Chapter 3: Health, Wellness, and Health Disparities PrepU

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When admitting an adolescent to the hospital, the nurse anticipates that the client will respond to questions about the client's health beliefs based primarily on the client's: a. age and developmental stage. b. gender and medical history. c. peer influence and education. d. health promotion activities.

a. age and developmental stage. Age and developmental stage are important considerations in the health belief model. Other factors are influential, but age and developmental stage are paramount.

A client has been admitted to the hospital for the treatment of diabetic ketoacidosis, with a random blood glucose reading of 575 mg/dL (31.91 mmol/L), vomiting, and shortness of breath. This client has experienced which phenomenon? a. Exacerbation b. Morbidity c. Infection d. Risk factor

a. Exacerbation This client has experienced a significant exacerbation of a chronic disease (diabetes mellitus), which has manifested as an acute threat to the client's health. Morbidity is an epidemiological statistic of the frequency of a disease. The client's problem does not have an infectious etiology. A risk factor is any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or injury.

Which nursing activity reflects care given on the tertiary level of healthcare delivery? a. Educating the client about safe habits b. Recommending regular exams c. Assisting with transplant surgery d. Teaching the client about exercise programs

c. Assisting with transplant surgery Tertiary care is health services provided at hospitals or medical centers that have complex technology and specialists. Educating the client about safe habits, recommending regular exams, and teaching the client about exercise programs are examples of primary care.

An older adult client who has been hospitalized due to a stroke is about to be discharged from a rehabilitation center where the client had to relearn how to perform activities of daily living, including feeding and dressing. The client has often voiced a desire to be as active as possible. The client now expresses a strong desire to go home. The nurse recognizes that these statements made by the client indicate that the client is: a. maintaining dependence. b. needing further recovery. c. giving up the dependent role. d. hopeless due to disease process.

c. giving up the dependent role. By stating that the client wants to be as active as possible, as well as healthy, the client is reflecting a desire to give up a dependent role and become more independent. Therefore, when at home, the client wants to resume normal activities and responsibilities. The client seems hopeful and not hopeless.

What is a misconception about chronic disease? a. Almost half of chronic deaths occur prematurely in people under 70 years of age. b. Chronic illness typically does not result in sudden death. c. The major cause of chronic disease is known. d. Chronic illnesses cannot be prevented.

d. Chronic illnesses cannot be prevented. A misconception regarding chronic disease is that chronic illnesses cannot be prevented. Almost half of chronic deaths occur prematurely in people under 70 years of age. Chronic illness typically does not result in sudden death. The major cause of chronic disease is known.

Which is the goal of tertiary prevention of illness? a. Preventing disease or illness b. Providing prompt treatment c. Improving general well-being d. Minimizing complications

d. Minimizing complications The goal of tertiary prevention of illness is to minimize complications and maximize function. Prevention of illness or disease, and improvement of the general well-being of a client, is a goal of primary prevention. Providing prompt treatment is a goal of secondary prevention.

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? a. The symptoms of the illness reappear. b. The disease is no longer present. c. New symptoms occur at this time. d. Symptoms are not experienced.

d. 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.

The recognition of health as an ongoing process toward a person's highest potential of functioning is defined as: a. illness. b. agent-host-environment. c. health belief model. d. high-level wellness.

d. high-level wellness. High-level wellness is defined as recognizing health as an ongoing process toward a person's highest potential of functioning. The Health Belief Model focuses on how the client's beliefs about health influence the client's health and response to health and health care. Illness is a person's response to disease. the Agent-Host-Environment model explores the factors that contribute to infection in a client.

A nurse is providing care for client who experienced a stroke. Which nursing intervention reflects the tertiary level of prevention? a. provide care transition at discharge for speech therapy b. assess blood pressure every 4 hours c. conduct mental status assessment every 2 hours d. discuss family history of hypertension

a. provide care transition at discharge for speech therapy Tertiary prevention minimizes the consequences of a disorder through aggressive rehabilitation or appropriate management of the disease. An example is speech therapy to help restore ability. Blood pressure and mental status exams are examples of secondary prevention associated with the acute stroke. Discussing family history is also secondary prevention in terms of assessing for further risk factors.

