prep u chapter 3
To be an effective change agent for wellness, the nurse must: -skip breakfast to reduce calories. -drink caffeinated beverages. -lead a sedentary lifestyle. -consume a diet low in fat.
-consume a diet low in fat. Chapter 3: Health, Wellness, and Health Disparities - Page 60
Which nursing intervention is an example of tertiary preventive care?
Assisting with speech therapy a client with a traumatic brain injury -Tertiary prevention begins after the illness and is used to help rehabilitate clients. Speech therapy is an example of tertiary preventive care. The administration of immunizations and teaching stress reduction classes are examples of primary preventive care. Blood pressure screening is an example of secondary preventive care. Chapter 3: Health, Wellness, and Health Disparities - Page 59
Which are factors that impact how a client defines health? Select all that apply. Family Society Music Community Culture
family, culture, community, society Music does not affect how a person defines health.
The nurse should identify the need for further teaching when the client with diabetes who is taking daily insulin and follows a strict diet makes which statement? "I can achieve a maximum level of functioning." "I can achieve a high quality of health and life." "I cannot possibly ever be considered as healthy." "I have an illness, but I can feel as if I am healthy."
"I cannot possibly ever be considered as healthy." -The statement that describes the client as never being able to be considered healthy is incorrect. One who has an illness or injury can still achieve maximum functioning and consider oneself to be healthy. One who has a chronic illness can also achieve a quality of life that is acceptable as one works on achieving a satisfying health standard. Chapter 3: Health, Wellness, and Health Disparities - Page 48
Why are health promotion and illness prevention a key responsibility of nurses? Chronic illnesses are the leading health problem in the world. People do not like to be sick and feel bad. Chronic illnesses can cause pain and suffering. Treatment of chronic illnesses is very expensive.
Chronic illnesses are the leading health problem in the world. -Because chronic illnesses are the leading health problems in the world, health promotion and illness prevention activities are vital to nursing care. By endorsing health promotion and illness prevention, the nurse can assist the client to achieve optimal health even with a chronic illness. It is true that treating chronic illnesses can be expensive, they do cause pain and suffering, and people do not like to be sick, but these are not the most important reasons for promoting health and preventing illnesses. Chapter 3: Health, Wellness, and Health Disparities - Page 51
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 Cerebrovascular accidents Lung cancer Emphysema
Coronary artery disease -Heart disease is the leading cause of death in the United States. Lung cancer, emphysema, and cerebrovascular accidents are not the leading causes of death in the United States.
When providing care to a client, the nurse integrates knowledge that a client's beliefs and actions are related and influenced by the client's personal expectations in relation to health and illness. The nurse is demonstrating an understanding of which health model? Holistic health model High-level wellness model Health belief model Clinical model
Health belief model According to the health belief model, a client's beliefs and actions are related and influenced by the client's personal expectations in relation to health and illness. According to the clinical model, health is defined narrowly as the absence of signs and symptoms of disease or injury. The holistic model views individuals as ever-changing systems of energy, and the interaction of a person's mind, body, and spirit within the environment. The high-level wellness model is the recognition of health as an ongoing process toward a person's highest potential of functioning. Chapter 3: Health, Wellness, and Health Disparities - Page 59-60
A nurse is immunizing children against measles. This is an example of what level of preventive care? Tertiary Chronic Secondary Primary
Primary -Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Immunizations are an example of primary health promotion. Secondary health promotion and illness prevention focus on screening for early detection of disease, with prompt diagnosis and treatment of any found. Tertiary health promotion and illness prevention begin after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate clients to a maximum level of functioning. The term chronic is not related to health promotion. Chapter 3: Health, Wellness, and Health Disparities - Page 56
The nurse's community outreach class is giving a presentation on seat belts and child safety seats at the local firehouse every weekend in October. Which level of health promotion is this an example of? Primary Secondary Medical Tertiary
Primary -Primary health promotion and illness prevention is directed toward promoting good health and preventing the development of disease process or injury. Primary-level activities include immunization clinics, providing poison-control information, and education about seat belt and child-safety seat use. Secondary-level activities include screening programs and early identification of disease. Tertiary-level prevention is concerned with returning the client to the optimal function after diagnosis. Medical is not a level of health promotion or illness prevention. Chapter 3: Health, Wellness, and Health Disparities - Page 56
The nurse is caring for a client with a diagnosis of heart failure. This admission is the client's third admission within 90 days. The nurse educates the client with the goal of preventing readmission. Which nursing activity for this client would represent tertiary level prevention? -Teaching about adhering to a low-sodium diet -Assessing for risk factors for heart disease -Screening for tuberculosis -Screening for breast cancer every 5 years
Teaching about adhering to a low-sodium diet -Tertiary health promotion and illness prevention begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate the client to a maximum level of functioning. Nursing activities on a tertiary level include teaching a client with heart failure the importance of adhering to a low-sodium diet. Primary prevention is directed toward promoting health and preventing the development of disease processes or injury. This client has a diagnosis. Secondary health promotion and illness prevention focus on screening for early detection of disease with prompt diagnosis and treatment of diseases found. Chapter 3: Health, Wellness, and Health Disparities - Page 58
A nurse is taking care of a client who has a new, permanent colostomy. The nurse is talking with the client about the new appliance and asking how the client feels about managing it. Which client response indicates understanding of the relationship between self-concept and health? I am a pretty smart guy, so I will learn to do this quickly." "I realize my overall health is important in determining my quality of life, so I will make sure to keep all appointments for my appliance care." "I am developing a set of realistic expectations to help me manage my overall health and quality of life." "I have lots of help at home, so I am not too worried about having to take care of it myself."
