Health & Wellness Promotion NCLEX
A nurse is counseling a teenager who smokes one pack of cigarettes a day. The teenager states he likes to smoke with his friends and does not recognize the connection between his smoking and his asthma. When planning an intervention for this person, the nurse must first recognize that the teenager is in the: a. precontemplation stage of change. b. preparation stage of change. c. action stage of change. d. maintenance stage of change.
A ~ A person in the precontemplation stage of change is not thinking about or considering quitting or adopting a behavior change within the next 6 months. Health education must be matched to the stage of change. This teenager does not see a connection between his smoking and his asthma. He likes to smoke and is therefore unlikely to make any changes at this time.
A client is discharged from the hospital to his home after a heart attack. The nurse recognizes the restrictions in the client's diet and activity. In using the Stages of Health Behavior Change as a guide, the nurse recognizes that the client is most likely to begin to accept information on diet and exercise during the: a. Contemplation stage b. Preparation stage c. Action stage d. Maintenance stage
A ~ During the contemplation stage, the client is considering a change within the next 6 months. The client may be ambivalent initially, but will more likely accept information as more belief develops in the value of change.
Client assessment provides the nurse with necessary information for the development of an effective plan of care. When determining the influence of an internal variable on the client's health status, the nurse will specifically look for: a. Anxiety level present b. Family remedies used c. Location and type of occupation d. Available health insurance coverage
A ~ Emotional factors, such as the client's degree of anxiety, are internal variables that can influence the client's health status.
Which of the following illustrates that the objectives of health education and counseling have been met? a. Asthmatic who has a decrease in emergency department visits b. Asthmatic who has been prescribed an albuterol inhaler c. Asthmatic who attends an asthma education program d. Asthmatic who visits the emergency department with an exacerbation
A ~ Health education encourages positive, informed changes in lifestyle behaviors that prevent acute and chronic disease, decrease disability, and enhance wellness. Two main objectives of health education and counseling are to change health behaviors and to improve health status. An asthmatic with a decrease in emergency department visits is an improvement in health status, which is a reflection of behavior changes used to prevent acute exacerbations of a chronic disease.
The client states, "Heart disease runs in our family. My blood pressure has been high." The nurse determines that this is an example of the clients: a. Risk factors b. Active strategy c. Negative health behavior d. Health beliefs
A ~ Risk factors are anything that increases the vulnerability of an individual or group to an illness or accident. This client is identifying the physical risk factor of genetic predisposition to heart disease.
A nurse would like to assist Americans in improving their health. Which strategy would be most beneficial to improve the health of the American public? a. Encourage Americans to stop smoking. b. Lobby for state-of-the-art magnetic resonance imaging machines in all hospitals. c. Provide free medications for Americans. d. Offer free condoms to teenagers.
A ~ The greatest opportunity to improve the health of the American people lies in addressing unhealthy, personal, behavioral risk factors. Intensive lifestyle changes can be effective not only in preventing chronic diseases, but also in reversing their progression and significantly reducing health care costs. Improvement of the publics health is more likely to come from behavior change than technology. Therefore, people deciding they are going to change their behavior and stop smoking are likely to lead to improvements in the health of the public.
Which of the following emphasizes that an individual's belief in being personally capable of performing the behavior is required to influence ones own health? a. Social cognitive theory b. Self-efficacy theory c. Health belief model d. Transtheoretical model
A ~ The model that emphasizes an individuals belief in being personally capable of performing the behavior required to influence ones own health is known as the social cognitive theory.
A nurse is using a health education component when teaching about smoking cessation. Which of the following actions is the nurse implementing? a. Setting a quit date for people in a smoking cessation class b. Providing education regarding the benefits of smoking cessation c. Allowing smokers to participate in a smoking cessation program only if they use the patch nicotine replacement system d. Encouraging attendees of a smoking cessation program to participate in a research study
B ~ Essential components of health education involve using teaching strategies, having learners maintain voluntary control over the decision to make changes in their actions, and focusing on behavior changes that have been found to improve heath. Providing smokers with the information regarding the benefits of smoking cessation allows them to make their own decision and provides them with information that is known to improve health.
