or is part of professionalism that guides nursing practice. Some nurses are lobbyists, but being a lobbyist is not expected of all professional nurses

Which of the following is closely aligned with Leininger's theory? A. Caring for patients from unique cultures B. Understanding the humanistic aspects of life C. Variables affecting a patient's response to a stressor D. Caring for patients who cannot adapt to internal and external environmental demands

A. Caring for patients from unique cultures Leininger's theory of transcultural nursing focuses on the patient's culture and the impact of culture heritage on health care needs and interventions.

Which entities recommend that health practitioners within the United States use growth charts for children from birth to 24 months? (select two that apply) A. Centers for Disease Control and Prevention B. World Health Organization C. The Joint Commission D. Healthy People 2020

A. Centers for Disease Control and Prevention B. World Health Organization Growth is one of the most important indications of a child's overall health and well-being. Based on input from an expert panel, the Centers for Disease Control and Prevention (CDC) recommended that health practitioners within the United States use the 2006 WHO international growth charts for children from birth to 24 months, and continue to use the revised 2000 CDC growth charts (including the BMI and the 3rd and 97th percentile) for children aged 2 to 20 years. This recommendation was based on the fact that WHO growth charts were compiled from healthy breastfed infants living in optimal conditions—achieving the greatest potential of growth possible, which was recognized as the desired standard against which to compare the growth of all other infants (CDC, 2010).

The client who would be least likely to participate in health teaching activities would choose which model? A. Clinical model B. Adaptive model C. Role performance model D. Eudaimonistic model

A. Clinical model The clinical model of health has the absence of signs and symptoms of disease as indicative of health. People who use this model of health to guide their use of health care services may not seek preventative health services, or they may wait until they are very ill to seek care. Personal responsibility for health may not be a motivating factor for this individual because the provider is responsible for dealing with the health problem and returning the person to a state of health. Attempts at health-promoting activities may not be effective with this person. The role performance model has the ability to perform social roles as indicative of health. This model is the basis for work and school physical examinations and physician-excused absences. The adaptive model of health has the ability to adapt positively to social, mental, and physiological changes indicative of health. The eudaimonistic model of health uses exuberant well-being as indicative of health. This model is also more congruent with integrative modes of therapy.

A nurse is teaching a 27-year-old gentleman how to adjust his insulin dosages based on his blood sugar results. What type of learning is this? A. Cognitive B. Affective C. Adaptation D. Psychomotor

A. Cognitive Cognitive learning requires thinking; learning how to adjust insulin requires analysis, synthesis, and evaluation, which are all types of cognitive learning.

What are some ethical standards that nurses can utilize for interpersonal communications? (select all that apply) A. Communicate information accurately. B. Take a laissez-faire approach to minimize conflict C. Change the subject when unsure of the correct answer. D. Be sensitive to gender and cultural context. E. Communicate verbal and nonverbal messages in a congruent manner.

A. Communicate information accurately. D. Be sensitive to gender and cultural context. E. Communicate verbal and nonverbal messages in a congruent manner. The nurse's responsibility in communication is to help the individual to examine values, identify conflicts, and prioritize goals and desired health care outcomes. The nurse should not take a laissez-faire approach and avoid the conversation. Guidelines that may be adapted as ethical standards for interpersonal communication include: • Being aware and open to changing concepts of self and others • Communicating verbal and nonverbal messages with congruent meanings • Sharing responsibility for the consequences among communicators • Recognizing the multicultural context of all communication • Respecting the dignity of every person • Avoiding coercion and use of power in communicating.

Ethnicity is evident in customs of particular groups. Which of the following statements accurately reflect the definitions of culture, values and value orientation? (select all that apply) A. Culture refers to patterns of human behavior that include language, communication, customs and beliefs. B. Ethnicity is shaped by values, beliefs, norms, and practices that are shared by members of the same group. C. Health care beliefs and attitudes among ethnic groups are congruent with health care providers. D. Values are beliefs about the worth of something and serve as standards that influence behavior.

A. Culture refers to patterns of human behavior that include language, communication, customs and beliefs. D. Values are beliefs about the worth of something and serve as standards that influence behavior. Culture is an element of ethnicity that refers to patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. Values are beliefs about the worth of something and serve as standards that influence behavior. Value orientations reflect the personality type of a particular society. Culture is shaped by values, beliefs, norms, and practices that are shared by members of the same cultural group. Ethnic groups have unique beliefs and attitudes about health and health care services. Beliefs are generally incongruent with health care providers and prove to be major barriers to improving the health status of ethnic group members.

Research has documented what symptom one of the strongest predictors of adolescent obesity? A. Depression B. Excessive TV watching C. Lack of physical activity D. Meal skipping

A. Depression Studies have shown a strong correlation between inactivity, such as viewing television, and the tendency to be overweight. Research has identified depression as one of the strongest predictor of adolescent obesity.

What are the leading nutritional guidelines that are used for translation into law, policy, programs and consumer messages in the United States? (select all that apply) A. Dietary Reference Intakes B. Recommended Dietary Allowances C. Dietary Guidelines for Americans D. My Plate E. Food and Drug Administration

A. Dietary Reference Intakes C. Dietary Guidelines for Americans D. My Plate Dietary Reference Intakes (DRIs) were developed by the Institute of Medicine in 1997 to reflect the latest understanding about nutrient requirements based on optimizing health in individuals and groups. They replaced previously issued Recommended Dietary Allowances (RDAs), which focused on the minimum amount of nutrients needed to protect against nutrient deficiency. Dietary Guidelines for Americans is released by USDA and My Plate is a food guidance system which can be used as a visual reminder to consumers about what a healthy plate looks like in a familiar place setting. The Food and Drug Administration (FDA) is the federal agency responsible for oversight of the safety of dietary supplements, drugs, and food products.

A male patient has been laid off from his construction job and has many unpaid bills. He is going through a divorce from his marriage of 15 years and has been seeing his pastor to help him through this difficult time. He does not have a primary health care provider because he has never really been sick and his parents never took him to the physician when he was a child. Which external variables influence the patient's health practices? (Select all that apply.) A. Difficulty paying his bills B. Seeing his pastor as a means of support C. Family practice of not routinely seeing a health care provider D. Stress from the divorce and the loss of a job

A. Difficulty paying his bills C. Family practice of not routinely seeing a health care provider External factors impacting health practices include family beliefs and economic impact.

When action is taken on one's prejudices: A. Discrimination occurs. B. Delivery of culturally congruent care is ensured. C. Effective intercultural communication develops. D. Sufficient comparative knowledge of diverse groups is obtained.

A. Discrimination occurs. Prejudices associate negative permanent characteristics with people who are different from the valued group. When a person acts on these prejudices, discrimination occurs.

When interviewing a Native American patient on admission to the hospital emergency department, which questions are appropriate for the nurse to ask? (Select all that apply.) A. Do you use any folk remedies? B. Do you have a family physician? C. Do you use a Shaman? D. Does your family have a history of alcohol abuse?

A. Do you use any folk remedies? B. Do you have a family physician? C. Do you use a Shaman? Obtain information about folk remedies and cultural healers that the patient uses. Assessment data yield information about the patient’s beliefs about the illness and the meaning of the signs and symptoms.

You are caring for a recently retired man who appears withdrawn and says he is "bored with life." Applying the work of Havinghurst, you would help this individual find meaning in life by: A. Encouraging him to explore new roles. B. Encouraging relocation to a new city. C. Explaining the need to simplify life. D. Encouraging him to adopt a new pet.

A. Encouraging him to explore new roles. The activity theory states that continuing an active, involved lifestyle results in greater satisfaction and well-being.

As an art nursing relies on knowledge gained from practice and reflection on past experiences. As a science nursing relies on (select all that apply): A. Experimental research. B. Nonexperimental research. C. Research from other disciplines. D. Professional opinions.

A. Experimental research. B. Nonexperimental research. As a science, nursing relies on knowledge gained through research from nursing and other disciplines and scientifically tested knowledge applied in the practice setting.

Match the following components of systems theory with the definition of that component. A. Feedback B. Input C. Content D. Output 1. Data entering the system 2. End product 3. Data related to system functioning 4. Product and information obtained from the system

A. Feedback is 3. Data related to system functioning B. Input is 1. Data entering the system. C. Content is 4. Product and information obtained from the system D. Output is 2. End product

When a nurse assesses a patient for pain and offers a plan to manage the pain, which principal is used to encourage the nurse to monitor the patient's response to the pain? A. Fidelity B. Beneficence C. Nonmaleficence D. Respect for autonomy

A. Fidelity Requiring a return to the patient to evaluate the effectiveness of an intervention exemplifies keeping a promise, a concrete example of fidelity.

Advanced practice registered nurses generally: A. Function independently B. Function as unit directors C. Work in acute care settings D. Work in the university setting

A. Function independently Advanced practice registered nurse functions independently as a clinician, educator, case manager, consultant, and researcher within his or her area of practice to plan or improve the quality of nursing care for the patient and family.

Match the following theories with their definitions. A. Grand theory B. Middle-range theory C. Descriptive theory D. Prescriptive theory 1. Addresses specific phenomena and reflect practice 2. First level in theory development and describes a phenomenon 3. Provides a structural framework for broad concepts about nursing 4. Linked to outcomes (consequences of specific nursing interventions)

A. Grand theory is 3. Provides a structural framework for broad concepts about nursing. B. Middle-range theory is 1. Addresses specific phenomena and reflect practice. C. Descriptive theory is 2. First level in theory development and describes a phenomenon. D. Prescriptive theory is 4. Linked to outcomes (consequences of specific nursing interventions)

Which of the following agencies or initiatives have been driving forces in health care reform and the prevention of disease in society? (select all that apply) A. Healthy People B. Health Insurance Portability and Accountability Act C. U.S. Department of Health, Education, and Welfare D. Patient Protection and Affordable Care Act E. U.S. Department of Health and Human Services

A. Healthy People C. U.S. Department of Health, Education, and Welfare E. U.S. Department of Health and Human Services Public health has always had the prevention of disease in society as its focus. Over the past 30 years, the promotion of health and individual responsibility moved to the forefront within public health. A key milestone in promoting health was the advent of Healthy People, related to the U.S. Department of Health, Education and Welfare. The U.S. Department of Health and Human Services is now responsible for the Healthy People objectives. The Health Insurance Portability and Accountability Act and the Patient Protection and Affordable Care Acts are not associated with the prevention of disease in society.

Which of the following general statements about physical activity are true? (select all that apply) A. Higher education and income are associated with more leisure-time activity. B. People who are obese are usually less active than their leaner counterparts. C. Women are more active than men. D. Physical activity increases with age. E. Ethnic minorities are less active than white Americans.

A. Higher education and income are associated with more leisure-time activity. B. People who are obese are usually less active than their leaner counterparts. E. Ethnic minorities are less active than white Americans. Although benefits of physical activity are common to all people, patterns of physical activity vary among population subgroups defined by gender, age, racial background, income and body fat. The following generalities are true: • Men are more active than women. • Physical activity declines with age. • Ethnic minorities are less active than white Americans. • Higher education and income are associated with more leisure-time activity. • People who are obese are usually less active than their leaner counterparts.

When taking care of patients, the nurse routinely asks them if they take any vitamins or herbal medications, encourages family members to bring in music that the patient likes to help the patient relax, and frequently prays with her patients if that is important to them. The nurse is practicing which model? A. Holistic B. Health belief C. Transtheoretical D. Health promotion

A. Holistic The nurse is using a holistic model of care that considers emotional and spiritual well-being and other dimensions of an individual to be important aspects of physical wellness. The holistic health model of nursing attempts to create conditions that promote optimal health. Nurses using the holistic nursing model recognize the natural healing abilities of the body and incorporate complementary and alternative interventions such as music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery because they are effective, economical, noninvasive, nonpharmacological complements to traditional medical care.

The nurse is preparing a class on young adult risk factors for violence. The nurse includes content on which of the following? (select all that apply) A. Homicide is the second leading cause of death in young adults. B. Violence is becoming less prevalent globally. C. Homicide is the leading cause of death for black young men. D. Firearms are involved in less that ½ of homicides. E. More women than men are at risk for death from a firearm. F. The presence of firearms in the home is associated with the increased risk of firearm injury to children.

A. Homicide is the second leading cause of death in young adults. C. Homicide is the leading cause of death for black young men. F. The presence of firearms in the home is associated with the increased risk of firearm injury to children. Homicide is the second leading cause of death in the 15- to 24-year-old age group and the leading cause of death for black men in the same age category. Firearms are involved in approximately two thirds of these deaths, and men have twice the risk of dying than women. The presence of firearms in the home is associated with the increased risk of unintentional and intentional firearm injury to children. Violence is becoming more prevalent globally related to organized terrorism.

A nurse needs to teach a young woman newly diagnosed with asthma how to manage her disease. Which of the following topics does the nurse teach first? A. How to use an inhaler during an asthma attack B. The need to avoid people who smoke to prevent asthma attacks C. Where to purchase a medical alert bracelet that says she has asthma D. The importance of maintaining a healthy diet and exercising regularly

A. How to use an inhaler during an asthma attack It is important to start with essential life-saving information when teaching people because they usually remember what you tell them first.

Allison, age 15 years, calls her best friend Laura and is crying. She has a date with John, someone she has been hoping to date for months, but now she has a pimple on her forehead. Laura firmly believes that John and everyone else will notice the blemish right away. This is an example of the: A. Imaginary audience. B. False-belief syndrome. C. Personal fable. D. Personal absorption syndrome.

A. Imaginary audience. Adolescents are quite egocentric and have the belief that everyone is focused on them and sees all of their flaws.

What are the two overarching goals of Healthy People 2010? (select two that apply) A. Increase quality and years of life B. Eliminate health disparities C. Create access to preventive services for all. D. Increase the span of healthy life

A. Increase quality and years of life B. Eliminate health disparities Healthy People 2010 set out two overarching goals. They are to: increase quality and years of healthy life, and eliminate health disparities. Healthy People 2000 set out three broad goals. They were to: increase the span of healthy life, reduce health disparities, and create access to preventive services for all.

In health-promotion activities, which of the following statements is accurate regarding respect for autonomy? (select all that apply) A. Individuals must be given the information they need to make choices. B. Choices are autonomous when public policy dictates the action. C. Autonomous choices are made when the person can understand the risks and benefits of the choices. D. Autonomous choices are acceptable even when mental capacity is questionable. E. Choices are considered autonomous in the absence of coercive influence.

A. Individuals must be given the information they need to make choices. C. Autonomous choices are made when the person can understand the risks and benefits of the choices. E. Choices are considered autonomous in the absence of coercive influence. In health-promotion activities, respect for autonomy requires that individuals be given the information they need to make choices. Choices can be considered autonomous only if certain criteria are met. The criteria that determine whether or not a person is actually capable of autonomous (voluntary) choice include cognitive maturity, possession of appropriate information to permit decision-making, intact mental capacities (the ability to reason logically), the absence of internal or external coercive influences, and the ability to appreciate the risks and benefits of alternative choices.

A 48-year-old woman complains to her nurse that she is experiencing frequent episodes of insomnia. What are some measures the nurse should educate her about? (select all that apply) A. Insomnia is common for this age group. B. Engage in activity 1 to 2 hours before bed to encourage sleep. C. Avoid or reduce the amount of caffeinated beverages that are consumed. D. Occasional napping should be avoided. E. Have a regular schedule for waking and sleep.

A. Insomnia is common for this age group. C. Avoid or reduce the amount of caffeinated beverages that are consumed. E. Have a regular schedule for waking and sleep. Insomnia is a common finding in this age category. This condition may be the result of overstimulation resulting from drinking too much caffeinated beverages, strenuous exercise within two hours of bedtime, not having a regular schedule for waking and sleep in a 24-hour period (National Sleep Foundation, 2012). Frequently-occurring insomnia can lead to distractibility and irritability and fatigue during the daytime hours. Rest is essential to allow restorative functions of the body to occur. The effects of insomnia can be counteracted by regularly scheduled, high-quality sleep and occasional napping when fatigued.

A nurse is applying Henderson's theory as a basis for theory based-nursing practice. Which other elements are important for theory-based nursing practice? (Select all that apply.) A. Knowledge of nursing science B. Knowledge of related sciences C. Knowledge about current health care issues D. Knowledge of standards of practice

A. Knowledge of nursing science D. Knowledge of standards of practice Regardless of which particular nursing theory is selected, the nurse must use knowledge from nursing and related sciences, experience, and standards of practice when providing care

Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform? A. Moving from an acute illness to a health promotion, illness prevention model B. Moving from illness prevention to a health promotion model C. Moving from an acute illness to a disease management model D. Moving from a chronic care to an illness prevention model

A. Moving from an acute illness to a health promotion, illness prevention model Health care reform also affects how health care is delivered. There is greater emphasis on health promotion, disease prevention, and management of illness.

The patient states she joined a fitness club and attends the aerobics class three nights a week. The patient is in what stage of behavioral change? A. Precontemplation B. Contemplation C. Preparation D. Action

D. Action The patient is in the action stage of behavioral change. In this stage the patient is actively engaged in strategies to change behavior. This stage may last up to 6 months.

What are the two main types of dementia in older adults? (select two that apply) A. Multiinfarct dementia B. Parkinson-related dementia C. Alzheimer's disease D. Lewy body dementia Huntington disease

A. Multiinfarct dementia C. Alzheimer's disease Dementia is an illness of the cognitive system and is not accepted as a normal change of aging. Two main types of dementia exist. The first type is multiinfarct dementia, which is caused by the death of brain tissue and diagnosed through brain imaging. Tissue death may be caused by of a lack of blood flow to the brain from a cerebral vascular accident (CVA) or from another cause. The other main type of dementia is Alzheimer's disease (AD), the most common type, which makes up about 50% of all dementia diagnoses. Other dementias include Parkinson-related dementia, Huntington disease, Creutzfeldt-Jakob disease, Pick disease, and Lewy body dementia.

Which of the following statements accurately describe ethical theories? (Select all that apply) A. Normative theories are concerned with ensuring good actions. B. Descriptive theories tell us what actions to take. C. Consequentialist theories hold that decisions should take into account all knowable potential consequences. D. Religions and duty-based theories assert that certain duties will produce good outcomes. E. Descriptive theories are directive.

A. Normative theories are concerned with ensuring good actions. C. Consequentialist theories hold that decisions should take into account all knowable potential consequences. D. Religions and duty-based theories assert that certain duties will produce good outcomes. Descriptive theories do not tell us what actions we ought to take. They are not directive; they merely tell us how people act toward each other and their environments and what they seem to believe are good or moral actions. Normative theories, on the other hand, are concerned with ensuring good actions. The consequentialist theory holds that the consequences or intended consequences of actions matter. Therefore from the consequentialist perspective, any decision about intended actions or interventions must take into account all knowable potential consequences. Duty-based theories, such as that of Immanuel Kant (1724-1804) and those of various religions (Judaism, Christianity, Islam), depend more on adherence to duties than on good consequences. Individuals are viewed as having certain duties that cannot be circumvented, even if deliberately side-stepping the duty would result in good outcomes. For religions, these rules are imparted in some way by a divine being.

The nurse utilizes strategies associated with client-centered communication by doing which of the following? (select all that apply) A. Not being "too busy" to talk B. Focusing on the nurse's views C. Developing mutual understanding D. Emphasizing the technical aspects of care E. Using a conversational interviewing style F. Tuning in to the client's preferences and style

A. Not being "too busy" to talk C. Developing mutual understanding E. Using a conversational interviewing style F. Tuning in to the client's preferences and style All of those responses focus attention on the client. The other two options focus on the nurse, and emphasizing the technical aspects of care is for information giving, again with the major focus on the nurse.