The nurse is caring for a client who has recovered from injuries incurred from a motor vehicle accident where two other family members did not survive. The client informs the nurse that he or she will grieve without demonstrating ineffective coping mechanisms. Which type of health behaviors does the nurse identify the client is exhibiting? a. physical health b. emotional health c. spiritual health d. social health

b. emotional health The client is exhibiting the holistic concept of emotional health since the client is demonstrating an ability to cope with a stressor effectively. Physical health is an optimal state of physical functioning when body organs function normally. Social health is an outcome of feeling accepted and useful. Spiritual health is the feeling that one's life has a purpose and function.

When chronic illnesses and disabilities are present, individuals benefit most from activities that: a. help them eat well. b. help them maintain independence. c. preserve their social interactions. d. accomplish financial stability.

b. help them maintain independence. Although their chronic illnesses and disabilities cannot be eliminated, adults can benefit most from activities that help them maintain independence and achieve an optimal level of health. The other answers, while beneficial, are not as helpful.

The nurse instructor has completed a session detailing major factors differentiating exacerbations from remissions. The instructor determines the session is successful when the students point out which factor(s) can contribute to exacerbations? Select all that apply. a. immune system is functioning poorly b. sleep has been disrupted due to family issues c. client is facing a potential eviction d. dietary log shows improvement on food choices e. skin turgor indicates good hydration status

a. immune system is functioning poorly b. sleep has been disrupted due to family issues c. client is facing a potential eviction Exacerbations of illnesses are often related to how poorly the immune system is functioning, the stressors the client is facing and overall health status (e.g., nutrition, sleep, hydration). Remission is the opposite and usually indicates how well the immune system is acting, how well the client is handling stressors, and his or her overall health status. Improving food choices and good hydration status are indications the individual is recovering and showing improvement in his or her health status.

Which nursing activity provides an example of primary prevention? a. Suggesting alternative housing options for a family after a case of lead poisoning b. Teaching a family how to recognize and avoid environments containing lead paint c. Assessing the home environment for evidence of lead paint d. Screening school-aged children for exposure to lead

b. Teaching a family how to recognize and avoid environments containing lead paint Primary prevention focuses on health promotion and preventing disease, such as teaching a family how to recognize lead paint so that they can avoid exposure to it. Secondary prevention focuses on screening or early detection of disease, such as assessing a home for evidence of lead paint, to which a family has already been exposed, or screening school-aged children for exposure to lead. Tertiary prevention occurs after diagnosis and treatment and focuses on restoring the client to health and preventing further disease progression or complications, such as suggesting alternative housing options for a family after a case of lead poisoning.

How can the nurse best demonstrate being a role model for health promotion? a. Educate others about healthy lifestyles b. Avoid smoking and drinking alcohol c. Prevent exposure to communicable diseases d. Take prescribed medications accordingly

b. Avoid smoking and drinking alcohol Nurses can best role model health promotion strategies by engaging in behaviors and activities that demonstrate a healthy lifestyle. The other options do not meet the definition for role modeling.

What are common sources of stress in family members due to a hospitalization of a family member? Select all that apply. a. Alterations in roles b. Economic problems c. Alterations in lifestyle d. Decrease in social interactions e. Increase in exercise

a. Alterations in roles b. Economic problems c. Alterations in lifestyle d. Decrease in social interactions A chronic illness hospitalization can create stress for both the client and family because of alterations in role or lifestyle, frequent hospitalizations, economic problems, and decreased social interactions among family members. An increase in exercise would be more likely to relieve stress rather than increase it.

Which nursing intervention is an example of tertiary preventive care? a. Assisting with speech therapy a client with a traumatic brain injury b. Administration of immunizations to a 6-month-old child c. Blood pressure screenings at a senior center d. Teaching stress reduction classes at a wellness center

a. 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.

An older adult patient has been recently diagnosed with vascular dementia. Because the client lives alone and has poorly controlled hypertension, the client has begun to receive home healthcare. This new aspect of the client's care is characteristic of which stage of illness? a. Assuming a dependent role b. Assuming the sick role c. Experiencing the symptoms d. Achieving recovery and rehabilitation

a. Assuming a dependent role The stage of assuming a dependent role often requires assistance in carrying out activities of daily living. As well, the patient often requires care, which may be provided in the home. Experiencing symptoms and assuming a sick role may precede (or accompany) this process. Recovery and rehabilitation are not evident in the patient's present circumstances.