Client assessment provides the nurse with necessary information for the development of a plan of care. Risk factors are important to identify to assist the client, if possible, to respond and modify her lifestyle. Which one of the following assessment findings indicates a lifestyle risk factor? a. Obesity b. Sunbathing c. Overcrowded housing d. Industrial-based occupation
B ~ Excessive sunbathing is a lifestyle risk factor for skin cancer.
A teenager, who lives at home with her parents and school-aged brother, has been diagnosed with anorexia nervosa. Which of the following would be the most appropriate teaching goal for this family? a. Increased energy level b. Improved coping c. Enhanced self-esteem d. Facilitated family conversation
B ~ The family plays an important role in health and illness. Understanding and intervening with the family is essential to promoting health and reducing risk. Health teaching includes all family members although the general teaching goal is the same for all, approaches and specific goals for each member will be different. An illness in one member of the family can alter the entire familys ability to cope. As a result, improved coping is the most appropriate goal.
The client is a paraplegic and is in the hospital for an electrolyte imbalance. Based on the levels of prevention, the client is receiving care at the: a. Primary prevention level b. Secondary prevention level c. Tertiary prevention level d. Health promotion level
B ~ The secondary prevention level focuses on early diagnosis and prompt treatment as well as on disability limitations. Adequate treatment for the electrolyte imbalance is sought to prevent further complications.
Which one of the following is one of the main, overreaching goals for Healthy People 2010? a. Reduction of health care costs. b. Elimination of health disparities. c. Investigation of substance abuse. d. Determination of acceptable morbidity rates.
B ~ Two overarching goals for Healthy People 2010 are (1) to increase quality and years of healthy life, and (2) to eliminate health disparities.
An overweight woman is in the preparation stage of change. Which of the following interventions would be the most appropriate for the nurse to implement? a. Inform her of the health risks associated with being overweight. b. Prepare her for the setbacks. c. Develop a low-calorie/low-fat diet with her so she can follow it at home. d. Praise her for her recent successes.
C ~ A person in the preparation stage of change has made a change or is seriously thinking about making a change in the next month. At this stage, people make small or sporadic changes. Health education must be matched to the stage of change. During this stage, it is the educator's role to provide the woman with the tools to move forward with her plan. Working on a diet together will decrease barriers to change by making it easier for the woman to follow a diet. Enlisting her cooperation achieves better results.
Any combination of planned experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire the information and skills needed to make quality health decisions is known as health: a. promotion. b. counseling. c. education. d. knowledge.
C ~ Any combination of planned experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire the information and skills needed to make quality health decisions is known as health education.
A nurse is providing education about safe driving with a group of newly licensed teenagers. Which factor would most likely influence a teenagers decision to drive within the speed limit? a. A speed limit sign b. Having his parents telling him not to speed c. A previous traffic violation for speeding d. Seeing someone get pulled over for speeding
C ~ Effective health education requires an understanding of the influential factors affecting the individuals decision making. These factors include values, beliefs, attitudes, life stresses, religion, previous experiences, and life goals. Having had a previous experience with receiving a speeding ticket may positively influence the teenagers decision to drive within the speed limit because (1) he knows he is vulnerable to being caught and ticketed again, and (2) further tickets may have an effect on his ability to drive at all (e.g., his parents may punish him by not allowing him to drive, his driving privileges with the department of motor vehicles may be affected, or his insurance premium may be affected). Although seeing someone get pulled over may influence a persons decision through modeling and observing others, teenagers believe they are invincible and therefore would probably not be effective in this age group.
Which of the following illustrates that the objectives of health education and counseling are being met? a. Diabetic who attends a diabetes education program b. Diabetic who watches a video about self-administration of insulin c. Diabetic who starts taking his medications regularly d. Diabetic who is admitted in diabetic ketoacidosis
C ~ Health education encourages positive, informed changes in lifestyle behaviors that prevent acute and chronic disease, decrease disability, and enhance wellness. Two main objectives of health education and counseling are to change health behaviors and to improve health status. A diabetic who starts taking his medications regularly is an example of a behavior change intended to decrease disability.
A teenager, who lives at home with her parents and school-aged brother, has been diagnosed with anorexia nervosa. Which of the following would be the most appropriate teaching goal for this teenager? a. Increased energy level b. Improved coping c. Enhanced self-esteem d. Accomplished activities of daily living
C ~ Health teaching includes all family members; although the general teaching goal is the same for all, approaches and specific goals for each member will be different. Teenagers with anorexia nervosa often have decreased self-esteem. As a result, an appropriate goal for this teenager would be enhanced self-esteem.