What are some of the definitions that support using the term profession to denote the status of nursing? (select all that apply) A. Nursing is considered a profession because it provides a service to society. B. Nursing is considered a profession because of the stable employment opportunities. C. Nursing is self-governing. D. Members of the nursing profession are accountable for their actions. E. Members of a profession abide by a code of ethics

A. Nursing is considered a profession because it provides a service to society. C. Nursing is self-governing. D. Members of the nursing profession are accountable for their actions. E. Members of a profession abide by a code of ethics. Using the term profession to denote the status of nursing and other disciplines is controversial. Nursing is a profession insofar as it provides a service to society, is self-governing, and its members are accountable for their actions (Grace, 2001). One important characteristic of professions, especially those that provide crucial services to society, is that they have codes of ethics that provide essential elements of their promises of service to society. A significant consequence of professional status is that members can be held accountable for their practice formally by professional licensure boards. More importantly, they are morally accountable for practicing according to their discipline's implicit or explicit code of ethics. Codes of ethics provide a normative framework for professional actions. A professional implicitly accepts these codes on acquiring membership in the discipline.

When Ryan was 3 months old, he had a toy train; when his view of the train was blocked, he did not search for it. Now that he is 9 months old, he looks for it, reflecting the presence of: A. Object permanence. B. Sensorimotor play. C. Schemata. D. Magical thinking.

A. Object permanence. He is now in Piaget's later stage of sensorimotor thought and has learned that objects exist even though he cannot see or touch them.

Health is considered to be a metaparadigm for nursing and includes which of the following components? (select all that apply) A. Person B. Health C. Environment D. Nursing E. Psychosocial wellness

A. Person B. Health C. Environment D. Nursing Health is defined as a state of physical, mental, spiritual, and social functioning that realizes a person's potential and is experienced within a developmental context. Health is considered to be part of the metaparadigm for nursing, which includes the four components of person, health, environment, and nursing. Health encompasses spiritual, developmental, and environmental aspects over time. Psychosocial wellness is not considered to be one of the four components of the metaparadigm for nursing.

According to many CAM practitioners, which of the following dimensions comprise the concept of whole health? (select all that apply) A. Physical B. Social C. Emotional D. Spiritual E. Sociophysical

A. Physical B. Social C. Emotional D. Spiritual Whole health is comprised of five dimensions—physical, spiritual, emotional intellectual, and social; other sources add environmental as a six element. To be truly healthy, all the dimensions must be healthy. Western or allopathic medicine traditionally supports the physical dimension, and most often promotes curative interventions rather than preventive modalities.

Which of the following stressors are examples of intrinsic factors? (select all that apply) A. Poor time management B. A traffic jam C. Social interactions D. Poor communication E. Catastrophic negative thinking

A. Poor time management D. Poor communication E. Catastrophic negative thinking Intrinsic factors that create stress for an individual are those that are created or exacerbated by poor time management, procrastination, poor communication, catastrophic negative thinking (expecting the worst), or struggling with self-defeating behaviors. A traffic jam is an example of an extrinsic factor, which is something that a person has no control over. Stressors that individuals can modify include changing their environment and social interactions or behaviors.

Music therapy has been used successfully to produce desired outcomes in which of the following client conditions? (select all that apply) A. Postoperative pain B. Postpartum depression C. Acute myocardial infarction D. Pain associated with labor E. Osteoarthritis pain F. Nausea and vomiting induced by chemotherapy

A. Postoperative pain C. Acute myocardial infarction D. Pain associated with labor E. Osteoarthritis pain F. Nausea and vomiting induced by chemotherapy Music therapy works by influencing the area of the brain involved with emotions and feelings, the limbic system. Music therapy has been documented as decreasing anxiety and increasing pain thresholds in postoperative clients. Music therapy has had a significant effect on pain and distress in laboring mothers. Others have found music therapy can be used with clients with osteoarthritis pain. Classical music used with clients with acute myocardial infarction documented a significant decrease in heart rate, respiratory rate, and oxygen demand, after these clients listened to 20 minutes of music. Music therapy has produced a significant decrease in nausea and vomiting associated with administration of chemotherapy.

Common visual conditions which may occur in middle-aged adults include which of the following? (select all that apply) A. Presbyopia B. Glaucoma C. Cataracts D. Macular degeneration E. Presbycusis

A. Presbyopia B. Glaucoma C. Cataracts D. Macular degeneration Presbyopia (farsightedness) is common in middle-age adults, even in individuals who have had no previous problems with their vision. Glaucoma occurs as a result of increased intraocular pressure, which can damage the optic nerve. Cataracts, an opacity of the lens, can develop and cloud the vision in later years of middle age. Macular degeneration is a progressive deterioration of the maculae of the retina and choroid structures of the eye (Mosby, 2008). Presbycusis is an impairment in auditory acuity.

Nurses in the school setting can participate in health promotion activities through creating nut-free schools. This would protect hypersensitive children from life-threatening allergic reactions to peanuts and other nut products. This type of program is an example of which of the following interventions? A. Primary B. Secondary C. Tertiary D. Emergent

A. Primary Primary prevention interventions are considered health protection when they emphasize shielding or defending the body (or the public) from specific causes of injury or disease. An example is creating nut-free schools to protect hypersensitive children from life-threatening allergic reactions to peanut and other nut products. Such initiatives have largely been the result of grassroots parent organizations working with formal community organizations to adopt policies that protect the health of these children. Nurses may be involved in the parent organizations or the school or public health boards that review the proposed policies. Secondary prevention ranges from providing screening activities and treating early stages of disease to limiting disability by averting or delaying the consequences of advanced disease. Tertiary prevention occurs when a defect or disability is permanent and irreversible. Emergent care is not associated with health promotion activities.

The nurse is participating at a health fair at the local mall giving influenza vaccines to senior citizens. What level of prevention is the nurse practicing? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Quaternary prevention

A. Primary prevention Primary prevention is aimed at health promotion and includes health-education programs, immunizations, and physical and nutritional fitness activities. It can be provided to an individual and includes activities that focus on maintaining or improving the general health of individuals, families, and communities. It also includes specific protection such as immunization for influenza.

Which of the following are Healthy People 2020 objectives for heart disease? (select all that apply) A. Reduce the proportion of adults with high total blood cholesterol levels. B. Decrease the number of persons requiring open-heart surgery. C. Reduce consumption of calories from solid fats and added sugars in the population aged 2 years and older. D. Increase the proportion of adults with coronary heart disease or stroke who have their LDL cholesterol level at or below recommended levels. E. Reduce the proportion of adults who are obese (to 30.6% from 34%). F. Increase the number of persons with heart disease who receive an aspirin at discharge.

A. Reduce the proportion of adults with high total blood cholesterol levels. C. Reduce consumption of calories from solid fats and added sugars in the population aged 2 years and older. D. Increase the proportion of adults with coronary heart disease or stroke who have their LDL cholesterol level at or below recommended levels. E. Reduce the proportion of adults who are obese (to 30.6% from 34%). Decreasing the amount of people needing open-heart surgery is not part of that document. Increasing the number of people who receive aspirin is part of the Core Measure requirements for a person who has been hospitalized for an acute myocardial infarction at discharge.

The nurse is teaching a parenting class to a group of pregnant adolescents. The nurse pretends to be the baby's father, and the adolescent mother is asked to show how she would respond to the father if he gave her a can of beer. Which teaching approach did the nurse use? A. Role play B. Discovery C. An analogy D. A demonstration

A. Role play In role play people are asked to play themselves or someone else in a situation to enhance their confidence in handling that situation in the future.

An effective method for older adults to feel engaged in the community is through: A. volunteering. B. downsizing. C. retirement. D. gardening.

A. volunteering. Volunteering can be an effective method for older adults to continue to feel engaged in the community as a productive, contributing member of society. Older adults who volunteer have an external incentive for getting dressed in the morning; they take a great amount of pride in their work. Filling a volunteer position can provide a feeling of self-worth and remedy any negative feelings about retirement and other role changes. Downsizing can contribute to profound feelings of loss for the older adult. Having retirement activities such as gardening or volunteering can provide enjoyment for the older adult.

Nurses caring for the Black/African American population need to maintain an awareness of which of the following health-related cultural aspects of care? (select two that apply) A. Severe high blood pressure is more common for African Americans. B. Cancer and mortality rates for African Americans is higher than that for White Americans. C. African Americans are less likely to be diagnosed with diabetes. D. African Americans have the highest percentage of women with low or no prenatal care in the first trimester.

A. Severe high blood pressure is more common for African Americans. B. Cancer and mortality rates for African Americans is higher than that for White Americans. Severe high blood pressure is more common for African Americans in both men and women. African American adults are 40% more likely to have high blood pressure. The incidence of cancer and mortality rates for African Americans is higher than that for White Americans. African Americans are two times more likely to be diagnosed with diabetes than non-Hispanic whites, and they are more likely to suffer complications from diabetes. African Americans experience high infant and maternal mortality rates and they have the second-highest percentage of women who lack prenatal care in the first trimester of pregnancy.

A community health nurse is making a healthy baby visit to a new mother who recently emigrated to the United States from Ghana. When discussing contraceptives with the new mom, the mother states that she won't have to worry about getting pregnant for the time being. The nurse understands that the mom most likely made this statement because: A. She won't resume sexual relations until her baby is weaned. B. She is taking the medroxyprogesterone (Depo-Provera) shot. C. Her husband was recently deployed to Afghanistan. D. She has access to free condoms from the clinic.

A. She won't resume sexual relations until her baby is weaned. In some African cultures such as in Ghana and Sierra Leone some women will not resume sexual relations with their husbands until the baby is weaned.

The nurse counsels the older adult about the benefits of regular physical activity. What are the educational points to use when promoting strength training? (select all that apply) A. Strength training can improve balance. B. Strength training can increase the risk of falls. C. Strength training can strengthen bones. D. Strength training can reduce the incidence of acute illnesses. E. Strength training reduces blood glucose levels.

A. Strength training can improve balance. C. Strength training can strengthen bones. E. Strength training reduces blood glucose levels. Regular physical activity can help or prevent many chronic health problems associated with aging, including hypertension, obesity, diabetes, and depression. Regular physical activity can increase both the years of life and the quality of those years. Strength training can improve balance and reduce the risk of falls, strengthen bones, and reduce blood glucose levels. Although exercise is not popular among this age group, no physiological or psychological explanation has been found to explain this decline in interest.

A patient with chest pain is having an emergency cardiac catheterization. Which teaching approach does the nurse use in this situation? A. Telling approach B. Selling approach C. Entrusting approach D. Participating approach

A. Telling approach The telling approach is most appropriate when preparing a patient for an emergency procedure.

Nurses caring for the young adult population maintain awareness about screening for hypertension. Which of the following statements are true about hypertension in young adults? (select all that apply) A. The Mexican American population has the lowest percentage of individuals with high blood pressure. B. African Americans have the highest rates of high blood pressure. C. Health insurance has a direct correlation with hypertension control. D. Adopting healthy behaviors after being diagnosed with hypertension will not reduce the incidence. E. The prevalence of treatment and control of hypertension is lowest in young adults.

A. The Mexican American population has the lowest percentage of individuals with high blood pressure. B. African Americans have the highest rates of high blood pressure. E. The prevalence of treatment and control of hypertension is lowest in young adults. The Mexican American population has the lowest percentage of high blood pressure individuals (25.5%); the White only, non Hispanic is intermediate at 28.8%; whereas the non-Hispanic, Black/African American population has the highest (42%) (USDHHS, 2010). The prevalence of treatment and control of hypertension was also lowest in young adults (31%) and Mexican Americans (37%). This may be related to lack of a usual source of care, but most surveyed had health insurance, so health insurance alone is not sufficient to correlate with better hypertension control (Gillespie, Kuklina, Briss, Blair, & Hong, 2011). Gillespie et al. (2011) goes on to report that adoption of healthy behaviors, particularly of reducing dietary salt from an average of 3400 mg. to 2300 mg. daily could dramatically reduce the incidence of hypertension.

Successful ethical discussion depends on people who have a clear sense of personal values. When a group of people share many of the same values, it may be possible to refer for guidance to philosophical principals of utilitarianism. This philosophy proposes which of the following? A. The value of something is determined by its usefulness to society. B. People's values are determined by religious leaders. C. The decision to perform a liver transplant depends on a measure of the moral life that the patient has led so far. D. The best way to determine the solution to an ethical dilemma is to refer the case to the attending physician or health care provider.

A. The value of something is determined by its usefulness to society. Utilitarianism specifically refers to the greatest good for the greatest number of people, whereas goodness is determined primarily by usefulness. The concept is easier to apply in a community where shared values allow for agreement about a definition of usefulness.

Resolution of an ethical dilemma involves discussion with the patient, the patient's family, and participants from all health care disciplines. Which of the following describes the role of the nurse in the resolution of ethical dilemmas? A. To articulate his or her unique point of view, including knowledge based on clinical and psychosocial observations B. To await new clinical orders from the physician C. To limit discussions about ethical principals D. To allow the patient and the physician to resolve the dilemma without regard to personally held values or opinions regarding the ethical issues

A. To articulate his or her unique point of view, including knowledge based on clinical and psychosocial observations Nursing plays a unique and critical role in the resolution of difficult ethical situations. The nurse is often able to contribute information not available to others on the team, the result of the special relationship that nurses build with patients. In providing this information, it is important to remain aware of one's own values and how they may differ from those of the patient and others on the health care team.

Independent seniors may experience which of the following barriers to obtaining adequate nutritional intake? (select all that apply) A. Transportation issues B. Income C. Socialization D. Social support resources E. Cultural food preferences

A. Transportation issues B. Income D. Social support resources For independent seniors, barriers that may interfere with the ability to obtain adequate and nutritional food include limited transportation, income, and social support resources. Problems with access to food are compounded by the effect of normal changes of aging. Declines in gastrointestinal organ function can lead to changes in digestive metabolism and the absorption and elimination of nutrients. A deterioration of the smell, vision, and taste senses and the high frequency of dental and swallowing problems make maintaining adequate daily nutrition even more difficult. Additionally, side effects of required medications may affect appetite. Cultural food preferences and lifelong eating habits, such as diets high in fat and cholesterol, are other obstacles to maintaining optimal nutrition.

Which of the following methods of communication are most appropriate for use with individuals who are deaf, hard of hearing, or have a language barrier? (select all that apply) A. Utilize written communication with someone who is deaf or hard of hearing. B. Untrained personnel or relatives are acceptable interpreters as long as they are fluent in the language. C. Nonverbal messages are universal. D. Touch is an acceptable form of communication with the blind. E. Braille is used in communication with the deaf and hard of hearing.

A. Utilize written communication with someone who is deaf or hard of hearing. D. Touch is an acceptable form of communication with the blind. People who are deaf or hard of hearing often use sign language to communicate. Signs, similar to spoken or written words, are used consistently to represent a particular meaning. Braille assists blind and visually challenged people to read. Touch is used to interpret markings that represent letters and words. Verbal communication with people who speak a different language poses a challenge. Confidentiality issues, the complexity of health information, and the need to validate understandings and reach mutual decisions make it inappropriate to use untrained personnel or relatives to interpret simply because they are available. Although all communication has the potential of being misunderstood, nonverbal communication is particularly subject to misunderstanding because it does not always reflect the sender's conscious intent.

Which theory of development asserts that learning precedes development? A. Vygotsky's theory of cognitive development B. Piaget's theory of cognitive development C. Erikson's theory of psychosocial development D. Kohlberg's theory of moral development

A. Vygotsky's theory of cognitive development Vygotsky proposed that learning precedes development. One of the significant differences between the cognitive theories of Piaget and Vygotsky is that Piaget believed that development preceded learning. Piaget proposed that a level of cognitive development must be reached before learning could take place. Vygotsky thought that by viewing development and learning in this way, that adults would teach to the lowest ability, aiming instruction at those mental functions or intellectual operations that had already matured in the child

Major goals in assessing each person's functional pattern are to determine: (select all that apply) A. ability to manage health-promoting activities. B. herbal medications that promote health. C. knowledge of health promotion. D. the need for physician referral for illness care. E. the value that the person ascribes to health promotion.

A. ability to manage health-promoting activities. C. knowledge of health promotion. E. the value that the person ascribes to health promotion. A major goal in assessing each pattern is to determine the individual's knowledge of health promotion, the ability to manage health-promoting activities, and the value that the individual ascribes to health promotion. The assessment of herbal medications is important to determine potential for interactions with other prescribed medications, and adverse effects produced by the herbal medications. Referral to the physician for illness care would not be part of the assessment of functional health patterns.

The nurse, teaching a class on smoking cessation to a group of middle-age adults, presents the adverse effects of smoking, which include that nicotine: A. acts to stimulate the heart. B. calms the central nervous system. C. assists in decreasing blood pressure. D. causes a decrease in carbon monoxide.

A. acts to stimulate the heart. Nicotine acts in the two divisions of the nervous system to affect the central part of the brain and the spinal cord, and the peripheral portion that controls the arms and legs. Nicotine stimulates the heart, leading to an increased pulse and elevated blood pressure. Although smokers frequently believe that cigarettes have a calming effect, this notion is misleading. Nicotine stimulates the body, whereas increasing levels of carbon monoxide causes lethargy. Smokers may feel calm, although they are actually having their sensations dulled by the elevated level of carbon monoxide.

According to Piaget's theory of cognitive development, the young adult is in the stage of formal operational thought and demonstrates abilities to: A. analyze concepts. B. manipulate concrete objects. C. participate in cooperative interactions. D. perceive specific examples.

A. analyze concepts. Piaget's stage of formal operational thought evolves from concrete operational thought in adolescence and extends through the reasoning process of young adults. Achievement of formal operational thinking allows a person to analyze all combinations of possibilities and construct hypotheses that are capable of being tested. Young adult thought becomes more perceptive and insightful; issues can therefore be evaluated realistically and objectively. The person in the concrete operational thought stage is able to manipulate concrete objects, participate in cooperative interactions, and perceive specific examples.

Emphasis on disease prevention for the young adult, after age 25, is on modifying risk factors related to: A. coronary artery disease. B. cirrhosis of the liver. C. cervical cancer. D. colon cancer.

A. coronary artery disease. After age 25, the emphasis is on modifying coronary risk factors. Recommendations for screening young adults are undergoing revision, as more information becomes available about the interactive risks of high cholesterol, familial high lipid levels, diabetes mellitus, and smoking.

The nurse emphasizes warning signs of suicidal risks in adolescents during a health education class. These signs include: (select all that apply) A. difficulty concentrating. B. increased accidents. C. hyperactivity. D. lethargy. E. sleep disorders.

A. difficulty concentrating. B. increased accidents. E. sleep disorders. Typical warning signs of suicidal risk in adolescents include: behavioral changes; increased risk taking; increased accidents; substance use/abuse; physical violence to self, others, or animals; decreased appetite; alienation from family and/or peer group; giving away personal items; writing letter or notes, essays, and poems with suicidal content; cognitive/mood changes; expression of hopelessness; increasing rage or anger; dramatic swings in affect; sleep disorders; preoccupation with death; difficulty concentrating; hearing voices/seeing things or people; and new found interest in religion or cults.

The nurse participates in the process of ethical inquiry in health promotion to: (select all that apply) A. facilitate in-depth data gathering. B. resolve all ethical problems related to health promotion. C. understand what is expected of the health-promotion agent viewed as a moral agent. D. gain clarity on actual or potential issues regarding health-promotion endeavors. E. foresee all possible consequences of ethical issues related to health promotion. F. permit the uncovering of hidden agendas and interests. G. focus on salient aspects of problems, thus enhancing professional judgment.