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? a. Coronary artery disease b. Lung cancer c. Emphysema d. Cerebrovascular accidents

a. 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.

Which client growth needs are included in the love and belonging level of Maslow's hierarchy? (Select all that apply.) a. Family b. Self-respect c. Intimacy d. Status e. Friendships

a. Family c. Intimacy e. Friendships Love and belonging includes the need for affection, belonging, and meaningful relations with others (family, intimacy, friendships). Self-esteem includes self-respect and status.

What is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity? a. Health b. Wellness c. Holism d. Host

a. 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.

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? a. Health promotion b. Illness prevention c. Self-concept d. Diagnosis of disease

a. 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.

Which behaviors are necessary for a person to successfully adapt to a chronic illness? Select all that apply. a. Learn to live as normally as possible b. Accept dependence and adjust to it c. Maintain a positive self-concept d. Maintain a sense of hope e. Give up control of one's life

a. Learn to live as normally as possible c. Maintain a positive self-concept d. Maintain a sense of hope To successfully adapt to a chronic illness, the person must learn to live as normally as possible and maintain a positive self-concept and sense of hope, despite symptoms and treatments. It is important that the person maintain a feeling of being in control of his or her life, as well as in control of the prescribed treatments. The client needs to maintain independence and not dependence on chronic illness outcomes.

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? a. Primary b. Secondary c. Tertiary d. Medical

a. 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.

The nurse provided teaching to a client newly diagnosed with gout. Which behavior observed by the nurse indicates the client understood the teaching? a. Selects foods low in purine from the dinner menu b. Performs range-of-motion exercises on painful joints c. Applies heat to painful, swollen joints d. Orders seafood and red meat from the lunch menu

a. Selects foods low in purine from the dinner menu Gout is arthritic-type pain exacerbated by purine in the diet. As such, selecting foods low in purine while filling out the dinner menu indicates the client understood the teaching. Performing range-of-motion exercises on painful, swelling joints should not be done, as this exacerbates the symptoms. Ice, not heat, should be applied to painful joints. Seafood is high in purine and red meat is high in fat; both should be avoided with gout.

What are some examples of healthy self-care behaviors everyone should adopt? Select all that apply. a. Sleeping 7 to 8 hours each night b. Eating regular healthy meals c. Maintaining an ideal body weight d. Exercising infrequently e. Having a low self-esteem

a. Sleeping 7 to 8 hours each night b. Eating regular healthy meals c. Maintaining an ideal body weight Some self-care behaviors that everyone should adopt to promote health are: sleeping 7 to 8 hours regularly, eating regular and healthy meals, maintaining an ideal body weight, having a regular schedule of exercise, using alcohol in moderation if at all, not smoking, and maintaining a positive self-concept.

A teenaged client reports having diarrhea before every test in school. The nurse recognizes that this client needs to focus on which dimension of health? a. Physical dimension b. Emotional dimension c. Intellectual dimension d. Sociocultural dimension

b. Emotional dimension

A client has been admitted to the hospital for treatment of pancreatitis secondary to alcoholism. The client states that it is nearly impossible to quit drinking because of the deep entrenchment of alcohol use in the client's circle of friends and line of work. As well, the client claims to have thought that drinking only beer and foregoing hard alcohol would prevent health problems. This client is exhibiting health consequences rooted in which human dimensions? a. Sociocultural and intellectual b. Environmental and spiritual c. Emotional and environmental d. Physical and emotional

a. Sociocultural and intellectual That the patient is situated in a context that normalizes heavy alcohol use is an example of the sociocultural dimension. The client's ignorance of the health consequences of drinking beer rather than spirits is a component of the intellectual dimension.

Which model is most useful in examining the cause of disease in an individual, based upon external factors? a. The Agent-Host-Environment Model b. The Health-Illness Continuum c. The High-Level Wellness Model d. The Health Belief Model

a. The Agent-Host-Environment Model The Agent-Host-Environment Model is useful for examining the cause of disease in an individual. The agent, host, and environment interact in ways that create risk factors. The Health-Illness Continuum is a way to measure a person's level of health. The High-Level Wellness Model is characterized by functioning to one's maximum potential while maintaining balance and purposeful direction in the environment. The Health Belief Model is used to describe health behaviors.