"I am developing a set of realistic expectations to help me manage my overall health and quality of life." -The statement indicating that the client is developing realistic expectations demonstrates understanding that self-concept is an integral part of overall health. Since self-concept is an important part of overall health, a client statement involving self-perception and self-concept should include an understanding of how the two are related. Spiritual beliefs, intellectual dimension, and physical dimension all are factors that influence a person's health-illness status. The client may be intelligent, but this is only a small component of self-concept. Having help at home is not a component of this client's self-concept. Likewise, realizing overall health is important, but keeping appointments is not a component of self-concept.
A pregnant client at 10 weeks' gestation is receiving education by the nurse about the importance of abstaining from alcohol while pregnant. What statement made by the client demonstrates an understanding of the education provided? -"If I drink alcohol while pregnant, my child will have a hereditary disorder." -"I should abstain from alcohol to prevent the development of a fetal alcohol spectrum disorder." -"Abstaining from alcohol will prevent any type of congenital disorder." -"Alcohol use while pregnant will predispose my child to idiopathic illness."
"I should abstain from alcohol to prevent the development of a fetal alcohol spectrum disorder." -Congenital disorders such as fetal alcohol spectrum disorders may be prevented by the client abstaining from alcohol while pregnant. Fetal alcohol spectrum disorders are congenital disorders caused by an undetermined amount of alcohol ingested by the mother which affects the fetus in the developmental stages of growth. Abstaining from alcohol will not prevent all types of congenital disorders, but clients should be educated about a variety of preventative measures in order to prevent interruption of the growth and development of the fetus. An idiopathic illness is one in which the cause is undetermined. A hereditary disorder is genetic and not altered by substance intake during pregnancy. Chapter 3: Health, Wellness, and Health Disparities, Nursing Care to Promote Health and Prevent Illness, p. 62.
Which activities would the nurse consider to be lifestyle risk factors for the development of health problems? Select all that apply. -Participating in extreme sports -Maintaining a stressful job -Living in an area with high smog levels -Avoiding exercise -Family history of hypertension
-Avoiding exercise -Maintaining a stressful job -Participating in extreme sports A family history of an illness is a genetic risk factor. Pollution is an environmental consideration. Chapter 3: Health, Wellness, and Health Disparities - Page 48
Which definition of health is the best?
A classic definition of health is that health is a state of complete physical, mental, and social well-being, not merely the absence of disease or physical symptoms. Health encompasses a state of mind and not just how a client feels. Chapter 3: Health, Wellness, and Health Disparities - Page 48
The nurse is using Leavell and Clark's Agent-Host-Environment Health Model to help plan nursing interventions for clients in a hospital setting. Which examples of nursing actions to prevent hospital-acquired infections (HAIs) best illustrate the principles of this model? Select all that apply. -The nurse should examine environmental stressors in clients' lives to see how these stressors might affect their recovery and ability to ward off infection. -The nurse should assess client's ability to fight off infection by using a graduated scale with high-level wellness on one end and death on the other. -The nurse should assess what the clients believe to be true about themselves and their illnesses when developing a nursing plan to prevent HAIs. -The nurse should consider client's past behavior when determining goals for recovery. -The nurse should consider the client's family history and age when assessing risk factors for infection. -The nurse should assess the clients for risk factors for infection when planning nursing care.