A. facilitate in-depth data gathering. C. understand what is expected of the health-promotion agent viewed as a moral agent. D. gain clarity on actual or potential issues regarding health-promotion endeavors. F. permit the uncovering of hidden agendas and interests. G. focus on salient aspects of problems, thus enhancing professional judgment. The purpose of ethical inquiry in health promotion is to gain clarity on actual or potential moral issues arising in the context of health-promotion endeavors, and to understand what is expected of the health-promotion agent viewed as a moral agent. Ethical inquiry will not permit the resolution of all problems, mainly because the environments in which health-promotion efforts are conceptualized are incredibly complex. It is impossible to foresee all possible consequences of an action. But ethical reasoning can facilitate appropriate and in-depth data gathering, permit the uncovering of hidden agendas and interests, and focus on salient aspects of a particular problem, thus enhancing professional judgment.

The client asks the nurse, "Should I take a nutrient supplement?" The nurse explains that nutrient supplementation is indicated in situations such as: A. folic acid prior to pregnancy. B. vitamin A during the first trimester of pregnancy. C. vitamin E during anticoagulation therapy. D. calcium in iron-deficiency anemia.

A. folic acid prior to pregnancy. Nutrient supplements are sometimes necessary for specific populations to obtain desirable amounts of particular nutrients. These include: • Folic acid for women who could be pregnant to help prevent neural tube defects • Iron during pregnancy • Calcium for individuals who do not meet the recommended intake of calcium • Vitamin D for elderly people who do not drink generous quantities of fortified milk or who do not manufacture vitamin D from sunlight Large doses of vitamin A may be teratogenic and supplementation should be avoided during the first trimester of pregnancy, unless there is a specific deficiency. Calcium supplements interfere with iron absorption. High doses of vitamin E can interfere with vitamin K action and enhance the effect of Coumadin.

The leading causes of death in middle adulthood, in both White and Black populations, are the same and include: A. heart disease. B. kidney disease. C. respiratory disease. D. gastrointestinal disease.

A. heart disease. The three leading causes on both White and Black populations are the same: heart disease, cancer, and cerebrovascular accident. Reducing disabilities and deaths from these chronic conditions are national health-promotion and disease-prevention objectives. Most of the diseases and conditions targeted in the Healthy People 2020 goals and objectives are preventable, or at least, modifiable. Health education, often conducted by professional nurses, is effective with adults who want or must change their life style behaviors.

The nurse provides anticipatory guidance to people during middle age to meet developmental tasks of: (select all that apply) A. helping children become responsible, happy adults. B. rediscovering new satisfaction in the relationship with one's C.spouse. developing an affectionate but independent relationship with aging parents. D. reaching the peak in one's career. E. passing on traditions and skills to grandchildren. F. developing leisure-time activities.

A. helping children become responsible, happy adults. B. rediscovering new satisfaction in the relationship with one's C.spouse. developing an affectionate but independent relationship with aging parents. D. reaching the peak in one's career. F. developing leisure-time activities. The developmental tasks of middle age include: • Helping children become responsible, happy adults • Rediscovering new satisfaction in the relationship with one's spouse • Developing an affectionate but independent relationship with aging parents • Reaching the peak in one's career • Developing leisure-time activities • Achieving mature social and civic responsibility • Accepting and adapting to biological changes • Maintaining or developing friendships

The nurse is reviewing the immunization record of a sexually active adolescent. The nurse determines that the adolescent should receive a: A. hepatitis B vaccine. B. Haemophilus influenzae vaccine. C. measles, mumps, and rubella vaccine. D. pneumococcal meningitis vaccine.

A. hepatitis B vaccine. Because hepatitis B is sexually transmitted, it should be given to the sexually active adolescent, if she has not yet received it, to provide for protection against hepatitis B infection. There is no data to support administration of the measles, mumps, and rubella vaccine. Data should be collected from previous immunization records or from history of exposure to those communicable diseases. The Haemophilus influenzae vaccine is given to adolescents who have chronic illness. The pneumococcal meningitis is administered to college students residing in a dormitory.

The nurse is presenting information on the effects of exercise on lipid metabolism. The nurse emphasizes that: A. increases in HDL lower the total cholesterol-HDL ratio. B. longer periods of exercise produce smaller increases in HDL. C. the effect of exercise on lipid metabolism is related to the intensity of the exercise. D. exercise has little influence on plasma levels of HDL (high-density lipoprotein) and triglycerides.

A. increases in HDL lower the total cholesterol-HDL ratio. Exercise has a major influence on lipoprotein metabolism, primarily on the levels of HDL and triglycerides (TRG). Increases in HDL lower the total cholesterol-HDL ratio. Exercise has a potent lowering effect on levels of plasma TRG that is evident within hours after a bout of exercise. TRG levels are lower and HDL levels are higher in physically active people compared with the sedentary population. The effect of exercise on lipid metabolism may be more related to the volume (duration and frequency) rather than to the intensity of the exercise. Short periods of exercise training result in modest increases in HDL, but longer periods of training produce larger increases in HDL. Exercise's lowering effect on TRG is cumulative; therefore, frequent bouts of exercise result in a progressive decrease in TGR.

The nurse is developing a physical activity program for populations with low rates of physical activity. This program should focus on individuals with: A. lower incomes. B. higher education levels. C. no disabilities. D. an age less than 50 years old.

A. lower incomes. Populations with low rates of physical activity include: • Women generally are less active than men are at all ages. • People with lower incomes and less education are typically not as physically active as those are with higher incomes and education. • African Americans and Hispanics are generally less physically active than Whites. • Adults in northeastern and southern states tend to be less active that adults in north central and western states. • People with disabilities are less physically active than people without disabilities. • By age 75, one in three men and one in two women engage in no regular physical activity.

Recommendations and precautions for people with diabetes who are interested in regular physical activity and exercise include (select all that apply) A. monitor blood glucose levels before and 20 to 30 minutes after exercise. B. exercise at the peak times of the insulin. C. inject the insulin into a muscle area that will be active during exercise. D. exercise approximately 1 hour before meals. E. avoid high-impact activity when prone to neuropathy in the legs and feet. F. carry a concentrated form of carbohydrate when exercising.

A. monitor blood glucose levels before and 20 to 30 minutes after exercise. E. avoid high-impact activity when prone to neuropathy in the legs and feet. F. carry a concentrated form of carbohydrate when exercising. Recommendation and precautions for people with diabetes who are interested in physical activity and exercise includes: • Monitor blood glucose levels before and 20 to 30 minutes after exercise to determine the response to exercise. • Exercise approximately 1 hour after meals when blood glucose level is the highest. • Know the action and peak times of insulin dosage and avoid exercising at peak times. • Avoid injecting insulin into a muscle area that will be active during exercise; the pumping action of the muscle may speed up absorption on the insulin and cause a rapid decrease of blood glucose. • Carry a concentrated form of carbohydrate when exercising to be used if signs of hypoglycemia are felt.

The nurse, teaching a class on reducing the incidence of heart disease, emphasizes that the major risk factors for heart disease are: A. peripheral arterial disease. B. HDL greater than 40 mg/dL. C. age between 45 and 55. D. fasting blood glucose between 90 and 100 mg/dL.

A. peripheral arterial disease. peripheral arterial disease. Correct HDL greater than 40 mg/dL. age between 45 and 55. fasting blood glucose between 90 and 100 mg/dL. Major risk factors for heart disease include: • HDL less than 40 mg/dL • Clinical forms of atherosclerotic disease (peripheral arterial disease, abdominal aortic aneurysm, and symptomatic carotid artery disease) • Age 55 for men and 65 for women • Cigarette smoking • Hypertension (BP = 140/90 mm Hg, or on antihypertensive medication) • Diabetes (fasting glucose 110 mg/dL) • Family history of premature heart disease (heart disease in a first-degree relative at age 55 for men or age 65 or younger for women)

Any psychological, social, environmental, physiological, or spiritual stimulus that disrupts homeostasis requiring change or adaptation is a: A. stressor. B. trigger. C. distress. D. cognitive restructuring.

A. stressor. A stressor is any psychological, social, environmental, physiological, or spiritual stimulus that disrupts homeostasis requiring change or adaptation. Stress is a state of threatened homeostasis that triggers various adaptive changes in order to handle the event. Stress can be situational or maturational. One's coping strategies and resources will determine the outcomes of each crisis experience.

he nurse recognizes that the American Nurses Association (ANA) Code of Ethics identifies expectations of ethical behavior through statements regarding: A. the primary goals, values, and obligations of the profession. B. specific standards of care for selected populations. C. disciplinary actions for incompetent nursing practice. D. legal standards of practice.

A. the primary goals, values, and obligations of the profession. The ANA Code of Ethics identifies the primary goals, values, and obligations of the profession of nursing. The specific standards of care and practice are developed by professional organizations and the Nursing Practice Acts of each state based on evidence-based practice. The Board of Nurse Examiners for each state also has been charged with the disciplinary actions for incompetent nurses in the respective state.

Research has demonstrated the role of stress-hardy characteristics of individuals in promoting better health. These characteristics of stress hardiness include: A. viewing stress as a challenge rather than a threat. B. feeling as though one does not have internal control over stressful situations. C. having to focus commitment on primarily one component (home or work) in life. D. reporting more physical symptoms related to the degree of stress.

A. viewing stress as a challenge rather than a threat. Individuals who possess characteristics of stress-hardiness are shown to be less vulnerable to stress-related symptoms and disease. The characteristics of stress hardiness are control, challenge, and commitment. For stress-hardy individuals, stress is viewed as a challenge rather than a threat; they feel in control of situations in their lives; and they are committed to, rather than alienated from, work, home, and family.

When assessing the older adult for sleep quality, the nurse expects to find that the person will state: A. "I continue to be a night owl." B. "I experience difficulty returning to sleep." C. "I experience a night of deep sleep." D. "I rarely wake up during the night."

B. "I experience difficulty returning to sleep." Most difficulties associated with sleep are amenable to nursing therapies. Frequent awakenings do not necessarily imply sleep interruption. Many individuals may awaken numerous times during the night but return to sleep within seconds. This may be especially true of older adults who generally spend most of the night in stages of light sleep. Their normal developmental pattern does not include deep sleep; therefore, awakenings may not affect the sleep cycles and resultant feelings after awakening in the morning. More commonly, older adult individuals experience difficulty returning to sleep because they experience discomfort, fears, or other variables.

The nurse is developing a health promotion program on healthy eating and exercise for high school students using the health belief model as a framework. Which statement made by a nursing student is related to the individual's perception of susceptibility to an illness? A. "I don't have time to exercise because I have to work after school every night." B. "I'm worried about becoming overweight and getting diabetes because my father has diabetes." C. "The statistics of how many teenagers are overweight is scary." D. "I've decided to start a walking club at school for interested students."

B. "I'm worried about becoming overweight and getting diabetes because my father has diabetes." The statement indicates that the patient is concerned about developing diabetes and believes that there is a risk or susceptibility based on recognition of a familial link for the disease. Once this link is recognized, the patient may perceive the personal risk for diabetes.

Which question best assists the nurse who is helping a person to formulate the problem as a step in the problem-solving process? A. "What pattern is there?" B. "What do you want to see changed?" C. "What would you do the next time?" D. "What meaning does this have for you?"

B. "What do you want to see changed?" "What do you want to see changed?" assists the individual to focus on formulating the problem, by having the person state what he wants to see changed to resolve the problem. Asking about pattern and meaning both assist the person to analyze the parts of the experience and see relationships to other events. "What would you do the next time?" assists the individual to identify how another, similar problem could be resolved.

You ask another nurse how to collect a laboratory specimen. The nurse raises her eyebrows and asks, "Why don't you figure it out?" What would be the best response? A. Say nothing and walk away. Find a different nurse to help you. B. "When you brush me off like that, it takes me even longer to do my job." C. "Why do you always put me down like that?" D. "I guess I just enjoy having you make fun of me."

B. "When you brush me off like that, it takes me even longer to do my job." Lateral violence can be dealt with by using assertive communication. Simple assertive statements include referencing the person you are addressing, the behavior that is a problem, and its effect. Avoiding the situation, becoming defensive, or making sarcastic remarks does not help to resolve the problem.

Which of the following statements would be most likely to block communication? A. "You look kind of tired today." B. "Why do you always put so much salt on your food?" C. "It sounds like this has been a hard time for you." D. "If you use your oxygen when you walk, you may be able to walk farther."

B. "Why do you always put so much salt on your food?" Avoid asking "why" questions. They tend to imply an accusation and can build resentment.

A patient comes to the local health clinic and states: "I've noticed how many people are out walking in my neighborhood. Is walking good for you?" What is the best response to help the patient through the stages of change for exercise? A. "Walking is OK. I really think running is better." B. "Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" C. "Yes, I want you to begin walking. Walk for 30 minutes every day and start to eat more fruits and vegetables." D. "They probably aren't walking fast enough or far enough. You need to spend at least 45 minutes if you are going to do any good."

B. "Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" The patient's response indicates that the patient is in the contemplative state, possibly intending to make a behavior change within the next 6 months. The nurse's statement reinforces the behavior and provides a specific goal for the patient to begin a walking plan.

A nurse is planning a teaching session about healthy nutrition with a group of children who are in first grade. The nurse determines that after the teaching session the children will be able to name three examples of foods that are fruits. This is an example of: A. A teaching plan. B. A learning objective. C. Reinforcement of content. D. Enhancing the children's self-efficacy.

B. A learning objective. A learning objective describes what the learner will do after the teaching session.

A 46-year-old woman from Bosnia came to the United States 6 years ago. Although she did not celebrate Christmas when she lived in Bosnia, she celebrates Christmas with her family now. This woman has experienced assimilation into the culture of the United States because she: A. Chose to be bicultural. B. Adapted to and adopted the American culture. C. Had an extremely negative experience with the American culture. D. Gave up part of her ethnic identity in favor of the American culture.

B. Adapted to and adopted the American culture. Assimilation results when an individual gradually adopts and incorporates the characteristics of the dominant culture.

Which of the following best represents the dominant values in American society on individual autonomy and self-determination? A. Physician orders B. Advance directive C. Durable power of attorney D. Court-appointed guardian

B. Advance directive Informed consent and advance directives protect the right of the individual to know and make decisions ensuring continuity of individual autonomy and self-determination.

A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with the family. The nurse is acting as the patient's: A. Educator B. Advocate C. Caregiver D. Case manager

B. Advocate An advocate protects the patient's human and legal right to make choices about his or her care. An advocate may also provide additional information to help a patient decide whether or not to accept a treatment or find an interpreter to help family members communicate their concerns.

According to Healthy People 2020 objectives, which type of physical activity uses stored adipose tissue as a major fuel source? A. Exercise training B. Aerobic exercise C. Anaerobic exercise D. Muscular fitness

B. Aerobic exercise To fully understand the Healthy People 2020 objectives, definitions of physical activity include the following: Aerobic exercise is activity that uses large muscle groups in a repetitive, rhythmic fashion over an extended period to improve the efficiency of the oxidative energy-producing system and improve cardiorespiratory endurance; it uses stored adipose tissue as major fuel source. Anaerobic exercise is a high-intensity, short-duration activity that improves the efficiency of the phosphocreatine and glycolytic energy-producing systems and increases muscle strength, power, and speed of reactivity; it uses phosphagens and glucose-glycogen as major fuel sources. Exercise training is planned, structured, and repetitive bodily movement performed to improve or maintain one or more components of physical fitness. Muscular fitness is the strength and endurance of muscles that allows for participation in daily activities.

A patient is admitted to an acute care area. The patient is an active business man who is worried about getting back to work. He has had severe diarrhea and vomiting for the last week. He is weak, and his breathing is labored. Using Maslow's hierarchy of needs, identify this patient's immediate priority. A. Self-actualization B. Air, water, and nutrition C. Safety D. Esteem and self-esteem needs

B. Air, water, and nutrition The immediate priority is air, water, and nutrition. The patient needs to have sufficient air exchange, which might require oxygen administration. In addition the patient needs to have appropriate fluid balance and some nutritional supplement.

When a nurse is teaching a patient about how to administer an epinephrine injection in case of a severe allergic reaction, he or she tells the patient to hold the injection like a dart. Which of the following instructional methods did the nurse use? A. Telling B. Analogy C. Demonstration D. Simulation

B. Analogy Analogies use familiar images when teaching to help explain complex information.

Which measures are used to diagnose an individual as being obese? (select all that apply) A. BMI 25.0 to 29.9 B. BMI 30.0 or higher C. Body fat percentage of 15% for women D. Body fat percentage greater than 16% for men E. Body fat percentage greater than 24% for women

B. BMI 30.0 or higher D. Body fat percentage greater than 16% for men E. Body fat percentage greater than 24% for women Overweight and obesity are conditions of excess body fat (adipose tissue). Adults are considered overweight if their BMI is 25.0 to 29.9 and obese if their BMI is 30.0 or higher. Obesity may also be defined as weight that is equal to or greater than 120% to 125% of the ideal body weight. Fat mass (body fat percentage) is also important in determining the ideal body weight. The recommended body fat levels for men and women are approximately 15% to 16% for men and 23% to 24% for women (American College of Sports Medicine, 2003). The average American man and woman tend to exceed the recommended body fat level. An increase in fat mass and the development of obesity occur when energy intake exceeds total daily energy expenditure for a prolonged period.

A child's immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation? A. Fidelity B. Beneficence C. Nonmaleficence D. Respect for autonomy

B. Beneficence The immunization is a clear effort to provide benefit. Beneficence refers to "doing good." Fidelity refers more to keeping promises. Nonmaleficence refers to the commitment to avoid harm. Respect for autonomy refers to the commitment to include patients in the decision-making process regarding health care plans.

The nurse states, "When you tell me that you're having a hard time living up to expectations, are you talking about your family's expectations?" The nurse is using which therapeutic communication technique? A. Providing information B. Clarifying C. Focusing D. Paraphrasing

B. Clarifying The nurse is not sure what the patient means by living up to expectations and is clarifying the patient's concern.

Mrs. Jones states that she gets anxious when she thinks about giving herself insulin. How do you use your understanding of intrapersonal communication to help with this? A. Provide her the opportunity to practice drawing up insulin B. Coach her to give herself positive messages about her ability to do this C. Bring her written material that clearly describes the steps of insulin administration D. Use therapeutic communication to help her express her feeling about giving herself an injection

B. Coach her to give herself positive messages about her ability to do this Intrapersonal communication is self-talk. The other options may help her better understand insulin administration or deal with her anxiety, but they do not involve intrapersonal communication.

Health literacy is the capacity to read, comprehend, and follow through on health information and is a crucial component of health promotion. What are some of the techniques nurses can utilize to reduce low health literacy? (select all that apply) A. Communicate in a standing position to demonstrate authority. B. Create a safe and comfortable environment. C. Refer the client to websites for clarification of conditions and procedures. D. Establish eye contact during communication. E. Have the client teach back the information they have been provided to assess understanding.

B. Create a safe and comfortable environment. D. Establish eye contact during communication. E. Have the client teach back the information they have been provided to assess understanding. Nurses promote health literacy by creating a safe and comfortable environment, sitting down to establish eye contact rather than standing when communicating, using visual aids and models to illustrate conditions and procedures, and verifying understanding of care instructions by having individuals teach the content back. Developing strategies for confirming understanding and individualizing methods of communicating health information is critically important.

While working in a community health clinic, it is important to obtain nursing histories and get to know the patients. Part of history taking is to develop the nurse-patient relationship. Which of the following apply to Peplau's theory when establishing the nurse-patient relationship? (Select all that apply.) A. An interaction between the nurse and patient must develop. B. The patient's needs must be clarified and described. C. The nurse-patient relationship is influenced by patient and nurse preconceptions. D. The nurse-patient relationship is influenced only by the nurse's preconceptions.

B. The patient's needs must be clarified and described. There is continual interaction by both the patient and the nurse throughout all phases of the nurse-patient relationship.

