Fundamentals of Nursing CH 4: Health and Illness

The nurse is planning care for several clients in an outpatient clinic. Which client requires follow-up care due to a chronic condition?

client with chronic obstructive pulmonary disease (COPD) symptoms of wheezing and cough who needs a medication refill

To be an effective change agent for wellness, the nurse must:

consume a diet low in fat.

A nurse is planning a health fair in the community to highlight promotion and prevention of the leading cause of death in the United States. Which disease process should the nurse address?

coronary artery disease

Unlicensed assistive personnel are performing duties that nurses and practical nurses once provided. This change is an effect of:

cost-driven changes.

Which clients, at risk for health disparities, may require additional assistance from the nurse in order to access healthcare services? (Select all that apply.)

migrant farm workers older adult clients in a senior citizen complex clients who have been unemployed for several months

The nurse is explaining primary and secondary care to the client. Which nursing activity reflects secondary care as provided by the nurse?

ordering a mammography

A type of nursing which includes individualized care provided by the same nurse throughout the period of care is defined as

primary nursing

The nurse is ccertified in providing Therapeutic Touch and is preparing to initiate this for a client. What activity should the nurse perform initially?

request the client's permission prior to touching the body

The public health nurse is performing activities within the community. Which nursing activity provides an example of primary prevention?

screening school-aged children for lead

The client is admitted with a gastrointestinal bleed (GI). The physician ordered a colonoscopy. Which level of care encompasses this procedure?

secondary

A client enjoys high-calorie carbohydrates but understands that they raise her blood sugar sharply and ultimately cause a feeling of butterflies in her stomach as her blood sugar decreases. This is considered:

self-awareness.

A nurse assists the client in the development of a healthy lifestyle. The adoption of these lifestyle changes in the client's life is considered:

self-care.

Which client would benefit from the nurse including interventions addressing their social health in the plan of care?

spouse and parent who is angry about no longer being able to work due to a spinal cord injury

Which client would benefit from the nurse including interventions addressing emotional health in the plan of care?

stressed client who is experiencing paranoid delusions

The nurse is preparing a plan of care for a client with nutritional deficits. Which is the priority intervention for this client?

teaching about intake of food and vitamins

The nurse is preparing to create a plan of care for a client admitted with chronic obstructive pulmonary disease (COPD). The nurse understands that the client's self-actualization needs can be met by implementing which interventions? (Select all that apply.)

teaching the client about the COPD diagnosis educating the client about the course of the disease process creating a treatment and prevention plan to decrease readmissions

A public health nurse has been doing research in preparation for an influenza vaccination campaign and has learned that among adults in the community, 73 people out of every 1000 were infected with influenza last year. This epidemiological statistic represents:

the morbidity of influenza.

A client tells the nurse that her doctor just told her that she had a "chronic condition." She asks the nurse what does "chronic condition" mean. What would be the nurse's best response?

"Chronic conditions usually come on slowly and may have periods of remission and exacerbation."

The nurse is counseling a newly pregnant woman who is concerned about developing infections during her pregnancy. The pregnant woman states, "I'm so afraid something will happen to my baby. My friend developed an infection while she was pregnant and the baby died." Which of the following responses by the nurse would be most appropriate?

"Early prenatal care like you are receiving is very beneficial in reducing chances of infection.

Maslow developed a hierarchy of needs from the simple to the complex. Using Maslow's hierarchy of needs, place the following client needs in the order in which the nurse would address them, from simplest to most complex.

"Nurse, my pain is terrible and I need pain medication right away." "There have been three neighborhood break-ins on the street in the last month. I am going to sell my house and move to a different neighborhood." "When I first joined the golf club, I felt welcomed and looked forward to the weekly golf games." "I'm very proud to be placed on the Dean's List for spring semester."

A 48-year-old client was just diagnosed with type 2 diabetes mellitus. The client has a BMI of 35 and leads a sedentary lifestyle. The nurse informs the client of risk factors for the diagnosis and the need to change diet and exercise behavior. Which client statement indicates a need for further teaching?

"There is nothing that can be done anyway; chronic diseases cannot be prevented"

The nurse is preparing a sterile field for a procedure. While opening an instrument, the outer wrapper of the sterilized instrument touchs the extreme edge of the field. Which of the following should the nurse do next.

Discard the sterile field and prepare a new one

The student nurse is assessing a severely disabled elderly patient hospitalized for infection. The patient's family ask the nurse why their loved one keeps getting infections. The student nurse explains to the family which of the following increases the risk of infection for this patient? Select all that apply.