-The nurse should examine environmental stressors in clients' lives to see how these stressors might affect their recovery and ability to ward off infection. The nurse should consider the client's family history and age when assessing risk factors for infection. -The nurse should assess the clients for risk factors for infection when planning nursing care. The Agent-Host-Environment model of health and illness, developed by Leavell and Clark (1965), views the interaction between an external agent, a susceptible host, and the environment as causes of disease in a person. It is a traditional model that explains how certain factors place some people at risk for an infectious disease. These factors are constantly interacting, and a combination of factors may increase the risk of illness. The nurse assessing the clients for risk factors for infection when planning nursing care helps to illustrate this model. The nurse assessing the client's family history and age when assessing risk factors for infection helps to illustrate this model. The nurse assessing environmental stressors in clients' lives is another example to illustrate this model. The other options are not examples illustrating the Agent-Host-Environment health model. Chapter 3: Health, Wellness, and Health Disparities - Page 61
Which scenario accurately depicts the influence of one's religious beliefs? -A client who practice the Jehovah's Witnesses faith will not eat shellfish. -A client who practices Islam requests a baptism for live birth. -A client who practices Orthodox Judaism will not eat pork. -A client who practices Conservative Catholicism opposes a blood transfusion.
A client who practices Orthodox Judaism will not eat pork. Examples of such influences include Roman Catholics' requirement of baptism for both live births and stillborn babies; Kosher dietary laws prohibiting the intake of pork and shellfish (practiced by orthodox and conservative Jews), and the opposition to blood transfusions common among Jehovah's Witnesses. Islam do not have a baptism ritual for newborns. Blood transfusion is acceptable in the belief system of the Catholic church. Consumption of shellfish is acceptable in the belief system of those who identify as Jehovah's Witnesses. Chapter 3: Health, Wellness, and Health Disparities - Page 55
What is the definition of wellness? Being without disease Maximizing the state in which you live A desire to be without disease An active state of being healthy
An active state of being healthy -Wellness, a reflection of health, is an active state of being healthy by living a lifestyle that promotes good physical, mental, and emotional health. It is not simply an absence of disease or a desire to be without disease, nor is it maximizing the state in which one lives. Chapter 3: Health, Wellness, and Health Disparities - Page 48
A client comes to the health center for a routine visit. During the visit, the client tells the nurse, "I'm motivated to do things now to make sure I'm the healthiest I can be." When planning this client's care, the nurse should focus on which area? -Self-concept -Illness prevention -Diagnosis of disease -Health promotion
Health promotion -Health promotion is the behavior of a person who is motivated by a personal desire to increase well-being and health potential. In contrast, illness/disease prevention, also called health protection, is behavior motivated by a desire to avoid or detect disease or to maintain functioning within the constraints of an illness or disability. Self-concept incorporates both how people feel about themselves (self-esteem) and the way they perceive their physical self (body image). Diagnosis of disease involves a medical aspect such that a disease is traditionally diagnosed—and treatment is prescribed—by a physician or advanced practice nurse, whereas nurses focus on the person with an illness. Chapter 3: Health, Wellness, and Health Disparities - Page 56
A community health nurse arranges for a dental checkup camp for the local children in the school district. Which of the following would most likely be the nurse's goal for this health camp? -High-level wellness -Illness prevention -Reversal of self-care deficit -Health promotion
Health promotion -The education on lifestyle choices is part of health promotion activity, which focuses on protecting the person's health. The goal of the prevention of illness is to detect and prevent the illness. High-level wellness focuses on maximizing the person's highest potential for functioning. Reversal of self-care deficits would involve therapeutic interventions that are directed at contributing factors.
Which lifestyle factor is associated with an increased risk for chronic diseases?
smoking Lifestyle factors, such as smoking, chronic stress, and sedentary lifestyle, increase the risk of chronic health problems, such as respiratory disease, hypertension, cardiovascular disease, and obesity. Exercise, eustress, and gastrointestinal disease have not been shown to be factors that have contributed to the increase in chronic conditions. Chapter 3: Health, Wellness, and Health Disparities - Page 51
Risk factors for illness are divided into six categories. Working with carcinogenic chemicals is an example of which type of risk factor? Environmental risk factor Lifestyle risk factor Physiologic risk factor Health habits risk factor
Environmental risk factor -Working and living environments may contribute to disease. Working with cancer-causing chemicals is an example of an environmental risk factor for illness. Physiologic risk factors are those relating to an individual's body or biology. Lifestyle risk factors are habits or behaviors people choose to engage in. A health habit risk factor is any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or injury. Chapter 3: Health, Wellness, and Health Disparities - Page 55
When caring for a client who has just been diagnosed with a chronic illness, the nurse understands the importance of promoting health by highlighting which concept? Focus on why the client has the illness. Focus on the altered functioning. Focus on what can no longer be. Focus on what is possible.