Which of the following statements are true about cultural competency in health care? (select all that apply) A. Recognizing and accepting cultural diversity achieves cultural competency. B. Cultural competency is a major element in eliminating health disparities. C. There is no association between the care recipient's cultural background and the health care providers' cultural beliefs. D. Health care services are to be provided that are respectful of and responsive to the diverse health beliefs of the care recipient. E. Health care providers must be aware of how people interpret their health issues or illnesses.

B. Cultural competency is a major element in eliminating health disparities. D. Health care services are to be provided that are respectful of and responsive to the diverse health beliefs of the care recipient. E. Health care providers must be aware of how people interpret their health issues or illnesses. ultural competency is one of the major elements in eliminating the health disparities and starts with an honest desire not to allow biases. Health care services should be provided that are respectful of and responsive to the diverse health beliefs of the client. It is very important for health care providers to be aware of how people interpret their health issues or illnesses and be capable to provide culturally competent care. Culture is an element of ethnicity that refers to patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. Values are beliefs about the worth of something and serve as standards that influence behavior. Value orientations reflect the personality type of a particular society. Culture is shaped by values, beliefs, norms, and practices that are shared by members of the same cultural group. Ethnic groups have unique beliefs and attitudes about health and health care services. Beliefs are generally incongruent with health care providers and prove to be major barriers to improving the health status of ethnic group members. Awarded 0.0 points out of 3.0 possible points.

During their clinical post-conference meeting, several nursing students were discussing their patients with their instructor. One student from a middle-class family shared that her patient was homeless. This is an example of caring for a patient from a different: A. Ethnicity. B. Culture. C. Heritage. D. Religion.

B. Culture. Culture is the context in which groups of people interpret and define their experiences relevant to life transitions. This includes events such as birth, illness, and dying. It is the system of meanings by which people make sense of their experiences.

A patient who is hospitalized has just been diagnosed with diabetes. He is going to need to learn how to give himself injections. Which teaching method does the nurse use? A. Simulation B. Demonstration C. Group instruction D. One-on-one discussion

B. Demonstration Demonstration is used to help patients learn psychomotor skills.

Which of the following theories describe the life processes of an older adult facing chronic illness? A. Systems theories B. Developmental theories C. Interdisciplinary theories D. Health and wellness models

B. Developmental theories Developmental theories describe and predict behavior and development at various phases of the life continuum, as in the phase of older adulthood.

An 18-month-old child is noted by the parents to be "angry" about any change in routine. This child's temperament is most likely to be described as: A. Slow to warm up. B. Difficult. C. Hyperactive. D. Easy.

B. Difficult. Children described as "difficult" adapt slowly to new routines and express their emotions forcefully; they like consistent structure.

The nurse is preparing education on prevention of urinary tract infections. A principle emphasized in the teaching plan would be: A. Decreasing oral intake facilitates urinary dilution. B. Empty the bladder at the first sensation of fullness. C. Frequency is a common symptom that can be ignored. D. Increasing time between urinations decreases the risk of infection.

B. Empty the bladder at the first sensation of fullness. The nurse uses evidence-based practice to guide his or her practice. Emptying the bladder as soon as bladder sensation of fullness occurs is a practice that decreases the time the urine remains in the bladder, thus decreasing the chance for bacterial growth to occur. Decreasing oral intake will cause the urine to become concentrated. Urinary frequency is a symptom seen with urinary tract infections. Research indicates that delayed time between urinations is associated with increased incidence of urinary tract infection.

The nurse is providing suggestions to individuals with sleep disturbances resulting from stress-related issues. The nurse recommends which of the following? (select all that apply) A. Have a glass of wine right before bedtime. B. Establish a regular sleep-wake schedule, even on weekends. C. Limit naps during the day to 45 minutes. D. Exercise within 1 hour of bedtime. E. Take a hot bath 2 hours before bedtime. F. Sleep in a warm room.

B. Establish a regular sleep-wake schedule, even on weekends. C. Limit naps during the day to 45 minutes. E. Take a hot bath 2 hours before bedtime. The nurse can provide suggestions to clients with stress-related sleep disturbances using the following strategies: • Keep a sleep diary, which helps determine sleep patterns. • Reduce consumption of alcohol and caffeine. • Have a regular sleep-wake schedule, even on weekends. • If unable to fall asleep within 20 to 30 minutes or if waking up and unable to fall back to sleep within that time, get out of bed and do something until groggy and sleepy again. • Use a relaxation tape or practice diaphragmatic breathing to help release tension and calm down. • Limit naps during the day to 45 minutes. • Exercise within 3 to 6 hours of bedtime. • Take a hot bath 2 hours before bedtime. • Sleep in a cool room.

What two groups comprise emerging populations in the United States? (select two that apply) A. Older Americans B. Ethnic minorities C. Homeless Correct D. Baby boomers

B. Ethnic minorities Currently, emerging populations in the United States include ethnic minorities, and persons who are homeless. Ethnic minority populations could include Asian Americans/Pacific Islanders, Blacks/African Americans, Latinos/Hispanic Americans, Native Americans, and Arab Americans. The increasing population of immigrants has been a significant contributor of the presence of increasing populations of major ethnic groups in the United States. Older Americans and baby boomers do not comprise emerging populations in the United States.

A theory is a set of concepts, definitions, relationships, and assumptions that: A. Formulate legislation. B. Explain a phenomenon. C. Measure nursing functions. D. Reflect the domain of nursing practice.

B. Explain a phenomenon. Theories are designed to explain a phenomenon such as self-care or caring. A theory is a way of seeing through a "set of relatively concrete and specific concepts" and the propositions that describe or link the concepts.

A patient needs to learn how to administer a subcutaneous injection. Which of the following reflects that the patient is ready to learn? A. Describing difficulties a family member has had in taking insulin B. Expressing the importance of learning the skill correctly C. Being able to see and understand the markings on the syringe D. Having the dexterity needed to prepare and inject the medication

B. Expressing the importance of learning the skill correctly Patients are ready to learn when they understand the importance of learning and are motivated to learn.

The nurse assesses the following risk factors for coronary artery disease (CAD) in a male patient. Which factors are classified as genetic and 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

B. Father died from CAD at age 50 C. History of hypertension 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.

Ethical dilemmas often arise over a conflict of opinion. What is the critical first step in negotiating the difference of opinion? A. Consult a professional ethicist to ensure that the steps of the process occur in full. B. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma. C. Ensure that the attending physician or health care provider has written an order for an ethics consultation to support the ethics process. D. List the ethical principles that inform the dilemma so negotiations agree on the language of the discussion.

B. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma. Before proceeding with discussion about any difficult situation, just as in the nursing process, participants take time to gather all relevant information as insurance for reliability and validity during the discussion.

The nurse is teaching about primary prevention and includes which educational statement in the instructions? A. Everyone should participate in colorectal cancer screening. B. Health teaching about the risk factors of heart disease should be performed. C. Limiting disability is a vital role of nursing since preventive measures are therapeutic. D. The nurse is involved in minimizing the effects of disease and disability by surveillance and maintenance.

B. Health teaching about the risk factors of heart disease should be performed. Primary prevention precedes disease or dysfunction. Primary prevention intervention includes health promotion, such as health teaching about risk factors for heart disease, and specific protection, such as immunization against hepatitis B. Its purpose is to decrease the vulnerability of the individual or population to disease or dysfunction. People are taught to use appropriate primary preventive measures. Screening is secondary prevention because the principle goal is to identify individuals in an early, detectable stage of the disease process. Delayed recognition of disease results in the need to limit future disability in late secondary prevention. Tertiary prevention occurs when a defect or disability is permanent and irreversible. The process is minimizing the effects the disease and disability by surveillance and maintenance activities aimed at preventing complications and deterioration.

According to the Centers for Disease Control, what are the leading causes of death in the older population? (select two that apply) A. Diabetes B. Heart disease C. Cancer D. Stroke E. Alzheimer's diseasE

B. Heart disease C. Cancer he Centers for Disease Control (2012) report that the five major racial groups; African Americans, Asian Americans, Hispanic Americans, Native Americans, and White Americans, share eight leading causes of death. Heart disease and cancer are the first and second leading causes, respectively, with stroke, respiratory diseases, flu, pneumonia, Alzheimer's disease, diabetes, and other causes following with varying disease rates depending on racial background.

When illness occurs, different attitudes about it cause people to react in different ways. What do medical sociologists call this reaction to illness? A. Health belief B. Illness behavior C. Health promotion D. Illness prevention

B. Illness behavior Illness behavior involves how people monitor their bodies, define and interpret their symptoms, take remedial actions, and use the resources in the health care system. Personal history, social situations, social norms, and past experiences can affect illness behavior

The increasing number of ethnic groups in the United States has been influenced by what? A. Communicable diseases in disadvantaged countries B. Increasing immigration C. Homelessness D. Healthcare reform

B. Increasing immigration Currently, emerging populations include ethnic minorities and persons who are homeless. Ethnic minority populations could include Asian Americans/Pacific Islanders, Blacks/African Americans, Latinos/Hispanic Americans, Native Americans, and Arab Americans. The increasing population of immigrants has been a significant contributor to the presence of increasing numbers of major ethnic groups in the United States.

The nurse teaches parents how to have their children learn impulse control and cooperative behaviors. This would be during which of Erikson's stages of development? A. Trust versus mistrust B. Initiative versus guilt C. Industry versus inferiority D. Autonomy versus sense of shame and doubt

B. Initiative versus guilt Toddlers are learning that parents and society have expectations about behaviors and that they must learn to control their behavior.

Which theorist developed his ideas based on interviews that focused on hypothetical moral dilemmas? A. Gilligan B. Kohlberg C. Piaget D. Erikson

B. Kohlberg Lawrence Kohlberg's theory of moral development is based on interviews that focused on hypothetical moral dilemmas such as: Should a man steal an expensive drug that would save his dying wife? Carol Gilligan's theory of moral development (1982; 1988) suggests that there is a different process of moral development in women in society. She did research with Lawrence Kohlberg and discovered that his research was conducted using men only, and developed her own research with females. Jean Piaget's theory of cognitive development is concerned primarily with structure rather than content, with how the mind works rather than with what it does. Erik Erikson described the development of identity of the self through successive stages that unfold throughout the life span.

A homebound older American would likely receive which of the following nutrition services? A. Congregate Nutrition Services Program B. Meals on Wheels C. Nutrition Services Incentive Program (NSIP) D. Indian Tribal Organization (ITO)

B. Meals on Wheels The Congregate Nutrition Services Program and the Nutrition Services Incentive Program gives states, territories, and Indian Tribal Organizations the ability to purchase food or cover the cost of commodities from USDA or Area Agencies on Aging. For NSIP, money or commodity allocation is determined by the share of population who received meals under Congregate or Meals on Wheels in the year prior. Meals on Wheels is a nutrition/health promotion program to help keep older adults in their communities.

When an ethical dilemma occurs on your unit, can you resolve the dilemma by taking a vote? A. Yes because ethics is essentially a democratic process, with all participants sharing an equal voice B. No because an ethical dilemma involves the resolution of conflicting values and principals rather than simply the identification of what people want to do C. Yes because ethical dilemmas otherwise take up time and energy that is better spent at the bedside performing direct patient care D. No because most ethical dilemmas are resolved by deferring to the medical director of the ethics department

B. No because an ethical dilemma involves the resolution of conflicting values and principals rather than simply the identification of what people want to do Voting about an outcome implies that participants simply express an opinion without regard for negotiating differences. The real goal in processing ethical dilemmas is to resolve differences, not simply to express opinion.

Which of the following nursing roles may have prescriptive authority in their practice? (Select all that apply.) A. Critical care nurse B. Nurse practitioner C. Certified clinical nurse specialist D. Charge nurse

B. Nurse practitioner Nurse practitioners and certified clinical nurse specialists encompass the role and preparation of the advanced practice registered nurse. According to the American Nurses Association standards of practice, prescriptive authority may be granted to these nurses

A patient with diabetes is controlling the disease with insulin and diet. The nursing health care provider is focusing efforts to teach the patient self-management. Which of the following nursing theories is useful in promoting self management? A. Neuman B. Orem C. Roy D. Peplau

B. Orem Orem's theory of self-care provides a solid theoretical background for self-management for a variety of diseases. This theory shows the nurse how to direct the patient toward self-management to promote health and/or sustain wellness.

A 50-year-old man is initiating an exercise program to help improve his cardiovascular health. What are some of the recommended guidelines that the nurse should instruct him on? (select all that apply) A, Every adult over the age of 50 should start with a daily running program. B. Overexertion should be avoided. C. Increase fluid intake during periods of strenuous exercise in hot weather. D. Adults over the age of 50 benefit from intense strength training. E. Suggested activities include walking, jogging, swimming and bicycling.

B. Overexertion should be avoided. C. Increase fluid intake during periods of strenuous exercise in hot weather. E. Suggested activities include walking, jogging, swimming and bicycling. Some suggested activities for the middle-aged adult include brisk walking, jogging, swimming, bicycling, and skipping rope as well as walking or biking to work. Activities that focus on skill and coordination should be attempted by the adult over age 40 rather than activities necessitating speed and strength. Moderation is important for all groups of individuals. Caution is recommended for adults nearing age 65 to prevent muscle strains and/or falls, etc. Overexertion, as evidenced by dizziness, chest pressure or chest pain, and unresolved shortness of breath should be avoided. Also, in hot weather, strenuous exercise should be balanced with rest periods and increased intake of fluids to prevent heat stroke.

Which nursing intervention would be based upon utilitarian theory? A. Initiating resuscitation of a 20-week gestation newborn B. Preparing a 52-year-old woman with uterine cancer for a hysterectomy C. Placing a 92-year-old client with terminal congestive heart failure on a ventilator D. Administering chemotherapy to a 17-year-old with leukemia who states that he wants everything terminated

B. Preparing a 52-year-old woman with uterine cancer for a hysterectomy Utilitarian theory proposes that actions are good in so far as they are aimed at yielding the greatest amount of happiness or pleasure, or cause the least amount of harm or pain, to persons and overall within the society. Any decision making must take into account the consequences of the decision. The professional involved in the decision making must also possess the appropriate skills and knowledge to undertake actions that will promote a "good" for persons. The situations stated above require the nurse to determine which situation has the greatest amount of good for society and which causes the least amount of pain. The woman with the uterine cancer diagnosis preparing for surgery has the most promising outcome, and therefore should be selected as the priority intervention based on utilitarian theory. The 20-week gestation newborn has almost no chance of surviving outside of the mother's womb. The adolescent with leukemia who has stated that he does not want the chemotherapy should be respected, even though his parents will make the final decision. Being placed on the ventilator will not cure the 92-year-old client with terminal congestive heart failure. Even with extraordinary interventions, the client with a terminal disease prognosis is one who will not be cured of that disease process.

Which of the following are goals of Gilligan's stages of moral development for women in the postconventional stage? (select all that apply) A. Agree upon rights B. Principle of nonviolence C. Justice D. Personal moral standards E. Do not hurt self or others

B. Principle of nonviolence E. Do not hurt self or others Gilligan identifies the goals for women in the postconventional stage as the principle of nonviolence and do not hurt self or others. Kohlberg's postconventional stage identifies the goals as: agree upon rights, personal moral standards, and justice.

Your patient has just been told that she has cancer, and she is crying. Which actions facilitate therapeutic communication? (Select all that apply.) A. Turning on the television to her favorite show B. Pulling the curtain to provide privacy C. Offering to discuss information about her condition D. Asking her why she is crying E. Sitting quietly by her bed and hold her hand

B. Pulling the curtain to provide privacy C. Offering to discuss information about her condition E. Sitting quietly by her bed and hold her hand Privacy and lack of distraction create an environment conducive to therapeutic communication. Nursing presence and touch convey caring and compassion and allow the patient to collect her thoughts. Providing information tells people what they need or want to know. “Why” questions may seem intrusive and block communication.

A patient newly diagnosed with cervical cancer is going home. The patient is avoiding discussion of her illness and postoperative orders. What is the nurse's best plan in teaching this patient? A. Teach the patient's spouse B. Focus on knowledge the patient will need in a few weeks C. Provide only the information that the patient needs to go home D. Convince the patient that learning about her health is necessary

C. Provide only the information that the patient needs to go home This patient is in denial; thus it is appropriate to only give her information that is needed immediately.

Which of the following explain how health care reform is an ethical issue? (Select all that apply.) A. Access to care is an issue of beneficence, a fundamental principal in health care ethics. B. Reforms promote the principle of beneficence, a hallmark of health care ethics. C. Purchasing health care insurance may become an obligation rather than a choice, a potential conflict between autonomy and beneficence. D. Lack of access to affordable health care causes harm, and nonmaleficence is a basic principal of health care ethics.

B. Reforms promote the principle of beneficence, a hallmark of health care ethics. D. Lack of access to affordable health care causes harm, and nonmaleficence is a basic principal of health care ethics. Since health care reform focuses on the public good, discussions about it inevitably involve reference to all aspects of ethical discourse. Reference to ethical principles helps to shape the discussion, even when individual values differ. Access to care is an issue of justice.

The philosophy sometimes called the ethics of care suggests that ethical dilemmas can best be solved by attention to which of the following? A. Patients B. Relationships C. Ethical principles D. Code of ethics for nurses

B. Relationships The foundation of the ethics of care is its attention to relationships, as distinguished from other more principal based philosophies.

A nurse is caring for an older-adult couple in a community-based assisted living facility. During the family assessment he notes that the couple has many expired medications and multiple medications for their respective chronic illnesses. They note that they go to two different health care providers. The nurse begins to work with the couple to determine what they know about their medications and helps them decide on one care provider rather than two. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? A. Patient-centered care B. Safety C. Teamwork and collaboration D. Informatics

B. Safety Helping the patients understand the consequences and complications of multiple medications helps to build the competency in safety.

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? A. Physiological B. Safety and security C. Love and belonging D. Self-actualization

B. 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.

The nurse assesses a community for evidence of health-promotion strategies. Which of the following are health-promotion strategies? (select all that apply) A. Seeking primary care in the acute care hospital B. Self-care for minor illness C. Entry into acute care facilities to manage chronic illness D. Environmental changes to enhance clean air E. Supporting Habitat for Humanity house construction

B. Self-care for minor illness D. Environmental changes to enhance clean air E. Supporting Habitat for Humanity house construction Health-promotion strategies go beyond providing information. It is proactive decision making at all levels of society. Strategies identified within this decision-making process are screening, self-care for minor illness, readiness for emergencies, successful management of chronic illness, environmental changes to enhance positive behaviors, and health-enhancing policies within an organizational setting. Health-promotion efforts focus on maintaining or improving the general health of individuals, families, and communities through support of housing at the public and community level; and at the personal level by voting and volunteering for improved low-income housing.

You are working in a clinic that provides services for homeless people. The current local regulations prohibit providing a service that you believe is needed by your patients. You adhere to the regulations but at the same time are involved in influencing authorities to change the regulation. This action represents which stage of moral development? A. Instrumental relativist orientation B. Social contract orientation C. Society-maintaining orientation D. Universal ethical principle orientation

B. Social contract orientation At this stage the individual recognizes that at times the law must be changed to meet the needs of society and that all people have basic rights, regardless of their social group.

When an individual elicits the relaxation response through meditation, which stress-management skill is being practiced? A. Healthy pleasures B. Spiritual practice C. Affirmation D. Empathy

B. Spiritual practice Meeting spiritual needs may be facilitated by spiritual practice or activities that help people find meaning, purpose, and connection. Engaging in healthy pleasures occurs when a person participates in activities that are important to them and being them feelings of peace, joy, and happiness. An affirmation is a positive thought, in the form of a short saying or phrase, that has meaning for the individual. Empathy is an effective stress management intervention because it assists with communication. Empathy is the ability to consider another person's perspective and to communicate this understanding back to that person.