A nurse observes that a client who has pneumonia is in the recovery and rehabilitation stage of the illness. Which statement describes the client response that the nurse would expect at this stage of the illness? a. The client gives up the dependent role. b. The client assumes a dependent role. c. The client seeks medical attention. d. The client recognizes symptoms of illness.

a. The client gives up the dependent role. In the recovery and rehabilitation stage, known as Stage 4, the person gives up the dependent role and resumes normal activities and responsibilities. The client would not seek medical attention, assume a dependent role, or recognize symptoms of illness in this stage. Stage 1 is when the client would recognize symptoms of the illness. Stage 2 is when the client would seek medical attention. Stage 3 is when the client would assume a dependent role.

What is the definition of wellness? a. Being without disease b. An active state of being healthy c. A desire to be without disease d. Maximizing the state in which you live

b. 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.

A nurse who is working in a long-term care facility is talking with a group of health care workers. One of the health care workers asks about current trends in health care. Which trend should the nurse mention? a. An increase in average income b. An increase in the incidence of chronic illnesses c. An increase in people dying at an early age d. An increase in people identified as upper class

b. An increase in the incidence of chronic illnesses There is a current trend of an increase in the incidence of chronic illness primarily due to a growing number of older adults living today. People are living longer, not dying at an earlier age. Income and upper-class status are socioeconomic factors that are related to health care.

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? a. Focus on what can no longer be. b. Focus on what is possible. c. Focus on why the client has the illness. d. Focus on the altered functioning.

b. Focus on what is possible. When a client has a chronic illness, the nurse needs to make every effort to promote health with a focus of care that emphasizes what is possible rather than what can no longer be. The focus should not be on the altered functioning or what can no longer be as this does not assist the client to move to promoting health in the current state. The basis for the change or why the client has an illness is not easy to determine.

The nurse is working in an acute care setting and performs primary, secondary, and tertiary prevention. Which activity performed by the nurse is classified as tertiary prevention? a. Promoting safety in the home b. Instructing a client on how to use crutches c. Counseling a client about a low-sodium diet d. Assessing a client's blood glucose level

b. Instructing a client on how to use crutches Tertiary prevention is used after an injury or sickness to help rehabilitate the client or to decrease potential risk and further damage, such as instructing the client on how to use crutches. Promoting safety in the home and counseling a client about a low-sodium diet are examples of primary prevention (preventing a disease from occurring in the first place). Assessing blood glucose level is an example of secondary prevention (screening to detect a disease early).

What level of prevention is represented by educating a group of clients on carseat safety? a. Educational prevention b. Primary prevention c. Secondary prevention d. Tertiary prevention

b. Primary prevention Primary prevention focuses on the health of a person with the goal of preventing disease or illness. Carseat safety education is primary prevention. Secondary prevention refers to screening and early detection of disease. Tertiary prevention refers to rehabilitation and prevention of complications after diagnosis with a disease. Educational is not a level of prevention.

The nurse is certified in providing Therapeutic Touch and is preparing to initiate this for a client. What activity should the nurse perform first? a. Calling to rebalance the soul b. Requesting the client's permission to touch the body c. Embracing the client for energy d. Moving the hands 2 to 6 in (5 to 16 cm) away from the client's skin surface

b. Requesting the client's permission to touch the body Prior to touching the client, the nurse should request permission and explain the process of therapeutic touch. All other interventions would be performed after this occurs.

Consultation and diagnostic tests are included in which level of health care? a. Primary care b. Secondary care c. Tertiary care d. Extended care

b. Secondary care Consultation and diagnostic tests are included in the secondary level of health care. The first contact with a general physician is the primary care, and the referral to a highly specialized facility for desensitization is the tertiary care level. The secondary and tertiary care facilities are equipped to provide highly specialized care. Extended care is care provided to clients who no longer require acute hospital care.

A mammogram represents which level of prevention? a. Primary prevention b. Secondary prevention c. Tertiary prevention d. Medical prevention

b. Secondary prevention Secondary prevention includes screening for those at risk to develop illness, or those who could be diagnosed early in the process, and thus receive prompt treatment. Primary prevention refers to health promotion and illness prevention. Tertiary prevention refers to rehabilitation or prevention of complications after diagnosis with a disease. Medical is not a level of prevention.