Focus on what is possible. Chapter 3: Health, Wellness, and Health Disparities - Page 56
A nurse is caring for a client with chronic obstructive pulmonary disease (COPD). The nurse explains to the client that COPD is a chronic disease. Why is COPD considered a chronic disease? -It persists for a long time. -It has a gradual onset and lasts for a long time. -It takes a long time to cure. -It is a sequela of acute illness.
It has a gradual onset and lasts for a long time. -Chronic illness has a gradual onset and lasts for a long time. It is usually seen in old age. It may or may not be due to acute illness. Chronic diseases are a major cause of morbidity in the population.
Which needs are being met when a nurse recommends a senior citizen community center for an older client who is living alone? Emotional needs Spiritual needs Sociocultural needs Intellectual needs
Sociocultural needs -Sociocultural: persons environmental level, lifestyle, family, and culture -emotional needs: how the mind affects the body functions and responds to body conditions. long term stress affects the body systems and anxiety affects the health habits conversely calm acceptance and relaxation can change the bodys responses to illness. -the intellectual dimension encompasses cognitive abilities, educational background, and past experiences. -Spiritual beliefs and values are assessed when addressing spiritual needs Health, Wellness, and Health Disparities - Page 55
A client enjoys eating high-calorie carbohydrate meals, but understands her blood sugar can increase sharply, ultimately causing the feeling of butterflies in her stomach as her blood sugar decreases. This is considered: health promotion. a holistic approach. illness prevention. self-concept.
self-concept. A person's self-concept is influenced by having knowledge and the ability to care for oneself, recognizing one's strengths and limitations.
The nurse manager of the acute care unit has decided to implement a team nursing approach for client care. One of the staff members asks, "Will we each take care of our own clients?" What is the appropriate response by the manager? "The care will be divided and the registered nurse (RN) will have a licensed practical/vocational nurse (LPN/LVN) and unlicensed assistive personnel (UAP) to provide care together." "I will plan the care based on the client's diagnosis or type of case." "One person will provide skilled care, one will give medications, and one will help with hygienic needs." "Each registered nurse (RN) will be assigned a client and be responsible for planning and evaluating care."
"The care will be divided and the registered nurse (RN) will have a licensed practical/vocational nurse (LPN/LVN) and unlicensed assistive personnel (UAP) to provide care together." The team nursing approach is organized and directed by a team leader who assigns and supervises the care of the team and may also contribute to the care. Functional nursing is when each nurse is assigned specific tasks to perform, such as medication administration or wound care. This is more of a task-oriented role. A case-based approach is used when the nurse manager assigns tasks based on the client's diagnosis
Which are characteristics of chronic conditions? (Select all that apply.) -Resolve spontaneously -Have a prolonged course -Are rarely curable -Have a rapid onset -Require lifelong management
Have a prolonged course Are rarely curable Require lifelong management Chronic conditions typically have a slower onset and prolonged course, do not resolve spontaneously, are rarely curable, and require lifelong management. Acute conditions typically have a rapid onset and short course and resolve spontaneously or are curable.
What is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity? Host Holism Wellness Health
Health The World Health Organization defines health as "a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity." Wellness is a dynamic and conscious process of making choices to achieve one's highest level of potential. Holism is care that addresses all dimensions of a person, including mind, body, and spirit. Host is the person who experiences an infection. Chapter 3: Health, Wellness, and Health Disparities - Page 48
A nurse is caring for a client who has COPD, a chronic illness of the lungs. The client is in remission. Which statement best describes a period of remission in a client with a chronic illness? New symptoms occur at this time. The symptoms of the illness reappear. Symptoms are not experienced. The disease is no longer present
Symptoms are not experienced. Chronic illnesses usually have a slow onset and many have periods of remission (the disease is present but the client does not experience symptoms). Exacerbation is when the symptoms of the disease reappear. Chronic illnesses do not go away; the disease continues to be present. Chapter 3: Health, Wellness, and Health Disparities - Page 51