The nurse is performing an initial antepartal assessment on a woman who has missed two periods. Assessment of this woman for alcohol consumption is best determined by the: A. CAGE test. B. T-ACE test. C. non-stress test. D. protein dipstick test.

B. T-ACE test. The T-ACE test provides a much more sensitive measure of alcohol intake patterns than that derived from the CAGE test. The T-ACE test considers the following assessment criteria: • How many drinks does it Take to make you feel high? • Have you ever been Annoyed by people criticizing your drinking? • Have you ever felt you ought to Cut down your drinking? • Have you ever had a drink first thing in the morning (Eye Opener) to steady your nerves or get rid of a hangover? The CAGE test considers data collected from the client on Cutting down on drinking, being Annoyed by criticism of drinking, feeling Guilty about drinking, and using alcohol as an Eye opener. The non-stress test evaluates the fetal heart rate response to fetal movement, which is assessed after the fetus is 20 weeks or more. The protein dipstick is performed at each prenatal visit and measures the amount of protein in the client's urine. Proteinuria is a symptom seen with pre-eclampsia.

Teaching an older adult how to use e-mail to communicate with a grandchild who lives in another state is an example of ____________, which aids cognitive performance by using new approaches. A. Cognitive development B. Activity theory C. Selective optimization with compensation D. Formal operations

C. Selective optimization with compensation As adults age, they put more of their energies into activities associated with meaningful relationships.

Four distinct models have been used to describe concepts of health. Which of the following statements accurately describes some of the models used? (select all that apply) A. In the clinical health model, health and illness are defined by signs and symptoms of disease. B. The role performance model of health defines health in terms of individuals' ability to perform social roles. C. The clinical model is the basis for occupational health evaluations. D. In the adaptive model of health, people's ability to adjust positively to social, mental, and physiological change is the measure of their health. E. In the eudaimonistic model, exuberant well-being indicates optimal health.

B. The role performance model of health defines health in terms of individuals' ability to perform social roles. D. In the adaptive model of health, people's ability to adjust positively to social, mental, and physiological change is the measure of their health. E. In the eudaimonistic model, exuberant well-being indicates optimal health. The role performance model of health defines health in terms of individuals' ability to perform social roles. Role performance includes work, family, and social roles, with performance based on societal expectations. Illness would be the failure to perform roles at the level of others in society. In the adaptive model of health, people's ability to adjust positively to social, mental, and physiological change is the measure of their health. Illness occurs when the person fails to adapt or becomes maladaptive to these changes. In the eudaimonistic model, exuberant well-being indicates optimal health. This model emphasizes the interactions between physical, social, psychological, and spiritual aspects of life and the environment that contribute to goal attainment and create meaning. In the clinical model, health is defined by the absence, and illness by the conspicuous presence, of signs and symptoms of disease. The role performance model of health defines health in terms of individuals' ability to perform social roles. This model is the basis for occupational health evaluations.

The nurse is planning to teach a patient about the importance of exercise. When is the best time for teaching to occur? (Select all that apply.) A. When there are visitors in the room B. When the patient's pain medications are working C. Just before lunch, when the patient is most awake and alert D. When the patient is talking about current stressors in his or her life

B. When the patient's pain medications are working C. Just before lunch, when the patient is most awake and alert. Plan teaching when the patient is most attentive, receptive, alert, and comfortable.

According to Piaget's cognitive theory, a 12-year-old child is most likely to engage in which of the following activities? A. Using building blocks to determine how houses are constructed B. Writing a story about a clown who wants to leave the circus C. Drawing pictures of a family using stick figures D. Writing an essay about patriotism

B. Writing a story about a clown who wants to leave the circus As adolescents mature, their thinking moves to abstract and theoretical subjects. They have the capacity to reason with respect to possibilities.

The nurse is discussing strong evidence on effectiveness of alternative and complimentary therapies in reducing harmful effects of stress. Emphasis is placed on the effectiveness of: A. aromatherapy. B. acupuncture. C. chiropractic. D. herbal therapy.

B. acupuncture. A variety of alternatives and complimentary therapies are available as techniques to prevent and reduce harmful effects of stress. Common therapies include acupuncture, hypnosis, aromatherapy, reflexology, chiropractic, and herbal therapies. People are increasingly using alternative therapies as self-help measures, and research to study their effects has exploded in recent years. Nurses can assist clients to base their use on evidence of safety and efficacy. Among the variety of alternative therapies available, acupuncture and hypnosis have strong evidence of effectiveness. Herbal remedies require cautions because they can have harmful as well as beneficial effects, and may interfere with other treatments.

When a nurse utilizes aggressive action on behalf of a care recipient, he or she is considered to be practicing: A. social justice. B. advocacy. C. moral agency. D. assertiveness

B. advocacy. Advocacy, as an expectation of nurses, is strongly reinforced both in the Code of Ethics and in innumerable scholarly articles. In legal jurisprudence, advocacy is aggressive action taken on behalf of an individual, or perhaps a group viewed as an individual entity, to protect or secure that individual's rights. Nurses and other health care professionals have a responsibility to speak up on behalf of people whose rights have been compromised or endangered. This is part of the nurse's role because people may not recognize either what is needed to meet their needs or when the care they are receiving is substandard. Social justice is concerned with disparities in socioeconomic conditions leading to poor health and fairness in the distribution of goods such as health, education, food, and shelter. Moral agency on the part of a nurse requires action and motivation directed to some moral end that is enacted through relationships. Utilizing aggressive action on behalf of a care recipient is not defined as assertiveness.

The nurse is assessing a 12-year-old female with an admission diagnosis of anorexia nervosa. The data collected that support this diagnosis should include: (select all that apply) A. binge eating followed by purging. B. compulsive physical activity. C. eating an amount of food that is definitely larger than most people would eat. D. preoccupation with food. F. self-starvation with significant weight loss

B. compulsive physical activity. D. preoccupation with food. F. self-starvation with significant weight loss Symptoms of anorexia nervosa include self-starvation with significant weight loss, amenorrhea, compulsive physical activity, preoccupation with food, and a distorted body image. Another eating disorder is bulimia nervosa, which involves a pattern of binge eating followed by purging, induced vomiting, and/or use of laxatives. This client eats an increased amount of food in a discrete period of time.

The nurse initiates an exercise program with middle-aged adults by: A. planning physical activity for a minimum of 45 minutes. B. considering activities that have the least potential for injury. C. counseling the adult that exercise should be rigorous to produce results. D. advising that the heart rate should double during exercise for cardiovascular benefits to be achieved.

B. considering activities that have the least potential for injury. Moderation is the key, along with increased caution as the adult approaches age 65. The exercise program should be realistic, and the activities selected should be activities that the individual enjoyed in the past. Activities should be selected with consideration of the potential for injury. Physical exercise should involve as many muscles as is possible, performed on a regular basis, preferably 3 to 4 times a week, for a minimum of 30 minutes each time. The appropriate level of performance for aerobic exercise is determined by achieving a pulse rate that is established for each individual: taking the number 220, subtracting the person's age, and then computing 75% of that number.

When working with an older adult, the nurse remembers to avoid: A. Touching the patient. B. Allowing the patient to reminisce. C. Shifting quickly from subject to subject. D. Asking the patient how he or she feels.

C. Shifting quickly from subject to subject. Shifting quickly from subject to subject may be difficult for an older person to follow, especially if the person is hard of hearing. Focusing on the patient's feelings and encouraging reminiscence help the person process changes or loss.

Piaget's stage of cognitive development states that characteristics of the sensorimotor stage include: A. development of egocentric animistic and magical thinking. B. development of the concept of object permanence. C. consideration of others' points of view. D. thought dominated by senses.

B. development of the concept of object permanence. Development of the concept of object permanence occurs from birth to 2 years old and is in the sensorimotor stage. Development of egocentric animistic and magical thinking occurs in 2- to 7-year-old children in the preoperational stage. Consideration of others' points of view is in the concrete operations stage, which is from 7 to 11 years of age. Thought dominated by senses occurs in the 2- to 7-year age group and is in the preoperational stage.

A person reports his exercise pattern is one golf game per week. The nurse evaluates this pattern and teaches the individual that: A. exercise should include jogging. B. exercises should be repetitive. C. golfing one time per week is adequate. D. weekly workouts at the gym should be included.

B. exercises should be repetitive. Exercise is a type of physical activity that is planned, structured, and repetitive, and performed to improve or maintain physical fitness. Active social activities such as backyard softball or golf would be considered physical activity. Activities such as jogging, walking, or gym workouts would be considered exercise. Sedentary social activities such as bingo, reading, knitting, stamp collection, cards, or participation in discussion groups would not be considered physical activity.

One concern that nurses have when using self-disclosure during therapeutic interactions is that: A. revealing oneself assists in developing a helping relationship. B. it may cross a boundary from a professional to a personal relationship. C. care recipients value nurses who engage in interactions as real people. D. it creates reciprocity involving a mutual exchange between the nurse and the care recipient.

B. it may cross a boundary from a professional to a personal relationship. Self-disclosure involves sharing experiences that the nurse has had with a care recipient who has had a similar experience, to assist the person in recognizing that the nurse demonstrates understanding of his or her need. Self-disclosure is an indicator of a healthy personality and a strategy for developing rapport with an individual. Therapeutic interactions characterized by reciprocity involve a mutual exchange between the nurse and the care recipient. Traditionally, nurses have been wary of self-disclosure because it may cross a boundary from a professional to a personal relationship with care recipients. The nurse must recognize when self-disclosure is inappropriate and when it is needed in a therapeutic relationship. Literature documents that self-disclosure is an effective clinical strategy when developing a helping relationship. People value nurses who engage in interactions as real people and who are willing to share information about themselves.

The nurse recognizes that a minority group is perceived as: A. capturing biological variations within human populations. B. people who receive less than their share of wealth, power, or social status. C. people set apart on the basis of cultural or national origin characteristics. D. socially organized groups with salient differences with respect to other groups in society.

B. people who receive less than their share of wealth, power, or social status. A minority group may be perceived as consisting of people who receive less than their share of the wealth, power, or social status The U.S Department of Health and Human Services and the Institute of Medicine have well documented that racial and ethnic minorities have less access to health care, receive lower-quality health care, and have higher rates of illness, injury, and premature death. Race has been viewed as capturing biological variations within human populations. It emphasizes the physical and biological heredity. An ethnic group is a group that is set apart by insiders or outsiders primarily on the basis of cultural or national origin characteristics subjectively selected. Ethnic groups are socially organized with salient differences compared with other groups in society.

The nurse explains that the philosophical base for energy medicine involves: A. reading auras. B. rebalancing life energy. C. placing the hands and making symbolic gestures. D. inserting of fine needles into precisely mapped points on the skin surface.

B. rebalancing life energy. The basic premise behind energy work is releasing blockages to energy flow, stimulating deficient life energy, and rebalancing life energy. Acupuncture is the insertion of fine needles into precisely mapped points on the skin surface. Reading auras is the extension of the energy field beyond the physical body. Reiki is placing the hands and making symbolic gestures that create attunement or the opening of the energy channel.

The nurse, teaching a class on primary prevention at a women's health club, emphasizes participation in: A. physician visits during illness. B. recommended immunization schedules. C. taking antibiotics at the first sign of symptoms. D. water aerobics to develop muscle building.

B. recommended immunization schedules. Primary prevention is a concept central to nursing and includes generalized health promotion and specific protection from disease. Health promotion connotes an active process involving specific protections, including immunizations, occupational safety, and environmental control, along with a set of behaviors that enhances health. Physician visits that promote health promotion focus on screening and wellness visits that include teaching on preventative health practices. Antibiotics should only be taken when there is evidence of an infection. Water aerobics focuses on flexibility, not muscle building.

Young adults are screened for cervical cancer through assessment of known risk factors that include: A. obesity. B. smoking. C. hypertension. D. alcohol use

B. smoking. Known risk factors for cervical cancer include smoking, early age of first intercourse, increasing number of sexual partners, and infection with human papillomavirus (HPV). The typical young adult health examination also looks for signs of chronic disease. Young adults would need to be educated about modifiable risk factors such as obesity and alcohol use.

A registered nurse is admitting a patient of French heritage to the hospital. Which question asked by the nurse indicates that the nurse is stereotyping the patient? A. "What are your dietary preferences?" B. "What time do you typically go to bed?" C. "Do you bathe and use deodorant more than one time a week?" D. "Do you have any health issues that we should know about?"

C. "Do you bathe and use deodorant more than one time a week?" Nurses need to avoid stereotypes or unwarranted generalizations about any particular group that prevents further assessment of the individual's unique characteristics.

Based on the transtheoretical model of change, what is the most appropriate response to a patient who states: "Me, exercise? I haven't done that since junior high gym class, and I hated it then!" A. "That's fine. Exercise is bad for you anyway." B. "OK. I want you to walk 3 miles 4 times a week, and I'll see you in 1 month." C. "I understand. Can you think of one reason why being more active would be helpful for you?" D. "I'd like you to ride your bike 3 times this week and eat at least four fruits and vegetables every day."

C. "I understand. Can you think of one reason why being more active would be helpful for you?" The patient's response indicates that the patient is in the precontemplation stage and does not intend to change his behavior in the next 6 months. In this stage the patient is not interested in information about the behavior and may be defensive when confronted with it. Asking an open-ended question may stimulate the patient to identify a reason to begin a behavior change. Nurses are challenged to motivate and facilitate change in health behavior when working with individuals.

A woman is scheduled for ambulation in the early morning of the first day after undergoing an abdominal hysterectomy. The nurse uses consensual validation of the individual's understanding of the plan of care by stating: A. "I will be back at 9 AM to take you on a walk." B. "The doctor wants you to walk one time this morning." C. "Tell me where you would like to walk this morning." D. "Walking soon after a surgical procedure prevents complications."

C. "Tell me where you would like to walk this morning." Consensual validation is a confirmation that both the sender and receiver understand the same information. The nurse should ask the woman to explain her sense of the message and of how to ask the nurse for further information. Consensual validation in communication is essential when providing health-promotion interventions. Without validating that the individual understands the information and its importance, and that she has a behavioral plan to follow, health-promotion efforts invariably are likely to fail. "Tell me where you would like to walk this morning" is the only response that asks the care recipient for her input regarding her understanding of the plan of care. The other options stated by the nurse contain information given to the care recipient.

When the nurse takes the patient's nursing history, he or she sits: A. Next to the patient. B. 4 to 12 feet from the patient. C. 18 inches to 4 feet from the patient. D. 12 inches to 3 feet from the patient.

C. 18 inches to 4 feet from the patient. The personal zone is 18 inches to 4 feet. This distance allows for easy communication without invading the person's personal space.

According to the National Resource Center on Nutrition, Physical Activity and Aging, it is estimated that between __________ of older residents living in long-term care facilities are malnourished. A. 10% and 15% B. 20% and 25% C. 35% and 50% D. 55% and 70%

C. 35% and 50% The National Resource Center on Nutrition, Physical Activity and Aging (2012) states that between 35% and 50% of older residents living in long-term care facilities are malnourished and approximately 65% of older adults in hospitals may be malnourished. This data underscores the problems of maintaining good nutrition.

According to the American Nurses Association, which of the following statements are true regarding a holistic nurse? (Select all that apply.) A. Holistic care is provided in private practice. B. Holistic nursing care is provided by nursing assistants. C. A mind-body-spirit-emotion approach is taken in holistic nursing care. D. Holistic nursing serves as a bridge between conventional and complementary alternative healing practices. E. A holistic nurse may specialize in one or more modalities.

C. A mind-body-spirit-emotion approach is taken in holistic nursing care. D. Holistic nursing serves as a bridge between conventional and complementary alternative healing practices. E. A holistic nurse may specialize in one or more modalities. The American Nurses Association recognizes holistic nursing as an official nursing specialty with its own defined scope and standards of practice. According to the American Holistic Nurses Association, a holistic nurse is a legally licensed nurse who takes a mind-body-spirit-emotion approach to the practice of nursing. The holistic nursing practice serves as a bridge between conventional healing and complementary and alternative healing practices, and is trained in both healthcare models. A holistic nurse works in a variety of settings and may specialize in one or more modalities, such as acupuncture, chiropractic, or energetic healing.

Evidence-based practice is defined as: A. Nursing care based on tradition B. Scholarly inquiry of nursing and biomedical research literature C. A problem-solving approach that integrates best current evidence with clinical practice D. Quality nursing care provided in an efficient and economically sound manner

C. A problem-solving approach that integrates best current evidence with clinical practice. Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.

A nursing student is taking postoperative vital signs in the postanesthesia care unit. She knows that some ethnic groups are more prone to genetic disorders. Which of the following patients is most at risk for developing malignant hypertension? A. Ashkenazi Jew B. Chinese American C. African American D. Filipino

C. African American Certain genetic disorders are linked with specific ethnic groups such as malignant hypertension among African Americans.

An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, auscultates her lung sounds, listens to her heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? A. Diagnosis B. Evaluation C. Assessment D. Implementation

C. Assessment Assessment is the collection of comprehensive data pertinent to the patient's health and/or the situation.

In addition to changes in ethnic and racial distribution within the population, it is expected that changes in _______ distribution will affect health promotion practice. A. geographic B. environmental C. age D. social

C. age In addition to changes in the ethnic and racial distribution within the population, the projected changes in age distribution will affect health promotion practice. Considerable growth is expected in the proportion of the population that is 25 years of age and older. Analysis of population trends and projections helps health professionals determine changing needs. Additionally, analysis of the social and economic environment is necessary for developing social policy concerning health. Geographic, environmental, and social aspects are not expected means of impacting health promotional practices although social and environmental concerns determine health outcomes.

What are the potential physiological and metabolic changes which are expected in an individual at risk for coronary heart disease once they have adopted regular physical activity? (select all that apply) A. Decreasing high-density lipoprotein (HDL) cholesterol B. Increasing low-density lipoprotein (LDL) cholesterol C. Decreasing high blood pressure D. Improving glucose tolerance E. Decreased risk of ventricular fibrillation

C. Decreasing high blood pressure D. Improving glucose tolerance E. Decreased risk of ventricular fibrillation The literature strongly demonstrates that the risk of coronary heart disease (CHD) decreases as physical activity increases and that a plausible relationship between the decreased risk and a number of potential physiological and metabolic mechanisms exists: • Increasing high-density lipoprotein (HDL) cholesterol • Decreasing low-density lipoprotein (LDL) cholesterol • Decreasing serum triglyceride levels • Decreasing high blood pressure • Improving glucose tolerance and insulin sensitivity • Decreasing obesity • Reducing the sensitivity of the myocardium to the effects of catecholamines, thereby decreasing the risk of ventricular arrhythmias • Enhanced platelet function

Mr. Sakda emigrated from Thailand. When taking care of him, you note that he looks relaxed and smiles but seldom looks at you directly. How do you respond? A. Use therapeutic communication to assess for increased anxiety B. Sit down and position yourself closer so you are at eye level C. Deflect your eyes downward to show respect D. Continue to maintain eye contact

C. Deflect your eyes downward to show respect Many cultures, especially the eastern cultures, view direct eye contact as rude. Deflecting your eyes downward indicates respect.

The school nurse is about to teach a freshman-level high school health class about nutrition. What is the best instructional approach to ensure that the students meet the learning outcomes? A. Provide information using a lecture B. Use simple words to promote understanding C. Develop topics for discussion that require problem solving D. Complete an extensive literature search focusing on eating disorders

C. Develop topics for discussion that require problem solving Adolescents learn best when they are able to use problem solving to help them make choices

Pregnant women are counseled about rubella screening and vaccination. Which of the following conditions are associated with congenital rubella syndrome? A. Blindness B. Sudden infant death syndrome (SIDS) C. Developmental delay D. Autism

C. Developmental delay Rubella in young adults is generally a minor disease; however, when the disease is contracted during the first trimester of pregnancy, miscarriage, stillbirth, or congenital rubella syndrome (CRS) can result. CRS is associated with loss of hearing, ocular defects, developmental delay and growth retardation, and cardiac malformations. All women of childbearing age should be screened (titer monitored) for rubella antibodies and those who are not immune should be immunized. Nurses inform women of childbearing age that antibody testing is recommended before pregnancy and that vaccination is available.