In the Health Belief Model, the nurse recognizes that the focus is placed on the: a. Basic human needs for survival b. Functioning of the individual in all dimensions c. Relation of perceptions and compliance with therapy d. Multidimensional nature of clients and their interaction with the environment
C ~ In the Health Belief Model, the nurse focuses on the relation between a persons beliefs and health behaviors. By focusing on the client's perceptions of health, the nurse is better able to understand and predict how a client will comply with health care therapies.
A nurse is using the health belief model as a framework when developing a community action campaign to increase the percentage of the population who receives the influenza vaccine. Which of the following considerations will need to be made? a. How empowerment can be used to motivate community members b. How modeling can be used in the community to increase public awareness c. Perceived susceptibility in the community about getting influenza d. Perceived stage of behavior change that exists in the community
C ~ The components of the health belief model that need to be considered are: individual perceptions or readiness for change; the value of health to the individual compared with other aspects of living; perceived susceptibility to a health problem, disease, or complications; perceived seriousness of the disease level threatening the achievement of certain goals or aims; risk factors to a disease attributed to heredity, race or culture, medical history, or other causes; perceived benefits of health action; perceived barriers to promotion action.
The client received a kidney transplant and is now unable to work. She is worried about her husband's stress level because of her illness and the need for him to take over her daily activities in the home. The client is in the process of adapting to a change in: a. Body image b. Illness behavior c. Family dynamics d. Self-concept
C ~ The effects of illness on the client and family have created change in family dynamics. Family dynamics is the process by which the family functions, makes decisions, gives support to individual members, and copes with everyday changes and challenges.
There are different ways to look on health and illness. When formulating a definition of health, a person should consider that health, within its current definition, is: a. The absence of disease b. A function of the physiological state c. A state of well being involving the whole person d. The ability to pursue activities of daily living
C ~ When formulating a definition of health, a person should consider the total person, as well as the environment in which the person lives. Health generally implies a state of well being, which is ultimately defined in terms of the individual.
An overweight woman joins a support group to help her lose weight. During her first session, the nurse explains the components of a healthy diet and discusses with the woman how she can eat out and still maintain a healthy diet. She asks the woman what her goal is and emphasizes that she herself is the key to success. What is the nurse promoting through the use of this strategy? a. Communication b. Values c. Advanced planning d. Empowerment
D ~ A goal of health education is empowerment. People who believe they can make a difference in their own health and who are included in decision making are more likely to make changes. By giving the woman the tools (education about a healthy diet) and involving her in the decision-making (set her own goal), the nurse empowers the woman to make a change in her eating habits.
When assessing the external variables that influence a client's health beliefs and practices, the nurse must consider his: a. Religious practices b. Reaction to the heart disease c. Educational background d. Income status
D ~ External variables influencing a persons health beliefs and practices include family practices, cultural background, and socioeconomic factors, such as income. Economic variable s may affect a client's level of health by increasing the risk for disease and influencing how or at what point the client enters the health care system. A person's compliance with the treatment to maintain or improve health also is affected by economic status.
The nurse incorporates the levels of prevention as a basis for the types of client needs that are evident and the nursing care that is provided. Which of the following activities of the nurse is an example of tertiary level preventive care giving? a. Teaching a client how to irrigate a new colostomy b. Providing a class on hygiene for an elementary school class c. Informing a client that immunizations for her infant are available through the health department d. Arranging for a hospice nurse to visit with the family of a client with cancer
D ~ Tertiary prevention occurs when a defect or disability is permanent and irreversible. Care of the hospice nurse at this level aims to help the client and the client's family achieve as high a level of functioning as possible, despite the limitations caused by the cancer.
A nurse is using a holistic approach with a client. To incorporate all of the factors that may influence the client, the nurse should respond to the client as follows: a. I would like you to perform this exercise once a day. b. Your physician has left orders for you to follow. c. The laboratory tests reveal the need to reduce your daily percentage of fat grams. d. Adapting your diet and activity will lower your blood glucose levels.
D ~ Using a holistic approach involves consideration of all factors that may affect a client's level of well being in all dimensions, not just physical health. Factors such as diet and exercise can influence ones level of health.