Dysphagia Incontinence Immobility

A nurse is caring for a client who is in the remission state of leukemia. The client expresses anxiety about the recurrence of leukemia and states feels depressed when thinking about the outcome of leukemia. Which aspect of health is the client talking about?

Emotional health

Which best describes the main role of a tertiary health care service?

Enhances the level of health in clients with chronic illness or disability

A client has been exposed to bacterial pneumonia. The client has been eating poorly, with limited intake of nutrients. This factor would predispose a client to the development of pneumonia. Poor nutritional intake is classified as the

Environment

The nurse understands that an idiopathic illness is a condition whose cause is unexplained. Which is an example of idiopathic illness?

Fever of undetermined origin

In a nursing unit, the nurse-in-charge delegates nursing duties as follows: one nurse is assigned to assist clients with nasogastric feeds; another nurse is assigned to wound dressings, and another nurse for giving medications. Which type of nursing care is being implemented?

Functional nursing

Nurses are working in a system in which each one is assigned specific tasks. Which model of nursing is represented?

Functional nursing

What is a dynamic state in which a person constantly adapts to changes in the internal and external environment?

Health

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

Health

A nursing instructor is working with a class of first semester nursing students. The instructor explains the interrelatedness of health and wellness. What would be the best definition the nursing instructor could give of health?

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

A nursing class is reviewing managed care organizations. What would students correctly identify as part of managed care? (Select all that apply.)

Health maintenance organizations Preferred provider organizations Capitation

A nursing student asks the instructor about the leading cause of death. What would the instructor identify as the most common cause of death in clients?

Heart disease

The nurse understands that Huntington's chorea is a neurologic disorder that manifests itself at adulthood. Which category of illness best defines Huntington's chorea?

Hereditary illness

Which statement most accurately defines illness?

Illness is the response of a person to a disease.

During a presentation, nursing students correctly identify what as targeted health goals for achievement in the Healthy People 2020 initiative? (Select all that apply.)

Increase the proportion of health and wellness and treatment programs and facilities that provide full access for people with disabilities. Reduce the number of new cases of cancer as well as the illness, disability, and death caused by cancer. Reduce infections caused by key food-borne pathogens.

The Healthy People initiative targets the improvement of health for all. In addition to eliminating health disparities, what are the broad goals of this plan?

Increasing the quality and length of a healthy life

Which is a factor upon which the financial stability of health maintenance organizations (HMOs) is based?

Keeping clients healthy and out of the hospital through periodic screening, health education, and preventive services

A client tells the nurse that she is struggling with conflicting values. What are examples of values? (Select all that apply.)

Knowledge Wealth Health Marital fidelity

A nursing instructor is teaching students about the concept of "continuity of care." Which of the following is the correct definition of this concept?

Maintenance of health care from one level of health to another and from one agency to another

The U.S. population is aging, and with the increased numbers of clients reaching age 65, health care has had to change its focus. What is one focus of health care today?

Management of chronic conditions and disability

What is an entitlement program designed to serve the poor that is administered by the state?

Medicaid

A nursing student has learned that an increasing number of individuals now live with one or more chronic illness. What health condition is an example of a chronic illness?

Osteoarthritis

What is an important role for a nurse in the health care delivery system?

Participation in disease prevention and health promotion activities

The patient is in protective isolation. The nurse expects which of the following while providing care for the patient in this type of isolation? Select all that apply.

Patient may feel lonely and dirty A private room

A client states, "I must be in poor health because I am a senior citizen. That's what my neighbor says and she is older than I am." This statement is based on which of the following factors?

Peer influence

A hospice nurse is caring for a client dying of lung cancer. According to Maslow's hierarchy of needs, what dimension of care should the nurse consider primary in importance when caring for a dying client?

Physiologic

An older adult is hospitalized. The client is suffering from poor nutrition. The client does not want to give up his independence, but is living in a neighborhood with an increasing crime rate. The client tells the nurse, "I feel so useless and lonely. My wife died 2 years ago, and my children live out of state. I am afraid to leave the house, but my friends don't want to come visit." Which of the client's problems would the nurse address first?

Physiologic

According to Maslow, which category of needs represents the most basic on the hierarchy?

Physiologic needs

An instructor is reviewing with a class the services provided by integrated delivery systems. Which services would the nursing instructor include? (Select all that apply.)

Preventive care Ambulatory care Emergency care

A nurse is educating women on the need for calcium to prevent bone loss. What level of prevention does this represent?

Primary prevention

What level of prevention is noted when the nurse educates a group of mothers of school-age children on self breast examinations?

Primary prevention

A client has cancer and undergoes treatment. During a follow-up visit, the health care providers can find no evidence of current disease. Which term would be used related to this client's condition?