Which of the following statements accurately describe race and ethnic categories in the United States as defined by the Office of Management and Budget? (select all that apply) A. Race and ethnicity have the same definition. B. Ethnicity is associated with power and indexes the history or ongoing imposition of one group's authority above another. C. Ethnicity focuses on differences in meaning, values, and ways of living. D. Ethnicity refers to commonalities in language, history, nation, or region of origin. E. A minority group consists of people living in society that is usually disadvantaged.

C. Ethnicity focuses on differences in meaning, values, and ways of living. D. Ethnicity refers to commonalities in language, history, nation, or region of origin. E. A minority group consists of people living in society that is usually disadvantaged. Ethnicity focuses on differences in meaning, values, and ways of living. Ethnicity is defined as a dynamic set of historically derived and institutionalized ideas and practices that allows people to identify or be identified with groupings of people on the presumed basis of commonalities in language, history, nation or region of origin, customs, ways of being, religion, names, physical appearance, and/or genealogy or ancestry. A minority group consists of people who are living within a society which is usually disadvantaged in relation to power, control of their own lives, and wealth. Race and ethnicity are different but somewhat alike. Race is associated with power and indexes the history or ongoing imposition of one group's authority above another.

A female Jamaican immigrant has been late to her last two clinic visits, which in turn had to be rescheduled. The best action that the nurse could take to prevent the patient from being late to her next appointment is: A. Give her a copy of the city bus schedule. B. Call her the day before her appointment as a reminder to be on time. C. Explore what has prevented her from being at the clinic in time for her appointment. D. Refer her to a clinic that is closer to her home.

C. Explore what has prevented her from being at the clinic in time for her appointment. Present-time orientation is in conflict with the dominant organizational norm in health care that emphasizes punctuality and adherence to appointments. Nurses need to expect conflicts and make adjustments when caring for ethnic groups.

Which of the following statements accurately describe biological growth? (select all that apply) A. Expected growth patterns exist in infants and children. B. Growth is steady throughout life. C. Extremely rapid growth occurs in the prenatal, infancy, and adolescent periods. D. Slower rates of growth occur during the toddler, preschool, and school-age periods. E. Infants typically double their birth weight by 6 months of age.

C. Extremely rapid growth occurs in the prenatal, infancy, and adolescent periods. D. Slower rates of growth occur during the toddler, preschool, and school-age periods. E. Infants typically double their birth weight by 6 months of age. Expected growth patterns exist for all people. Growth is not steady throughout life. The periods of extremely rapid growth—prenatal, infancy, and adolescence—are contrasted with slower rates of growth during the toddler, preschool, and school-age periods. Infants typically double their birth weight by 6 months of age and triple their birth weight by 1 year of age. The well known "growth spurt" in height typically occurs early in adolescence for girls and later in adolescence for boys.

Nine-year-old Brian has a difficult time making friends at school and being chosen to play on the team. He also has trouble completing his homework and, as a result, receives little positive feedback from his parents or teacher. According to Erikson's theory, failure at this stage of development results in: A. A sense of guilt. B. A poor sense of self. C. Feelings of inferiority. D. Mistrust.

C. Feelings of inferiority. School-age children need to feel real accomplishment and be accepted by peers to develop a sense of industry.

What goals would the nurse establish with the diabetic person who is given an exercise program? (select all that apply) A. Improve flexibility that is impaired as muscle collagen becomes glycosylated. B. Maintain or improve cardiovascular fitness to eliminate cardiovascular complications. C. Improve muscle strength. D. Assist with weight control for those with type 1 diabetes. E. Allow people with type 1 diabetes to safety participate in activities or sports.

C. Improve muscle strength. E. Allow people with type 1 diabetes to safety participate in activities or sports. Although each person with diabetes should be evaluated and given individual exercise recommendations, the goals of an exercise program are universal: • Maintain or improve cardiovascular fitness to prevent or minimize long-term cardiovascular complications. • Improve flexibility that is impaired as muscle collagen becomes glycosylated. • Improve muscle strength, which may deteriorate as a result of neuropathy. • Allow people with type 1 diabetes to safely participate in and enjoy physical activities or sports. • Assist with weight control for people with type 2 diabetes. • Allow people with diabetes to experience and gain the same benefits and enjoyment from regular exercise as do people without diabetes.

Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? A. Continuing education B. Graduate education C. In-service education D. Professional Registered Nurse Education

C. In-service education In-service education programs are instruction or training provided by a health care agency or institution. An in-service program is held in the institution and is designed to increase the knowledge, skills, and competencies of nurses and other health care professionals employed by the institution.

A nursing student is doing a community health rotation in an inner-city public health department. The student investigates sociodemographic and health data of the people served by the health department, and detects disparities in health outcomes between the rich and poor. This is an example of a(n): A. Illness attributed to natural and biological forces. B. Creation of the student's interpretation and descriptions of the data. C. Influence of socioeconomic factors in morbidity and mortality. D. Combination of naturalistic, religious, and supernatural modalities.

C. Influence of socioeconomic factors in morbidity and mortality. Health disparity populations are populations that have a significant increased incidence or prevalence of disease or that have increased morbidity, mortality, or survival rates compared to the health status of the general population.

Which is the best method of negotiating or processing difficult ethical situations? A. Ethical issues arise between dissenting providers and can be best resolved by deference to an independent arbitrator such a chaplain. B. Since ethical issues usually affect policy and procedure, a legal expert is the best consultant to help resolve disputes. C. Institutional ethics committees help to ensure that all participants involved in the ethical dilemma get a fair hearing and an opportunity to express values, feelings, and opinions as a way to find consensus. D. Medical experts are best able to resolve conflicts about outcome predictions.

C. Institutional ethics committees help to ensure that all participants involved in the ethical dilemma get a fair hearing and an opportunity to express values, feelings, and opinions as a way to find consensus. Ethics is ultimately an activity of community, resolved successfully through institutional ethics committees and not easily resolved by deference to a single expert or leader.

To practice in today's health care environment, nurses need a strong scientific knowledge base from nursing and other disciplines such as the physical, social, and behavioral sciences. This statement identifies the need for which of the following? A. Systems theories B. Developmental theories C. Interdisciplinary theories D. Health and wellness models

C. Interdisciplinary theories As the health system evolves and the health care needs of the patient focus on health promotion, illness prevention, and treatment, more disciplines are involved in patient care. To be effective in practice nurses need to be aware of theoretical approaches of care arising from other disciplines and from nursing.

Which of the following statements about theory-based nursing practice is incorrect? A. Contributes to evidence-based practice B. Provides a systematic process for designing nursing interventions C. Is not linked to nursing outcomes D. Guides the nurse's assessment

C. Is not linked to nursing outcomes Theory-based nursing practice does reflect nursing outcomes. For example, prescriptive theories address specific nursing interventions and predict the patient response.

The community health nurse is preparing to educate a group of mothers at the local middle school. Her teaching curriculum is aimed at providing the women with information about bone health and osteoporosis risk factors. Which of the following statements should be included in the presentation? (select all that apply) A. It is not possible to retard the effects of osteoporosis. B. Physical activity should include aerobic exercise but strength training is ineffective in preventing osteoporosis. C. It is important to optimize intake of calcium and vitamin D. D. Skeletal mass is maintained in adulthood through physical activity. E. Some loss of bone begins to occur after the age of 30.

C. It is important to optimize intake of calcium and vitamin D. D. Skeletal mass is maintained in adulthood through physical activity. E. Some loss of bone begins to occur after the age of 30. Osteoporosis, or porous bone, is the most common bone disease. It is a major health threat for 44 million Americans, particularly after the age of 50. Some loss of bone occurs naturally after the age of 30. Twenty to thirty percent of bone mass development is regulated by environmental factors, such as nutrition and physical activity. In addition to the importance of optimizing physiological intake of calcium and vitamin D (Kalyani et al., 2010), and maintaining normal menstrual cycles for maximizing peak bone mass, physical activity plays a significant role in developing bone mass during childhood and adolescence and in maintaining skeletal mass into adulthood and old age. Using environmental changes and lifestyle modification during the third and fourth decades of life, women can increase their bone mass and effectively retard osteoporosis. Physical activities that involve weight bearing will increase bone mineral density.

Which of the following is required in the delivery of culturally congruent care? A. Learning about vast cultures B. Motivation and commitment to caring C. Influencing treatment and care of patients D. Acquiring specific knowledge, skills, and attitudes

D. Acquiring specific knowledge, skills, and attitudes Specific knowledge, skills, and attitudes are required in the delivery of culturally congruent care.

Which of the following statements are accurate regarding the safety and effectiveness of complementary and alternative medicines (CAM)? (Select all that apply.) A. CAM therapies carry a strong scientific evidence base. B. CAM therapies are regulated by the FDA. C. Many CAM therapies have not been studied with clinical trials. D. FDA regulations are less strict for over-the-counter medications. E. Most CAM providers are not credentialed.

C. Many CAM therapies have not been studied with clinical trials. D. FDA regulations are less strict for over-the-counter medications. E. Most CAM providers are not credentialed. Most CAM therapies lack a strong scientific evidence base, as many have not been studied with rigorous, well-designed clinical trials. The U.S. Food and Drug Administration (FDA) regulate dietary supplements, but the regulations are less strict than for prescription or over-the-counter medications. For example, safety and efficacy do not have to be proved before marketed, although, once on the market, it does monitor label claims and inserts. Most CAM providers are not credentialed in a standardized national system, so credentialing regulations and standards vary nationally. Some require training, testing, and continuing education, but most do not. CAM safety precautions include careful selection of providers, taking time to research and understand the treatment and maintaining awareness of possible scams.

Which of the following concepts are accurate regarding the biological changes in the young adult period? (select all that apply) A. Young adulthood sees the highest illness rate of any other age group. B. Physical growth continues into the 30s. C. Most concerns are related to ensuring optimal body functioning. D. Physical abilities of the young adult are at their peak. E. Illness compensatory mechanisms generally operate optimally.

C. Most concerns are related to ensuring optimal body functioning. D. Physical abilities of the young adult are at their peak. E. Illness compensatory mechanisms generally operate optimally. Young adulthood is generally the healthiest time of life. Physical growth is mostly complete by the age of 20; most concerns related to physiological development are focused on ensuring the optimal functioning of body systems. The young adult's physical abilities are in peak condition, and compensatory mechanisms operate optimally during illness to provide minimal disruption in health patterns. Nursing goals for individuals of this age group are oriented toward prolonging this period of optimal physical energy; developing the mental, emotional, spiritual, and social potential; encouraging proper health habits; anticipating and screening for and, therefore, being able to treat the onset of chronic disease at an early stage; and treating disease when appropriate.

You are caring for an 80-year-old woman, and you ask her a question while you are across the room washing your hands. She does not answer. What is your next action? A. Leave the room quietly since she evidently does not want to be bothered right now B. Repeat the question in a loud voice, speaking very slowly C. Move to her bedside, get her attention, and repeat the question while facing her D. Bring her a communication board so she can express her needs

C. Move to her bedside, get her attention, and repeat the question while facing her You do not want to assume that she is hard of hearing because she is 80, but it is more likely. She may have not responded because you were across the room and water was running. Don't jump to conclusions, but instead try again to communicate with her as you would with someone who is hard of hearing.

The ANA code of nursing ethics articulates that the nurse "promotes, advocates for, and strives to protect the health, safety, and rights of the patient." This includes the protection of patient privacy. On the basis of this principal, if you participate in a public online social network such as Facebook, could you post images of a patient's x-ray film if you deleted all patient identifiers? A. Yes because patient privacy would not be violated as long as the patient identifiers were removed B. Yes because respect for autonomy implies that you have the autonomy to decide what constitutes privacy C. No because, even though patient identifiers are removed, someone could identify the patient based on other comments that you make online about his or her condition and your place of work D. No because the principal of justice requires you to allocate resources fairly

C. No because, even though patient identifiers are removed, someone could identify the patient based on other comments that you make online about his or her condition and your place of work Respect for patient privacy includes making the most conservative decisions possible regarding disclosure of personal health information.

The point of the ethical principal to "do no harm" is an agreement to reassure the public that in all ways the health care team not only works to heal patients but agree to do this in the least painful and harmful way possible. Which principle describes this agreement? A. Beneficence B. Accountability C. Nonmaleficence D. Respect for autonomy

C. Nonmaleficence Nonmaleficence refers specifically to the concept of avoiding harm. Beneficence refers more to generosity and goodness, accountability to keeping promises, and respect for autonomy to the commitment by providers to include patients in decisions about all aspects of care.

In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable? A. Nurses understand the principle of autonomy to guide respect for patient's self-worth. B. Nurses have a scope of practice that encourages their presence during ethical discussions. C. Nurses develop a relationship to the patient that is unique among all professional health care providers. D. The nurse's code of ethics recommends that a nurse be present at any ethical discussion about patient care.

C. Nurses develop a relationship to the patient that is unique among all professional health care providers. None of these options is wrong, but the point of the question is to build confidence and even pride in the value of the special body of knowledge that a nurse acquires about patients, the result of a unique relationship with them.

A patient with limited English proficiency is going to be discharged on new medication. How does the nurse complete the discharge teaching? A. Uses a dictionary to give directions for medication administration B. Explains the directions to the patient's 14-year-old daughter C. Obtains an interpreter to facilitate communication of medication information D. Uses a picture board and visual aids to communicate medication administration information

C. Obtains an interpreter to facilitate communication of medication information It is essential that patients understand discharge instructions to safely care for themselves at home. If a patient has limited ability to speak or understand English, he or she has a legal right to an interpreter to ensure understanding of essential information.

In health promotion, the nurse-person relationship is the context for care. Which of the following elements of communication are important considerations? (select all that apply) A. Health promotion requires sensitivity to the goals and values of the nurse and the care recipient's family. B. Helping a person adopt health-promoting behaviors is a matter of providing education. C. Successful health promotion involves interpersonal skills. D. Health promotion requires communication skills. E. Values clarification is an essential element of communication and health promotion.

C. Successful health promotion involves interpersonal skills. D. Health promotion requires communication skills. E. Values clarification is an essential element of communication and health promotion. Health promotion requires sensitivity to each person's goals and values—the individual's and the nurse's. Helping a person adopt health-promoting behaviors requires more than giving information. Health promotion also requires effective communication, interpersonal skills, personal insight, accountability, mutual respect, and a supportive working milieu. Essential to this interactional process are values clarification, communication, and the helping relationship.

A patient experienced a myocardial infarction 4 weeks ago and is currently participating in the daily cardiac rehabilitation sessions at the local fitness center. In what level of prevention is the patient participating? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Quaternary prevention

C. Tertiary prevention Tertiary prevention involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration following the myocardial infarction. Tertiary-prevention activities are directed at rehabilitation rather than diagnosis and treatment. Care at this level aims to help patients achieve as high a level of functioning as possible, despite the limitations caused by illness or impairment. This level of care is called preventive care because it involves preventing further disability or reduced functioning.

The community health nurse performs an assessment on a local family to determine their stress-coping abilities. Which of the following is an example of the primary appraisal of the coping ability of a family experiencing financial hardship? A. The family becomes aware of information of which they were previously unaware. B. The family identifies information related to their perceived problems. C. The family describes perceived actual and potential positive and negative outcomes. D. Individuals within the family verbalize methods to cope with the actual or potential harm, threat, or challenge.

C. The family describes perceived actual and potential positive and negative outcomes. Assessment of the stress-coping abilities of an individual, family, or community is part of a comprehensive health assessment that includes past and present subjective and objective data. Primary appraisal of coping includes descriptions of perceived actual and potential positive and negative outcomes. Negative outcomes refer to harm, whereas positive outcomes refer to the challenges resulting from stressors that an individual perceives can be overcome. Secondary appraisal consists of the individual's identification of choices to cope with the actual or potential harm, threat or challenge.

Which statement supports the principle of beneficence that overrides a person's autonomy? A. The nurse presses the button to administer pain medication through a patient-controlled analgesia (PCA) infusion. B. The nurse maintains confidentiality to an HIV-positive husband who does not want his wife informed of his HIV status. C. The nurse instructs parents that their newborn must be placed in a car seat that faces the back of the seat in the back seat of the car. D. The nurse counsels a 21-year-old woman delivering her third child that she should request a tubal ligation

C. The nurse instructs parents that their newborn must be placed in a car seat that faces the back of the seat in the back seat of the car. Beneficence means to do good. As a moral principle, beneficence presents us with the duty to maximize the benefits of actions while minimizing harm. When society formulates rules that are designed to protect persons against the negative effects of their own actions, these rules are considered "beneficent," yet they override a person's autonomy. One example of this is the use of safety restraints—car seats for children and seat belts for adults—when driving or riding in an automobile. It is inappropriate to consider beneficence as a moral principle when withholding confidential information that may harm another, as in the case of the HIV-positive husband. The client must control the PCA infusion and choice of when to administer additional pain medication. If the nurse presses the button to administer additional medication, the client may suffer adverse effects related to receiving too much medication, because the client is not determining pain medication needs. Counseling a client regarding when to request a tubal ligation is inappropriate based on the nurses' cultural values. The client should be given information on the advantages and disadvantages of the surgical procedure and its consequences, and the client has the autonomy to make her decision.

The nurse has a patient who is short of breath and calls the health care provider using SBAR (Situation-Background-Assessment-Recommendation) to help with the communication. What does the nurse first address? A. The respiratory rate is 28. B. The patient has a history of lung cancer. C. The patient is short of breath. D. He or she requests an order for a breathing treatment.

C. The patient is short of breath. Using the acronym SBAR, the nurse should begin with "S," which is Situation. The situation is that the patient is short of breath. The history of lung cancer is Background, the respiratory rate is Assessment, and the request for an order is a Recommendation.

A nurse is going to teach a patient how to perform breast self-examination. Which behavioral objective does the nurse set to best measure the patient's ability to perform the examination? A. The patient will verbalize the steps involved in breast self-examination within 1 week. B. The nurse will explain the importance of performing breast self-examination once a month. C. The patient will perform breast self-examination correctly on herself before the end of the teaching session. D. The nurse will demonstrate breast self-examination on a breast model provided by the American Cancer Society.

C. The patient will perform breast self-examination correctly on herself before the end of the teaching session. Return demonstration provides an excellent source of feedback and reinforcement to evaluate learning.

Which of the following diseases are Arab Americans at the highest risk for? A. colon cancer. B. hypertension. C. adult-onset diabetes. D. end-stage renal disease.

C. adult-onset diabetes. There is limited health information about Arab Americans who suffer from chronic health problems such as diabetes and coronary artery disease. Several factors put Arab Americans at high-risk for developing adult onset diabetes and cardiovascular disease including obesity, age, gender, and low employment rates. Health concerns on the rise for Arab Americans include mental illness and tobacco consumption among adolescents.

Bloom (1984) has developed a hierarchy of cognitive levels in the adult learner. The analysis cognitive level for the adult learner would be: A. recalling specific facts. B. grasping the meaning of the communicated message. C. breaking down material into its constituent parts while noting their relationship. D. applying knowledge in the form of abstractions and ideas to concrete situations.