Which lifestyle factor is associated with an increased risk for chronic diseases? a. Exercise b. Smoking c. Eustress d. Gastrointestinal disease

b. 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.

A client has a Staphylococcus infection in a decubitus ulcer. In this case, Staphylococcus is the: a. host. b. agent. c. environment. d. disease.

b. agent. The agent is any factor that leads to illness. The client is the host of the infection. The environment is setting in which the infection occurs. The disease is a pathological process that can result from the infection.

A community health nurse arranges for a dentist to teach local children in the school district how to properly brush their teeth. Which goal will the nurse set for this event? a. illness prevention b. health promotion c. high-level wellness d. reversal of self-care deficit

b. health promotion The education on lifestyle choices is part of health promotion activity, which focuses on protecting the person's health. Brushing one's teeth is a lifestyle choice. 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.

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? a. "If I drink alcohol while pregnant, my child will have a hereditary disorder." b. "Abstaining from alcohol will prevent any type of congenital disorder." c. "I should abstain from alcohol to prevent the development of a fetal alcohol spectrum disorder." d. "Alcohol use while pregnant will predispose my child to idiopathic illness."

c. "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.

A client who has recently been diagnosed with a chronic illness appears to be depressed. When the nurse asks if there is something wrong, the client states, "Nothing will ever be the same for me since I have this disease." What is the most appropriate response for the nurse? a. "You will never be able to care for yourself, but you can learn to live with that." b. "You will never be able to live the normal life you did before." c. "If you maintain a positive self-concept, you can live as normally as possible." d. "You do not have to worry, as other people will care for you."

c. "If you maintain a positive self-concept, you can live as normally as possible." To successfully adapt to a chronic illness a person must learn to live as normally as possible and maintain a positive self-concept and sense of hope. Telling the person that he or she will never be able to do what was done before (such as caring for themselves or living normally) is not appropriate or therapeutic. Telling the client that other people can take care of them is also nontherapeutic.

Why are health promotion and illness prevention a key responsibility of nurses? a. Chronic illnesses can cause pain and suffering. b. Treatment of chronic illnesses is very expensive. c. Chronic illnesses are the leading health problem in the world. d. People do not like to be sick and feel bad.

c. 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.

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? a. Clinical model b. Holistic health model c. Health belief model d. High-level wellness model

c. 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.

Which is the most accurate definition of health? a. Health is a state of maximal wellness. b. Health is a lack of disease. c. Health is a state of complete physical, mental, and social well-being. d. Health is a reflection of wellness and requires a conscious and deliberate effort to maintain.

c. Health is a state of complete physical, mental, and social well-being. Health is viewed as a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity. The other options would not be the best definition of health.

Which definition of health is the best? a. Health is the absence of disease. b. Health is how people feel. c. Health is a state of complete well-being. d. Health is the lack of physical symptoms.

c. Health is a state of complete well-being. 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.

A client who recently underwent a coronary artery bypass graft is taking furosemide and metoprolol following the procedure. While developing a plan for a heart-healthy diet with the nurse, the client states that diet did not contribute to the heart disease and that the client should be fine just continuing to take the medications. According to the Stages of Change Model, which stage of change is the client in related to diet? a. Contemplation b. Preparation c. Precontemplation d. Maintenance

c. Precontemplation The precontemplation stage is the first stage change, in which the client does not indicate any intention to make a change within the next 6 months. During the precontemplation stage, the client is not even thinking about or considering making a change. During the contemplation stage, the client is considering making a change. During the preparation stage, the client has decided to make a change and is preparing for it. During the maintenance stage, the client attempts to maintain the change in lifestyle begun in an earlier stage.

The client is admitted with a gastrointestinal bleed. The physician ordered a colonoscopy. Which level of care encompasses this procedure? a. Primary b. Quaternary c. Secondary d. Tertiary

c. Secondary Secondary care delivery is when primary caregivers refer clients for consultation and additional testing. Therefore, this scenario portrays secondary level of care. Primary care delivery is provided by the first healthcare provider or agency a person contacts. Quaternary care is an extension of tertiary care and includes experimental medicine and procedures and highly uncommon, specialized surgeries. Tertiary care is health services provided at hospitals or medical centers that have complex technology and specialists.

