VNSG 1304: Chapter 4 Prep U Questions

A client tells the nurse that her doctor just told her 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 definition of chronic conditions can be complex. Which factors would a nurse expect to be included in the definition of chronic conditions?

- Diseases that have a prolonged course - Diseases that do not resolve spontaneously - Diseases where complete cures are rare

Which clients, at risk for health disparities, may require additional assistance from the nurse in order to access healthcare services?

- Older adult clients in a senior citizen complex - Clients who have been unemployed for several months - Migrant Farm Workers

The nurse is performing a routine assessment of a male client who has an artificial arm as a result of a small plane crash many years earlier. How should the nurse BEST understand this client's health?

Despite the loss of his limb, the client may consider himself to be healthy.

The client has been seeing the nurse for a month for a health issue. The client reports decreasing dietary sodium intake and has noticed decreased swelling in the legs. What stage in the Stages of Change Model is the client experiencing?

Determination: Commitment to action stage Explanation: The client is implementing the plan and is beginning to achieve success. This stage is Action: Implementing the Plan. In the Contemplation stage, the client considers the need the change the problematic behavior. In the Determination: Commitment to Action stage the client has made the decision to change behavior and prepares for the change, as in decreasing sodium intake and removing salty foods from the home. In the Maintenance, Relapse, and Recycling stage the client focuses on sustaining the new behavior.

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 Explanation: Severely disabled older adults are at particular risk because they often cannot perform their own personal hygiene. Immobility, incontinence, and dysphagia also greatly increase infection risk, and if invasive devices are needed for these dysfunctions, the infection risk is even higher.

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

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

Which best describes the main role of tertiary health service?

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

A client has been admitted to the hospital for the treatment of diabetic ketoacidosis, a problem that was accompanied by a random blood glucose reading of 575 mg/dLm (31.91 mmol/L), vomiting, and shortness of breath. This client has experienced which phenomena?

Exacerbation

The client is in the terminal stage of leukemia. The client is discharged from the hospital and a LPN is assigned nursing care of the client at home. This is an example of:

Extended Care

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

Fever of unknown 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 Explanation: Functional nursing is a pattern in which each nurse on a client unit is assigned specific tasks. The nurse-in-charge delegates the major responsibilities to the staff and continuously does the assessment and evaluation of nursing care provided by the staff members. The team nursing pattern has many nursing staff providing care in a group. Primary nursing is different from all the others, with the admitting nurse being responsible for the nursing care of an individual client.

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

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

Health

A nurse educator uses models of health and illness when teaching. Which model of health and illness places high-level health and death on opposite ends of a graduated scale?

Health-Illness Continuum

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

Help them maintain independence.

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

Homeostasis

Which statement most accurately defines illness?

Illness is the response of a person to a disease. Explanation: Illness is the response of a person to a disease. Despite having an illness, one may be able to continue with normal activities of daily living. Illness is not a pathologic change in the body. A person may be abile to maximize one's potential and quality of life despite having an illness.

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 Explanation: Two broad goals of the Healthy People initiative are to (1) increase quality and years of healthy life and (2) eliminate health disparities. Healthy People initiatives will help with treatable problems but will not prevent problems. The initiative does not apply a systematic approach to health improvement or increase technological innovations.

What is a factor upon which the financial stability of health maintenance organizations (HMO's)is based?

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

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 to another and from one agency to another.

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

Ordering a mammography

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 Explanation: Such patients are placed in private rooms. Everyone practices strict and meticulous handwashing, including the patient and his or her family. Visitors are restricted. No fresh fruits or vegetables are allowed, only canned and cooked foods. Flowers, either in water or soil, are not permitted because soil harbors fungus and standing water supports the growth of microorganisms.

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

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

Physiologic needs

Managed care organizations (MCO's) are insurers who carefully plan and closely supervise the distribution of health care services. What factor is one of the goals of managed care?

Preventing illness through the screening and promotion of health activities

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 Explanation: Integrated delivery systems provide wellness programs, preventive care, ambulatory care, outpatient diagnostic and laboratory services, emergency care, secondary and tertiary services, rehabilitation, long-term care, assisted living facilities, psychiatric care, home health care services, hospice care, and outpatient pharmacies.

A client reports that she is 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?

Safety and Security

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

Secondary

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

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

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 Explanation: Hospitals are using unlicensed assistive personnel (UAP) to perform some duties practical and registered nurses once provided. Many are concerned that the use of UAP will jeopardize the quality of care. Increasing numbers of clients in hospitals, not devoting enough time to the client, or the rise of medical costs may not jeopardize the quality of care.

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

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

Wellness

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

Wellness is an active state, whereas health is a more passive state dependent on the absence of disease. Explanation: Good health is a passive state wherein the person is not ill. Wellness is a more active state, regardless of one's level of health. Wellness is not contingent on the resolution of disease or illness and it supersedes age. Both health and wellness can be influenced by nursing practice.

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

high-level wellness

The Employee Health Nurse has been providing counseling to the client for the past year. The client has exhibited all of the stages in the Stages of Change Model. Place in order the stages the client established during the past year.

- The client tells the nurse that he does not know why he was referred to the nurse and does not have a drinking problem. - The client informs the nurse that he has thought about obtaining literature on alcohol abuse. - The client took written and verbal information from the nurse about alcohol cessation. - The client attends AA meetings and discards alcohol from the home. - The client maintains sobriety and provides support for another member of AA. Explanation: The first stage in the Stages of Change Model is the Precontemplation stage. In this stage, the client is not even thinking about changing the behavior. In the Contemplation stage, the client considers the need to change. The client has thought about obtaining information on alcohol use. The third stage is the Determination: Commitment to action; the client has made the decision to change and prepares for the change. That is, the client took written and verbal information about alcohol cessation. The fourth stage is the Action: Implementing the plan stage. Here the client implements the plan and begins to achieve success. The client is attending Alcoholics Anonymous meetings and discards alcohol from the home. The last stage is Maintenance, relapse, and recycling stage. The client focuses on sustaining the new behavior. This is the client maintaining sobriety and providing support for another member.

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

Administering pain medication

When admitting an adolescent to the hospital, the nurse anticipates that the client will respond to questions about his health beliefs based primarily on his:

Age and developmental stage

Which nursing intervention is an example of tertiary preventative care?

Assisting with speech therapy with a traumatic brain injury.

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 Explanation: Chronic illnesses have expected symptoms, such as the client with COPD who has damage to the lungs that cannot be reversed. Symptoms of this chronic condition include shortness of breath, wheezing, or a chronic cough. The other clients all have new or recent symptoms that are acute in nature and require immediate care.

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

Consume a low fat diet

A nurse is planning a health fair in the community to highlight promotion and prevention of the leading cause of death in the U.S. Which disease proves 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. Explanation: Cost-driven changes in the health care industry are requiring that hospital unlicensed personnel perform some duties practical nurses once provided. Trends in health care are current issues and progression of health care. Integrated delivery systems provide highly coordinated and cost effective care. Health maintenance refers to protecting one's current level of health by preventing illness or deterioration.