C. breaking down material into its constituent parts while noting their relationship. Bloom (1984) developed a hierarchy of cognitive levels in the adult learner. The first level is knowledge, which is the recall of specifics. The second level is comprehension. The learner grasps the meaning of communicated messages and relates it to other material. The third level is application. The learner applies knowledge in the form of abstractions and ideas to concrete situations. Analysis is the fourth level, wherein the adult breaks down the material into its constituent parts while noting their relationship. The final and fifth level is synthesis, wherein the person is able to combine various elements to form a plan and then judge the extent to which the ideas and materials satisfy the established criteria.

The nurse assesses the cognitive abilities of the adolescent according to Piaget's stage of formal operations as: A. accepting family beliefs and values. B. developing extrovert behaviors. C. having an intolerance of things as they are. D. recognizing the importance of putting others' needs ahead of one's own

C. having an intolerance of things as they are.

The individual's perceived health and well-being and how health is managed describes the: A. cognitive-perceptual pattern. B. coping-stress tolerance pattern. C. health perception-health management pattern. D. self-perception-self-concept pattern.

C. health perception-health management pattern. The health perception-health management pattern provides an overview of the individual's health status and the health practices that are used to reach the current level of health or wellness. The focus is on perceived health status and the meaning of health, along with the individual's level of commitment to maintaining health. The cognitive-perceptual pattern focuses on sensory perceptual and cognitive patterns. The coping-stress tolerance pattern identifies the general coping pattern and effectiveness on stress tolerance. The self-perception-self-concept pattern describes the individual's perception of self to include body comfort, body image, and feeling state as well as self-conception and self-esteem.

Physiological effects of stress include: A. decreasing the antiinflammatory response. B. decreasing musculoskeletal tension and tone. C. increasing the heart rate, blood pressure, and respiratory rate. D. shifting of blood for the large muscle groups to the visceral organs.

C. increasing the heart rate, blood pressure, and respiratory rate. Stress causes physiological arousal along three pathways: the musculoskeletal system, the autonomic nervous system, and the psychoneuroendocrine system. The musculoskeletal system responds to stress by increasing tension and tone. The autonomic nervous system causes an increase in heart rate, blood pressure, and respiratory rate. The heightened awareness of the environment is triggered, and the blood shifts from the visceral organs to the large muscles. The psychoneuroendocrine system stimulates the secretion of glucocorticoids and other neuroendocrine substances into the systemic circulation, which increases glucose levels and the antiinflammatory response.

The scientific, evidence-based use of combined complementary and alternative medicine (CAM) and traditional medicine with an emphasis on safety and effectiveness is known as: A. complementary therapy. B. alternative therapy. C. integrative therapy. D. allopathic medicine.

C. integrative therapy. According to the National Institute of Health's National Center for Complementary and Alternative Medicine (NCCAM), integrative therapy is the scientific, evidence-based use of combined CAM and traditional medicine with an emphasis on safety and effectiveness. It defines complementary therapy as the use of CAM alongside and as a complement to allopathic traditional medicine. Alternative therapy uses CAM in place of traditional medicine. Allopathic medicine focuses on identifying diseases and conditions by a physician or mid-level practitioner.

In assessing the nutritional-metabolic pattern, the nurse performs an examination of: A. attention span. B. blood pressure. C. mucous membranes. D. urine color.

C. mucous membranes. Assessment of the mucous membranes determines hydration status, which is part of the nutrition-metabolic pattern. Other specific assessment findings for the nutritional-metabolic pattern may point to an individual who is overweight, underweight, overly hydrated, dehydrated, or experiencing difficulties in skin integrity, such as skin breakdown or delayed healing. The attention span is part of the self-perception-self-concept pattern. Measurement of blood pressure is part of the activity-exercise pattern. Urine color is part of the elimination pattern.

A condition of the bone that is the result of bone lysis exceeding the rate of bone matrix synthesis is called: A. osteoarthritis. B. kyphosis. C. osteopenia. D. osteoporosis.

C. osteopenia. Osteopenia is a condition of subnormally mineralized bone, usually as a result of a rate of bone lysis that exceeds the rate of bone matrix synthesis. Thoracic kyphosis is an angulation of the posterior spine that is sometimes referred to as "hunchback." Osteoarthritis is a degenerative joint disease that influences activity and endurance and is most frequently seen in the knees and hands. Osteoporosis is a disorder characterized by abnormal loss of bone density and deterioration of bone tissue, with an increased fracture risk. It occurs most frequently in postmenopausal women who have fair complexions and are small, sedentary individuals, and people on long-term steroid use.

The nurse is implementing cognitive restructuring as a stress-management intervention with a group of pregnant teens. The nurse explains that cognitive restructuring reduces stress by: A. glossing over misfortune, suffering, or negative feelings. B. helping people identify who is responsible for their stress. C. recognizing that negative thinking often causes emotional distress. D. assisting people to focus on a narrow range of feelings causing their stress.

C. recognizing that negative thinking often causes emotional distress. Cognitive therapy is a conceptual model for short-term intervention to modify thinking and reduce stress. In the context of cognitive therapy, cognitive restructuring is a technique or series of strategies that help people evaluate their thoughts, challenge them, and replace them with responses that are more rational. Cognitive restructuring teaches people to recognize that negative thinking often causes emotional distress. Cognitive restructuring does not gloss over or deny misfortune, suffering, or negative feelings. Cognitive restructuring assists people to become unstuck from negative moods, so they can experience a broader range of feelings.

The nurse is preparing a class on wellness and health promotion for a group of middle school students. Developmental tasks of early adolescence include a learning focus emphasis on: A. coping with life events and problems. B. economic responsibility. C. risk taking and its consequences. D. social responsibility for self and others.

C. risk taking and its consequences. Early adolescence developmental focus is on industry verses inferiority as identified by Erikson. The wellness tasks identified include: • learning that health is an important value. • learning self-regulation of physiological needs—sleep, rest, food, drink, and exercise. • learning risk taking and its consequences (injury prevention). The other three options define adolescent (identity verses role confusion) wellness developmental tasks, which include learning to cope with life events and problems, learning economic responsibility, and learning social responsibility for self and others.

The nurse advocates that acupuncture is a useful treatment intervention of: A. hypertension. B. osteoporosis. C. substance abuse. D. gastrointestinal bleeding.

C. substance abuse. Acupuncture is a useful treatment for substance abuse. It has also been found to be effective for postoperative pain, the nausea and vomiting of chemotherapy, other pain syndromes, stroke rehabilitation, and asthma.

In health promotion settings, individual autonomy may be limited by: A. freedom of action. B. freedom of speech. C. the duty of protecting the health and safety of society. D. public policy.

C. the duty of protecting the health and safety of society. In health-promotion settings and endeavors the concept of autonomy can be understood from two different perspectives. From the vantage point of public health, the extent of individual autonomy, or freedom of action, may be limited by the duty of protecting the health and safety of the society. From this perspective there is an age-old struggle between civil rights and public safety. Moral questions ask to what degree society is justified in regulating the health and safety of society at large. There is an inevitable tension associated with curtailing civil liberties in the name of safety or health. Freedom of speech is not associated with individual autonomy as it relates to health promotion.

During middle adulthood, physiological changes affect most bodily systems. These changes include: A. increased cardiac output. B. increased glomerular filtration rates. C. thinning of the intervertebral disks. Correct D. decreased bone density and mass.

C. thinning of the intervertebral disks. Correct Physiological changes that occur during middle adulthood include: • Hair of the adult begins to thin and turn gray. • The skin's moisture and turgor decreases and with the loss of subcutaneous tissue, wrinkles appear. • Fat deposits increase during these years with increases in weight gain. • Cardiac output decreases. • Bone density and mass progressively decrease. • Thinning of the intervertebral disks accounts for approximately a loss of 1 inch in height. • Acid indigestion and belching increases due to decreased gastrointestinal motility. • Stools become harder and dry due to decreased gastrointestinal motility. • As blood supply to the kidneys decrease, the glomerular filtration rate is decreased. • Blood vessels lose elasticity and become thicker.

The school nurse is performing scoliosis screening on 14-year-old girls. Signs indicative of scoliosis include: A. alignment of the spinous processes. B. lower scapula height on the side of thoracic convexity. C. thoracic convexity with lateral spine curvature. D. waist and leg symmetry.

C. thoracic convexity with lateral spine curvature. Scoliosis screening begins in early adolescence. So that the entire back can be seen, the adolescent should remove all clothing from the upper body. While the adolescent stands up straight, check for any asymmetry; observe and palpate for differences in shoulder or scapular height, a prominence of either scapula or hip, waist asymmetry, and misalignment of the spinous processes. Lateral curvature and thoracic convexity of the spine indicate scoliosis. With the feet together, legs straight, and arms hanging freely, the adolescent bends forward until the back is parallel with the floor. The adolescent is assessed for prominence of the ribs, or rib hump, on one side only, and leg asymmetry. With scoliosis, the chest wall on the side of convexity is prominent, and the scapula on the side of convexity is elevated.

A nurse tells a childbirth education class consisting of pregnant women and their coaches that alcohol use poses serious risks to the fetus. After the class, one woman comments, "Do you really think that having a drink once in a while is bad for the baby? I'm sick of being told that I can't do things because of the baby." This is an example of: A. self concept. B. bias. C. values clarification. D. empowering beliefs.

C. values clarification. Values clarification is a method for discovering one's values and the importance of these values. Values clarification does not tell a person how to act, but it helps people recognize what values they hold and evaluate how those values influence their actions. In this example an apparent conflict in values between the nurse and the individual exists. Intervention is needed to examine how this woman's wish for freedom from restrictions clashes with her desire to have a healthy child. Nurses must consider their own values related to health promotion for the individual and the fetus and must weigh the importance of respecting individuals' rights to make decisions about their own health behaviors. Self-concept is a picture of self. This scenario does not utilize bias unless the nurse exhibits judgmental behaviors and empowering beliefs is not associated.

During a health screening of Hispanic children for lead poisoning, the initial question the nurse should ask is: A. "How old is the house you are living in?" B. "Do you eat canned foods from the United States only?" C. "Are there any areas in your home where paint is chipping off?" D. "Do you use ceramic containers made outside the United States for cooking?"

D. "Do you use ceramic containers made outside the United States for cooking?" Questions addressing the age of a house where lead paint was used targets only children whose exposure to lead is through lead-based paint. During the last 2 decades, assessment of children from homes with lead-based paint has resulted in a 90% decline in the overall number of children affected; however, the risk for Hispanic children has remained steady. Lead-based paint is not the primary source of lead poisoning for these children. Food and culturally defined health practices bring additional unscreened risk to this population. Foods packaged or canned outside the United States, foods prepared in ceramic containers or pottery made outside the United States, and wrapped Mexican candies all increase lead exposure to these children. Another common risk for these children is in home remedies containing lead.

A patient with a 20-year history of diabetes mellitus had a lower leg amputation. Which statement made by the patient indicates that he is experiencing a problem with body image? A. "I just don't have any energy to get out of bed in the morning." B. "I've been attending church regularly with my wife since I got out of the hospital." C. "My wife has taken over paying the bills since I've been in the hospital." D. "I don't go out very much because everyone stares at me."

D. "I don't go out very much because everyone stares at me." The amputation resulted in a change in physical appearance that caused a change in body image. Reactions of patients and families to changes in body image depend on the type of changes (e.g., loss of a limb or an organ), their adaptive capacity, the rate at which changes take place, and the support services available. When a change in body image such as results from a leg amputation occurs, the patient generally adjusts in the following phases: shock, withdrawal, acknowledgment, acceptance, and rehabilitation. The patient's statement indicates he is in the stage of withdrawal.

The nurse demonstrates empathy toward a crying mother whose baby was stillborn by stating: A. "I know exactly how you feel; that happened to me once." B. "You are young and will be able to have another baby." C. "It was God's will that your baby was taken to heaven with him." D. "Loss of a baby is truly a sad occurrence."

D. "Loss of a baby is truly a sad occurrence." Empathy involves the ability to understand another's feelings without losing personal identity and perspective. It is the critical element creating the caring climate through therapeutic use of self. Empathy decreases a person's distress. When the nurse acknowledges the content of the person's communication, she transmits empathy. It is important that the nurse remains with clients, spending time listening and assisting them to discuss problems, fears, and anxieties. Nurses do not empathize by switching the focus of the interaction to themselves, like in response a, or by sympathizing. The only statement that demonstrates empathy is d, which states an observation reflective of the mother's crying. Response b does not focus on the loss of this baby, which is important for the grieving process. Response c does not take the mother's beliefs into consideration.

The nurse provides educational information to the female adolescent on decreasing the incidence of acne, which includes: A. "Decrease chocolate intake in your diet." B. "Expose your face to sunlight at least 2 hours per day." C. "Remove all pustules and papules with special instruments." D. "Wash your face with soap and water two to three times per day."

D. "Wash your face with soap and water two to three times per day." Washing with soap and water two or three times a day is the best way to remove dirt and oil. The adolescent should not attempt to remove the pustules and papules that form. Squeezing the lesions can result in further irritation of the gland and permanent injury to the tissue. Sunlight can have a beneficial effect on acne; however, prolonged exposure should be avoided. The effect of diet on acne is a highly controversial issue. Current evidence indicates that dietary restrictions specific to acne are unnecessary.

According to the U.S. Census Bureau, the fastest-growing group within the older population is: A. 65 to 70. B. 70 to 75. C. 75 to 80. D. 85 and older.

D. 85 and older. The fastest-growing group within the older adult population is 85 years and older. According to the U.S. Census Bureau, an individual who was 65 years of age in 2009 could expect to live 19.2 more years, for a total of 84.2 years. Individuals aged 85 years in 2009 could expect to live an average of 6.3 more years, for a total of 91.3 years (CDC, 2012).

An older adult is being started on a new antihypertensive medication. In teaching the patient about the medication, the nurse: A. Speaks loudly. B. Presents the information once. C. Expects the patient to understand the information quickly. D. Allows the patient time to express himself or herself and ask questions.

D. Allows the patient time to express himself or herself and ask questions. When teaching older adults, it is important to establish rapport, involve them in their care, and allow them to progress at their own pace.

The nurse is aware that preschoolers often display a developmental characteristic that makes them treat dolls or stuffed animals as if they have thoughts and feelings. This is an example of: A. Logical reasoning. B. Egocentrism. C. Concrete thinking. D. Animism.

D. Animism. This is the belief that inanimate objects have lifelike qualities; it is a component of magical thinking evident in preoperational thought.

What is the best example of the nurse practicing patient advocacy? A. Seek out the nursing supervisor in conflicting procedural situations B. Document all clinical changes in the medical record in a timely manner C. Work to understand the law as it applies to an error in following standards of care D. Assess the patient's point of view and prepare to articulate it

D. Assess the patient's point of view and prepare to articulate it Seeking out the nursing supervisor, documenting clinical change in the medical record in a timely manner and working to understand the law as it applies to an error in following standards of care are not wrong; but advocacy generally refers to the nurse's ability to help speak for the patient.

To enhance their cultural awareness, nursing students need to make an in-depth self-examination of their own: A. Motivation and commitment to caring. B. Social, cultural, and biophysical factors. C. Engagement in cross-cultural interactions. D. Background, recognizing her biases and prejudices.

D. Background, recognizing her biases and prejudices. Cultural awareness is an in-depth self-examination of one's own background, recognizing biases and prejudices and assumptions about other people.

Priority nursing assessments of Latino/Hispanic Americans should focus on what disease process, because of its higher incidence in this population? A. Cancer B. Stroke C. Diabetes D. Cardiovascular

D. Cardiovascular Cardiovascular disease is the number one cause of morbidity and mortality among Latino/Hispanic Americans. Cancer is the second most prevalent cause of morbidity and mortality. Diabetes is twice as prevalent in Latino/Hispanics as in non-Hispanic White Americans.

Which statement requires further teaching related to food safety practices? A. Always drink pasteurized juices. B. Wash fresh fruits and vegetables thoroughly. C. When shopping, buy perishable foods last and take them straight home. D. Cooked meat, poultry, and eggs may be left out at room temperature for up to 3 hours

D. Cooked meat, poultry, and eggs may be left out at room temperature for up to 3 hours Hand washing is one of the most important practices in the prevention of food-borne illness. Raw, cooked, and ready-to-eat foods should be separated while shopping, preparing, or storing foods. Additional preventative safety measures include: • Wash fresh fruits and vegetables thoroughly. • Drink pasteurized juices. • Do not consume raw (unpasteurized) milk and/or cheeses made from raw milk. • Eat food that has been chilled and refrigerated properly. • When eating out, make sure that food has been chilled and refrigerated properly. • When shopping, buy perishable foods last and take them straight home. • Whether raw or cooked, never leave meat, poultry, eggs, fish, or shellfish out at room temperature for more than 2 hours. Be sure to chill leftovers as soon as you are finished eating.

You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A nonnursing colleague asks about this code. Which of the following statements best describes this code? A. Improves self-health care B. Protects the patient's confidentiality C. Ensures identical care to all patients D. Defines the principles of right and wrong to provide patient care

D. Defines the principles of right and wrong to provide patient care. When giving care, it is essential to provide a specified service according to standards of practice and to follow a code of ethics. The code of ethics is the philosophical ideals of right and wrong that define the principles you will use to provide care for your patients. The code serves as a guide for carrying out nursing responsibilities to provide quality nursing care and the ethical obligations of the profession

The nurse is teaching a class to students of pediatric nursing on comparing the concepts of growth and development. Which statement most accurately represents these concepts? A. Growth patterns are qualitative changes. B. Growth is from the head to toe or cephalocaudal. C. Development reflects an increase in the number and size of cells. D. Development is a gradual change that includes advances in skills.

D. Development is a gradual change that includes advances in skills. Growth refers to changes in the structure, reflects an increase in the number and size of cells, and results in an increase in the size and weight of the whole or any of its parts. During childhood, physical changes in head circumferences, weight, height, and overall body proportion are part of growth. Growth also refers to increases or decreases, as in old age, in the size of organs and systems. Development refers to gradual change and expansion of ability and advance in skill from lower to more advanced complexity. In contrast to growth, which is a quantitative or precisely measurable change, development is a qualitative change. Development has best been conceptualized as a process that is assessed as following certain sequencing of patterns; however, the timing of the advancements are individual.

A 6-month-old child from Guatemala was adopted by an American family in Indiana. The child's socialization into the American midwestern culture is best described as: A. Assimilation. B. Acculturation. C. Biculturalism. D. Enculturation.

D. Enculturation. Socialization into one's primary culture as a child is known as enculturation.

The nurse summarizes the conversation with the patient to determine if the patient has understood him or her. This is what element of the communication process? A. Referent B. Channel C. Environment D. Feedback

D. Feedback Feedback is the message the receiver returns that indicates understanding. By summarizing what the patient has said, the nurse can determine if the message was received accurately.

A nurse is teaching a group of young college-age women the importance of using sunscreen when going out in the sun. What type of content is the nurse providing? A. Simulation B. Restoring health C. Coping with impaired function D. Health promotion and illness prevention

D. Health promotion and illness prevention Health promotion and illness prevention are the focus when nurses provide information to help patients improve their health and avoid illness.