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? a. Screening for tuberculosis b. Assessing for risk factors for heart disease c. Teaching about adhering to a low-sodium diet d. Screening for breast cancer every 5 years

c. 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.

A nurse refers an HIV-positive client to a local support group. This is an example of what level of preventive care? a. Primary b. Secondary c. Tertiary d. Chronic

c. Tertiary Tertiary health promotion and illness prevention begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate clients to a maximum level of functioning. Referring an HIV-positive client to a local support group would be an example of tertiary preventive care. Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Secondary health promotion and illness prevention focus on screening for early detection of disease, with prompt diagnosis and treatment of any found. The term chronic is not related to health promotion.

What have the models of health promotion and illness prevention been used for? a. To define a medical framework for the care of the disabled. b. To create a forum for improving rehabilitative care. c. To help health care providers understand health-related behaviors. d. To formulate care plans for the disabled population.

c. To help health care providers understand health-related behaviors. Several models of health promotion and illness prevention have been used to help health care providers understand health-related behaviors and adapt care to people from diverse economic and cultural backgrounds. The models include the health belief model, the health promotion model, the health-illness continuum model, and the agent-host-environment model. These models do not define a medical framework in the care of the disabled; these models do not create a forum for improving rehabilitative care; and these models do not formulate care plans for use with the disabled.

The nurse in a free clinic caring for clients uses the Health Belief Model, which is based on three components. What is the main focus for this model? a. How people interact with their environments b. How health is a constantly changing state c. What people believe to be true about their health d. Factors that predispose a person to infectious diseases

c. What people believe to be true about their health The Health Belief Model focuses on what people perceive or believe to be true about themselves in relation to their health. The Health Promotion Model focuses on how people interact with their environments, as they pursue health. The Health-Illness Continuum Model focuses on health as a constantly changing state, whereas The Agent-Host-Environment Model explains how certain factors place a person at risk for an infectious disease.

A community health nurse has noticed a large number of women in the community are not getting regular mammograms. This is a rural community with limited access to health care. Which action would be the most appropriate for the nurse to pursue to promote compliance in getting annual mammograms? a. Teach a class that stresses the importance of self-breast examination and regular mammogram screening. b. Arrange busses on a quarterly basis to take women to an urban area for mammogram screening. c. Mail flyers to women in the community offering instruction on where to go in a nearby city for mammograms. d. Arrange for a mobile mammography unit to come to the community several days a month.

d. Arrange for a mobile mammography unit to come to the community several days a month. The purpose of primary health promotion is to promote health and prevent disease or injury. Bringing a needed service into a community will benefit the greatest number of people in the community. Teaching a class, arranging transportation, or distributing flyers will not benefit the same number of people as actually bringing in the needed service.

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? a. It persists for a long time. b. It is a sequela of acute illness. c. It takes a long time to cure. d. It has a gradual onset and lasts for a long time.

d. 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.

A nurse is performing health promotion activities for clients at a local health care clinic. Which nursing actions exemplify the focus of secondary preventive care? Select all that apply. a. Scheduling immunizations for a child b. Educating parents about child safety in the home c. Performing range-of-motion exercises on a client d. Screening clients for hypertension e. Scheduling a mammogram for a client f. Referring a client to family counseling

d. Screening clients for hypertension e. Scheduling a mammogram for a client f. Referring a client to family counseling Secondary health promotion and illness prevention focus on screening for early detection of disease, with prompt diagnosis and treatment of any symptoms found. The goals of secondary preventive care are to identify an illness, reverse or reduce its severity or provide a cure, and thereby return the person to maximum health as quickly as possible. Scheduling a mammogram, screening for hypertension, and referring a client to family counseling are all examples of secondary preventive care. Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Scheduling immunizations and educating parents about child safety in the home are both examples of primary preventive care. Tertiary health promotion and illness prevention begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate clients to a maximum level of functioning. Performing range-of-motion exercises is an example of tertiary preventive care.

The concept of holism is based on the belief that: a. individuals can be seen in an atomistic fashion. b. health is achieved through medical care. c. health is achieved by treatment from physicians. d. individuals cannot be seen apart from the environment.

d. individuals cannot be seen apart from the environment. Holism is based on the belief that people cannot be fully understood if examined solely in pieces apart from their environment. The opposite of holism is the view that individuals can be treated atomistically or can achieve health through medical care or physicians.


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