Remission

Nursing students are learning about common causes of congenital illnesses. Which would they correctly identify as potential causes? (Select all that apply.)

Rubella Alcohol Thalidomide

A client reports that she is in an abusive relationship and does not know how to break it off. Which of Maslow's hierarchy of needs does the nurse need to prioritize most for this client?

Safety and security

A woman over the age of 40 years has an annual mammogram. What level of prevention does this represent?

Secondary prevention

The home health nurse is assisting a client and the family in planning the client's return to work after an extensive illness. On which level of Maslow's hierarchy of basic needs does the client's need for self-fulfillment fit?

Self-actualization

A 13-year-old client with cystic fibrosis has just recovered from a superimposed respiratory infection and is going home tomorrow. The client confides in the nurse that her home life is not the greatest right now. Her parents are fighting a lot. Sometimes, her mother has too much to drink and starts throwing things at people. At times she gets scared her mom will hurt someone. She feels as if she is causing her parents to fight and causing her mom to drink because she is always in the hospital. According to Maslow's hierarchy of human needs, which issue should take priority when caring for this client?

She feels scared that her mother will hurt someone.

Research has shown that the incidence of chronic conditions is increasing. Which lifestyle factor is associated with chronic diseases?

Smoking

An 81-year-old client experienced a fall and fractured his hip. Consequently, the client was admitted to the local hospital and had surgery to repair the hip fracture. What type of care did this client receive?

Tertiary care

Fifteen years ago, a client lost the right leg in a motor vehicle accident. Since then, the client and the client's spouse have formed a walking group to raise money for the homeless. Why would the client be considered healthy?

The client is experiencing a high quality of life within the limits of their physical condition

A recent nursing graduate has been making a concerted effort to ensure that clients receive holistic nursing care. Which action best demonstrates the principle of holism?

The nurse attempts to meet the physical, social, emotional, and spiritual health needs of clients

A man with Alzheimer's disease in a nursing home will follow directions for dressing and feeding better with one nurse than with other staff members. This factor is related to

Therapeutic model of interaction

Primary health promotion is an integral part of health care. What is the purpose of primary health promotion?

To promote health and prevent disease or injury.

In an effort to cut costs, hospitals have instituted many changes. Which of these cost-cutting factors is likely to jeopardize the quality of care?

Using unlicensed assistive personnel

When providing care to a client, what perspective is followed by the nurse?

Viewing client's health as a balance of body, mind, and spirit

What is a dynamic balance among the physical, psychological, social, and spiritual aspects of a person's life?

Wellness

When chronic illnesses and disabilities are present, individuals benefit most from activities that:

help them maintain independence.

The recognition of health as an ongoing process toward a person's highest potential of functioning is defined as:

high-level wellness

The body's attempt to restore balance through self-regulatory mechanisms is termed:

homeostasis.

The nurse is caring for a client admitted for the third time in 90 days with a diagnosis of heart failure. What nursing activities on a tertiary level will the nurse educate the client regarding to prevent readmission?

importance of adhering to a low sodium diet

The concept of holism is based on the belief that:

individuals cannot be seen apart from the environment.

The nurse understands that mortality denotes the number of people who died of a particular disease or condition. What does an infant mortality rate of 15 indicate?

15 infant deaths per 1,000 live births

Which statement reflects the World Health Organization's definition of health?

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

A client is diagnosed with influenza. Which type of illness does the client have?

Acute

Based on Maslow's hierarchy of needs, when prioritizing a client's plan of care, what would be the nurse's priority?

Administering pain medication

A 90-year-old woman has a staphylococcus infection in her decubitus ulcer. Staphylococcus is the:

Agent

An exacerbation refers to the reactivation of a disease. Which condition is associated with exacerbation?

Chronic illness

What is a misconception about chronic disease?

Chronic illnesses cannot be prevented.

The nurse documents that a client has compromises to their physiologic needs. Which areas would be involved in this scenario? (Select all that apply.)

Compromised nutrition Pain Polluted water supply

What is the definition of wellness?

an active state of being healthy

A nurse is planning a seminar for the local community. Which topics are examples of health promotion discussions? (Select all that apply.)

examples of heart-healthy diet information on increasing activity and exercise

A nurse is caring for a client with end-stage liver failure. Which healthcare agency should the nurse recommend for continuity of care?

extended care

Ventricular septal defect is a congenital disorder. The nurse understands that congenital disorders are due to:

faulty embryonic development.

An woman 80 years of age has had a cerebrovascular accident. She has flaccidity of her right side with aphasia. For this client, which of the following activities constitutes tertiary prevention?

gait training and speech therapy