A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed? A. Planning B. Evaluation C. Assessment D. Implementation

D. Implementation Implementation is completing coordinating care and the prescribed plan of care.

Who has priority for being served? A. Non-breastfeeding postpartum women with any nutritional risk B. Individuals at nutritional risk only because they are homeless C. Children (up to age 5) at nutritional risk from serious medical problems D. Infants determined to be at risk at nutritional risk from serious medical problems

D. Infants determined to be at risk at nutritional risk from serious medical problems. When the local WIC agency has reached its maximal caseload, vacancies are generally filled in the order of the following priority levels: • Pregnant women, breastfeeding women, and infants determined to be at nutritional risk from serious medical problems. • Infants up to 6 months of age whose mothers participate in WIC or are eligible to participate • Children (up to age 5) at nutritional risk from serious medical problems. • Pregnant or breastfeeding women and infants who are at nutritional risk from dietary problems. • Children (up to age 5) at nutritional risk for dietary problems. • Non-breastfeeding postpartum women with any nutritional risk. • Individuals at nutritional risk only because they are homeless or migrants, and current participants who would likely continue to have medical and/or dietary problems without WIC assistance

A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? A. Patient-centered care B. Safety C. Teamwork and collaboration D. Informatics

D. Informatics Using decision support systems is one example of using and gaining competency in informatics.

Dave reports being happy and satisfied with his life. What do we know about Dave? A. He is in one of the later developmental periods, concerned with reviewing his life. B. He is atypical, since most people in any of the developmental stages report significant dissatisfaction with their lives. C. He is in one of the earlier developmental periods, concerned with establishing a career and satisfying long-term relationships. D. It is difficult to determine Dave's developmental stage since most people report overall satisfaction with their lives in all stages.

D. It is difficult to determine Dave's developmental stage since most people report overall satisfaction with their lives in all stages. Each of the life stages can be achieved successfully and result in satisfaction, including old age.

The patient for whom you are caring needs a liver transplant to survive. This patient has been out of work for several months and doesn't have health insurance or enough cash. What principles would be a priority in a discussion about ethics? A. Accountability because you as the nurse are accountable for the well-being of this patient B. Respect for autonomy because this patient's autonomy will be violated if he does not receive the liver transplant C. Ethics of care because the caring thing that a nurse could provide this patient is resources for a liver transplant D. Justice because the first and greatest question in this situation is how to determine the just distribution of resources

D. Justice because the first and greatest question in this situation is how to determine the just distribution of resources Accountability, respect or autonomy and ethics of care are not necessarily wrong, but they deflect attention from the less personal but more pertinent issue that is at stake in this situation: justice.

According to Healthy People 2020, the leading causes of death among children and young adults are due to injuries from which of the following? A. Homicide B. Suicide C. Burns D. Motor vehicle crashes

D. Motor vehicle crashes Healthy People 2020 reports that 72% of all deaths among children and young adults are due to injuries from four causes: motor vehicle crashes (30%), all other unintentional injuries (15%), homicide (15%), and suicide (12%) (U.S. Department of Health and Human Services [USDHHS], 2010). Preventive health concerns for young adults can be separated into two categories: developing behaviors that promote a healthy lifestyle and decreasing the incidence of accidents, injuries, and acts of violence. Health behaviors, safety practices, diet, exercise, weight control, sexuality, and addictions are widely discussed topics for the young adult age group.

The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? A. Clinical nurse specialist B. Nurse administrator C. Nurse educator D. Nurse researcher

D. Nurse researcher The nurse researcher investigates problems to improve nursing care and to further define and expand the scope of nursing practice. He or she often works in an academic setting, hospital, or independent professional or community service agency.

A patient at the community clinic asks the nurse about health promotion activities that she can do because she is concerned about getting diabetes mellitus since her grandfather and father both have the disease. This statement reflects that the patient is in what stage of the health belief model? A. Perceived threat of the disease B. Likelihood of taking preventive health action C. Analysis of perceived benefits of preventive action D. Perceived susceptibility to the disease.

D. Perceived susceptibility to the disease. The health belief model addresses the relationship between a person's beliefs and behaviors. It provides a way of understanding and predicting how patients will behave in relation to their health and how they will comply with health care therapies. In the perceived susceptibility to the disease phase, the patient recognizes the familial link to the disease.

A precise definition for the word quality is difficult to articulate when it comes to quality of life. Why? (Select all that apply.) A. Quality of life is measured by potential income, and average income varies in different regions of the country. B. Community values are subject to change, and communities influence definitions of "quality."Correct C. Individual experiences influence perceptions of quality in potentially different ways, making consensus difficult. D. Placing measurable value on elusive elements such as cognitive skills, ability to perform meaningful work, and relationship to family is challenging.

D. Placing measurable value on elusive elements such as cognitive skills, ability to perform meaningful work, and relationship to family is challenging. Definitions of quality depend on individual experience and value integrated into community standards, but value refers to elements beyond monetary value.

A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her. She is using which form of cognitive development? A. Conventional reasoning B. Formal operations C. Integrity versus despair D. Postformal thought

D. Postformal thought Adults recognize that there are various solutions to problems and that different situations demand different solutions.

When preparing a 4-year-old child for a procedure, which method is developmentally most appropriate for the nurse to use? A. Allowing the child to watch another child undergoing the same procedure B. Showing the child pictures of what he or she will experience C. Talking to the child in simple terms about what will happen D. Preparing the child through play with a doll and toy medical equipment

D. Preparing the child through play with a doll and toy medical equipment Preschoolers are in the preoperational stage of cognitive development and learn more easily when play is used to teach.

The examination for registered nurse licensure is exactly the same in every state in the United States. This examination: A. Guarantees safe nursing care for all patients B. Ensures standard nursing care for all patients C. Ensures that honest and ethical care is provided D. Provides a minimal standard of knowledge for a registered nurse in practice

D. Provides a minimal standard of knowledge for a registered nurse in practice Registered nurse (RN) candidates must pass the NCLEX-RN® that the individual State Boards of Nursing administer. Regardless of educational preparation, the examination for RN licensure is exactly the same in every state in the United States. This provides a standardized minimum knowledge base for nurses.

A patient needs to learn to use a walker. Which domain is required for learning this skill? A. Affective domain B. Cognitive domain C. Attentional domain D. Psychomotor domain

D. Psychomotor domain Using a walker requires the integration of mental and muscular activity.

A nurse works in a special care unit for children with severe immunology problems and is caring for a 3-year-old boy from Greece. The boy's father is with him while his mother and sister are back in Greece. The nurse is having difficulty communicating with the father. What action does the nurse take? A. Care for the boy as she would any other patient B. Ask the manager to talk with the father and keep him out of the unit C. Have another nurse care for the boy because maybe that nurse will do better with the father D. Search for help with interpretation and understanding of the cultural differences by contacting someone from the local Greek community

D. Search for help with interpretation and understanding of the cultural differences by contacting someone from the local Greek community The nurse needs to understand how the Greek culture impacts the father's health beliefs and communication with health care providers. Cultural variables must be incorporated into the child's plan of care. Cultural background influences beliefs, values, and customs. It influences the approach to the health care system, personal health practices, and the nurse-patient relationship. Cultural background may also influence an individual's beliefs about causes of illness and remedies or practices to restore health. If nurses are not aware of their own and other cultural patterns of behavior and language, they may not be able to recognize and understand a patient's behavior and beliefs and may have difficulty interacting with the patient.

Elizabeth, who is having unprotected sex with her boyfriend, comments to her friends, "Did you hear about Kathy? You know, she fools around so much; I heard she was pregnant. That would never happen to me!" This is an example of adolescent: A. Imaginary audience. B. False-belief syndrome. C. Personal fable. D. Sense of invulnerability

D. Sense of invulnerability Adolescents can be risk takers and believe that they are immune to the negative consequences of behaviors; they are just beginning to be future oriented in their thought process and see everything as black or white.

Culture strongly influences pain expression and need for pain medication. However, cultural pain is: A. Not expressed verbally or physically. B. Expressed only to others from a similar culture. C. Usually more intense than physical pain. D. Suffered by a patient whose valued way of life is disregarded by practitioners.

D. Suffered by a patient whose valued way of life is disregarded by practitioners. Patients suffer cultural pain when health care providers disregard values or cultural beliefs.

You are caring for Mr. Smith, who is facing amputation of his leg. During the orientation phase of the relationship, what would you do? A. Summarize what you have talked about in the previous sessions B. Review his medical record and talk to other nurses about how he is reacting C. Explore his feelings about losing his leg D. Talk with him about his favorite hobbies

D. Talk with him about his favorite hobbies Socializing is used during the orientation phase of a relationship to get acquainted and help establish trust.

Which of the following are components of the paradigm of nursing? A. The person, health, environment, and theory B. Health, theory, concepts, and environment C. Nurses, physicians, health, and patient needs D. The person, health, environment/situation, and nursing

D. The person, health, environment/situation, and nursing The nursing paradigm focuses on person, health, environment/situation, and nursing. All the elements interact with one another, with the patient being central.

The statement that best explains the role of collaboration with others for the patient's plan of care is which of the following? A. The professional nurse consults the health care provider for direction in establishing goals for patients. B. The professional nurse depends on the latest literature to complete an excellent plan of care for patients. The professional nurse works independently to plan and deliver care and does not depend on other staff for assistance. D. The professional nurse works with colleagues and the patient's family to provide combined expertise in planning care.

D. The professional nurse works with colleagues and the patient's family to provide combined expertise in planning care. Collaboration involves everyone working together to best meet the needs of the patient. A care plan that incorporates the expertise of professionals from varied disciplines best addresses patient needs

Theory-based nursing practice uses a theoretical approach for nursing care. This approach moves nursing forward as a science. This suggests that: A. One theory will guide nursing practice. B. Scientists will decide nursing decisions. C. Nursing will only base patient care on the practice of other sciences. D. Theories will be tested to describe or predict patient outcomes.

D. Theories will be tested to describe or predict patient outcomes. There are multiple theories for the practice of nursing; these theories are tested to develop the evidence to describe or predict patient outcomes.

When teaching about proper nutrition to a person with congestive heart failure, which affective component should be included in the educational plan? A. Eating with someone B. Food preparation techniques C. Knowledge of dietary restrictions D. Values of adhering to the diet

D. Values of adhering to the diet The affective component of education addresses the attitudes and values the person believes regarding the education and how it will apply to his or her life beliefs. If the person values the education, it will be more likely to be followed as opposed to if the person finds that the education is not congruent with his or her values. Even when the person possesses the knowledge base, assessment of whether the individual also values the importance of adhering to the modifications in lifestyle is vital.

Erikson's theory of psychosocial development identifies the toddler stage as: A. trust versus mistrust. B. initiative versus guilt. C. industry versus inferiority. D. autonomy versus shame and doubt.

D. autonomy versus shame and doubt. Erikson identifies eight stages of psychosocial development across the life span. These include: • Infancy—trust versus mistrust • Toddler—autonomy versus shame and doubt • Preschool—initiative versus guilt • School-age—industry versus inferiority • Adolescence—identity versus role confusion • Young adulthood—intimacy versus isolation • Middle adulthood—generativity versus stagnation • Older adulthood—ego integrity versus despair

A target goal of Healthy People 2020 is to reduce the incidence of hepatitis C. The nurse focuses on individuals most at risk, which includes persons with: A. hepatitis A. B. Epstein-Barr virus. C. human papilloma virus. D. chronic renal disease on hemodialysis.

D. chronic renal disease on hemodialysis. Individuals most at risk for hepatitis C are those who have injected illicit drugs, received clotting factors before 1987, are on hemodialysis, are human immunodeficiency virus (HIV) positive, or have elevated liver function values. The other diseases listed do not have a positive correlation to hepatitis C.

The nurse understands that holistic health care practice: A. has no scientific basis. B. is not covered by health care insurance C. treats the symptoms that the client demonstrates D. considers that people have emotions, spirits, and relationships that combine with the physical body.

D. considers that people have emotions, spirits, and relationships that combine with the physical body. Holistic health practices are used to promote wellness. They are used to treat illness and reduce pain. Holism is the understanding that people are not just physical bodies; people have emotions, spirits, and relationships that combine with the physical body to make a whole person. The holistic movement in the healing arts reflects the theory of holism, and recognizes that all these aspects of the person must be considered when planning and delivering care. The entire person is treated, not only symptoms. It is important to identify the cause of the symptoms and treat the cause. Many of the interventions used in holistic health practices are backed by centuries of tradition, and today research is occurring to document their scientific merit. These holistic practices are often considered alternative practices, some of which are covered by health insurances.

The nurse, presenting a nutrition class to high school students, emphasizes that the leading cause of death associated with diet is: A. anemia. B. infection. C. cirrhosis of the liver. D. coronary heart disease.

D. coronary heart disease. The four leading causes of death directly associated with diet are coronary heart disease, some types of cancer, stroke, and diabetes mellitus. Anemia may be caused by inadequate iron and folate intake. A person's risk for infection is increased if the person is malnourished. Cirrhosis of the liver is caused by alcohol abuse.

The nurse incorporates epidemiological findings in assessing for risks associated with intimate partner violence, which include: A. adequate economic resources. B. equal job position C. both partners achieved college graduation. D. differences in prestige associated with the partners' careers.

D. differences in prestige associated with the partners' careers. Epidemiological studies have attempted to determine the risks for intimate partner violence. Poverty and associated stress stemming from lack of economic resources appear to induce abuse against women. The unequal position of women in a relationship and the manner in which conflict is managed, as well as differences in education and prestige associated with the partner's occupations, are related to risk of violence.

Characteristic behaviors of older adults who have successfully met Erikson's ego integrity versus despair developmental task include: A. fear of death. B. feelings that life has been lived in vain. C. identity is related to career and work only. D. honest acceptance of the life that has passed.

D. honest acceptance of the life that has passed. Ego integrity versus despair is the developmental stage of older adults. The quality associated with successful passage of this stage is integrity, defined as an honest acceptance of the life that has passed and the stage of life that is currently being lived. Individuals who have reached this stage are said to be at peace with themselves. The inability to reach this stage leads to fear of death and despair that life has been lived in vain. Ego differentiation, which is a part of the developmental stage of ego integrity, involves achieving an identity apart from work.

When assessing elderly adults, the nurse determines that malnutrition may be present in the person with: A. serum albumin level of 5.0 gm/dL. B. midarm muscle circumference at the 25th percentile. C. triceps skinfold thickness at the 20th percentile. D. involuntary decrease of weight of more than 10 lb in the last 6 months.

D. involuntary decrease of weight of more than 10 lb in the last 6 months. The single largest group at risk for malnutrition is composed of elderly adults. The health care professional should refer the individual to a physician when there has been an involuntary weight loss of 10 lb or more within a 6-month period. Additional anthropometric measurements suggesting malnutrition include: • Triceps skinfold thickness less than 10th percentile • Midarm muscle circumference less than 10th percentile • Serum albumin level less than 3.5 mg/dL • Evidence of osteoporosis or mineral deficiency (indicated by a history of bone pain or fractures, particularly in older women) • Evidence of vitamin deficiency (indicated by inadequate intake of fruits and vegetables, angular stomatitis, glossitis, or bleeding gums; pressure ulcers in bedridden individuals)

The process of gaining specific knowledge or skills that result from exposure, experience, education, and evaluation is known as: A. maturation. B. growth. C. development. D. learning

D. learning Learning is the process of gaining specific knowledge or skills that result from exposure, experience, education, and evaluation. Maturation is an increase in competence and adaptability that reflects changes in the complexity of a structure that make it possible for that structure to begin to function or to function at a higher level. Maturation of a structure, system, or individual refers to the emergence of the genetic potential of that structure, system, or individual. Development is closely interrelated with the concepts of learning and maturation.

The nurse is teaching a class to nursing students on the relationship between exercise and immune system function. Content should include: A. high-intensity exercise decreases the incidence of upper respiratory infections. B. moderate exercise decreases the release of immunostimulatory hormones. C. intense exercise is associated with a decrease in catecholamine and corticosteroid levels. D. moderate exercise is associated with a prolonged improvement in the killing capacity of neutrophils.

D. moderate exercise is associated with a prolonged improvement in the killing capacity of neutrophils. Changes in immune markers, such as CD4 and CD8 cell counts and the number and activity of natural killer (NK) cells, indicate that moderate exercise may help bolster an impaired immune system. Evidence indicates that moderate exercise stimulates the neuroendocrine system, which causes changes in the function and numbers of various immune system cells. Evidence also indicates that moderate exercise is associated with a prolonged improvement in the killing capacity of neutrophils. Moderate exercise may decrease the risk of upper respiratory tract infection. High-intensity marathoners have a significantly higher incidence of upper respiratory tract infections. Intense exercise is associated with a decrease in catecholamine and corticosteroid levels. Moderate exercise increases the release of immunostimulatory hormones.

Public health nurses are involved in supporting active health promotion strategies such as: A. supporting clean water. B. advocating for vitamin D in all milk. C. supporting sanitary sewage systems. D. participating in an individual daily exercise program.

D. participating in an individual daily exercise program. Health-promotion strategies are either active or passive. Passive strategies involve the individual as an inactive participant or recipient. Examples of passive strategies include public health efforts to maintain clean water and sanitary sewage systems, and efforts to introduce vitamin D in all milk to ensure that children will not be at risk for rickets when there is little sunlight. Active strategies depend on the individual becoming personally involved in adopting a proposed program of health promotion. Examples of lifestyle changes are daily exercise as part of a physical fitness plan and a stress-management program as part of daily living.

To facilitate the adolescent's need for controlling behaviors, the nurse implements an intervention that: A. asks the adolescent how he or she would like to handle the situation. B. consults with the parents regarding the adolescent's health care needs. C. gives specific, detailed instructions in writing. D. partners with the adolescent to develop a plan.

D. partners with the adolescent to develop a plan. Adolescents must be in charge of some aspects of life and can no longer accept family and school rules without question as they did in the past. This need to control extends to health care. The nurse cannot simply give directions or instructions, but rather, present the options and allow the adolescent to partner together to work out an acceptable plan. The primary discussion needs to be performed with the adolescent, instead of with the parents.

The nurse facilitates the adolescent's self-perception-self-concept development by: A. complementing the adolescent for what is accomplished. B. developing a plan for the adolescent's future growth. C. encouraging the adolescent to join in group activities. D. praising the adolescent for who he or she is.

D. praising the adolescent for who he or she is. Assessment, anticipatory guidance, education, and counseling are strategies that the nurse can use to guide the adolescent in developing a healthy self-perception that incorporates a healthy body image. It is important for nurses to remember to praise adolescents for who they are rather that for what they do, value each of them as unique, demonstrate belief in their abilities to grow and develop, and delight in their discoveries of themselves and their unique means of expressing it.

The nurse is preparing an educational activity for adolescents. The primary reason that emphasis is placed on teaching testicular self-examination is because: A. adolescents are naturally interested in their developing bodies. B. baseline assessment data is necessary for comparison in the future. C. rapid anatomical changes are occurring in the testes. D. testicular cancer is the number one cancer in the adolescent male.

D. testicular cancer is the number one cancer in the adolescent male. Testicular cancer is the number one cancer in adolescent and young adult males. Adolescent males should learn to do a testicular self-examination and continue this practice monthly. Nurses should introduce and teach methods of self-examination to adolescents who are naturally interested in their developing bodies. Even though the adolescent's body is undergoing anatomical changes, the primary reason for testicular self-examination is preventative for early identification of cancer. Baseline data collected during adolescence is not a priority for future comparison.

The most widely accepted form of exercise among older adults is reported to be: A. swimming. B. running. C. strength-training. D. walking.

D. walking. Walking, which can be done in both community settings and health care facilities, is broadly reported as the most widely accepted form of exercise among older adults. Other popular activities for older adults include swimming, weight-bearing, and aquatic exercises. Weight-bearing and muscle-building exercises help to maintain functional mobility, promote independence, and prevent falls. Weight-bearing exercises are shown to be highly effective in reducing bone wasting associated with osteoporosis.

The nurse, presenting a nutrition class to high school students, emphasizes that the leading cause of death associated with diet is: anemia. infection. cirrhosis of the liver. coronary heart disease. Correct

coronary heart disease. Correct The four leading causes of death directly associated with diet are coronary heart disease, some types of cancer, stroke, and diabetes mellitus. Anemia may be caused by inadequate iron and folate intake. A person's risk for infection is increased if the person is malnourished. Cirrhosis of the liver is caused by alcohol abuse.