Health Promotion Exam 3
Freud's psychosexual theory
oral stage (0-1 years), anal stage (2-3 years), phallic stage (3-6 years), latency stage (6-puberty), genital stage (puberty and beyond)
ages and stages questionnaire incorporates ______
parental observations
a nurse is providing anticipatory guidance about child development to the parents of a preschooler. which of the following developmental tasks should the nurse include as being expected of a preschooler?
participates in imaginary play
androgynous
partly male and partly female in appearance; of intermediate sex
a nurse is providing anticipatory guidance about child development to the parents of a toddler. which of the following developmental tasks should the nurse include as expected of a toddler?
separates easily from primary care giver for short periods of time
sentinel event
unexpected occurrence involving death or serious injury
adverse event
unintended harm by an act of commission or omission rather than as a result of disease process
a nurse is using the communication principle of presence when establishing a collaborative relationship with a client. which of the following actions should the nurse take?
use attentive listening with the client
transvestite
wears clothes designated for opposite sex
a nurse is completing an assessment of a 1 month old newborn. which of the following developmental skills is an expected finding?
follows movements of objects with eyes
school age children need _____ hours of sleep
6-13
risk factors for insomnia
60 years and older, women (especially after menopause), depression, stress
Gordon's psychomotor health patterns
nutritional metabolic, elimination, activity/exercise, sleep/rest, sexuality/reproductive
Gordon's funcional patterns
1. health perception 2. nutrition/metabolism 3. elimination 4. activity/exercise 5. sleep/rest 6. self perception/self concept 7. cognitive 8. role-relationship 9. sexuality/reproduction 10. stress/coping 11. values/beliefs
in order to protect from skin cancer, stay out of the sun from _______ and wear _____
10 am - 4 pm; bright or dark colors
toddlers/preschoolers need ______ hours of sleep
11-14
menopause
12 months after a woman's last period
infants need _____ hours of sleep
12-15
autism spectrum disorder should be diagnosed by age _____
2
a nurse is collecting data from a child who is descending stairs by placing both feet on each step and holding on to the railing. the nurse should understand that these actions are developmentally appropriate at which of the following ages?
3 years
treatment for insomnia
CBT, diet, medications (antihypertensives, cold meds, ADHD meds, antidepressants)
treatment for sleep apnea
CPAP (continuous positive airway pressure)
sleep apnea increases the risk of ____
CVD, depression, MVA, mortality
risk factors for restless leg syndrome
ESRD, DM, anemia, pregnancy, antihistamines
Basic Activities of Daily Living (BADLs)
Functions involved in maintaining personal physical care; bathing, toileting, dressing, feeding.
Hepatitis A spreads through ____
GI tract
a nurse is instructing a young adult client about healthful sleep habits. which of the following statements should the nurse identify as an indication that the client needs further teaching?
I watch television until I fall asleep at night
a nurse is teaching a client who reports insomnia about promoting rest and sleep. which of the following statements should the nurse identify as an indication that the client understands the instructions?
I will no longer have a glass of wine before bedtime
sleep hygiene
The practice of following good sleep habits to sleep soundly and be alert during the day
a charge nurse is anticipating the admission of four clients and planning their room assignments. which of the following clients should the nurse assign to the room closest to the nurse's station?
a client who sustained a head injury and is having periods of confusion
rest
a condition when the body is in a decreased state of activity, with the consequent feeling of being refreshed
sleep
a state of rest accompanied by altered consciousness and relative inactivity; complex rhythmic state involving a progression of repeated cycles which is crucial for physical, mental, and emotional well-being
a nurse is caring for a 10 months old infant who is in a cast for a developmental dysplasia of the hip. which of the following strategies should the nurse implement to promote the infant's growth and development?
allow the infant to stand in the crib
a nurse is teaching a group of newly licensed nurses on effective techniques for counseling clients about STIs. which statements should the nurse include in the teaching?
ask about the client's exposure to any past or present STIs
the 5 A's to intervention
ask, advise, assess, assist, arrange
early language milestone scale
auditory visual, auditory receptive, expressive language
intoxication
behavioral/physical symptoms resulting from substance use
genital herpes
blister like genital lesions, dysuria, fever, headache, muscle aches
affective learning domain
changing attitudes, values, and feelings
in order to promote sleep in the hospitals, healthcare staff should ____
cluster care to prevent waking multiple times, assess without waking if possible
functional ability
cognitive, social, physical, and emotional ability to carry out the normal activities of life
Gordon's cognitive health patterns
health perception/health management, cognitive/perceptual, value/belief
circadian rhythm/sleep-wake disorders
jet lag, shift work
tips on how to quit smoking
set a quit date, build a support system, learn how to relax, plan how to deal with urges, medications, understand challenges
a nurse is caring for an adolescent client who has pelvic inflammatory disease as a consequence of a sexually transmitted infection, and will need intravenous antibiotic therapy. the client tells the nurse, "my parents think I am a virgin. I don't think I can tell them I have this kind of an infection." which of the following responses should the nurse make?
you seem scared to talk to your parents
a nurse is observing a newly licensed nurse as she interacts with a client regarding his concerns about his relationship with his partner. which of the following statements by the newly licensed nurse requires intervention by the nurse?
you should try to see your partner's point of view before your own
methods to prevent poisoning
childproof containers, health education, poison control numbers, poison control number, activated charcoal if ingested, carbon monoxide detectors
latency stage
children spend more time and interact mostly with same sex peers
the leading cause of fire deaths is ____
cigarettes
the leading cause of home fires is ____
cooking
cisgender
sexual identity matches anatomical identify
a community health nurse is conducting an educational program on various environmental pollutants. the nurse should emphasize that clients who have which of the following disorders are especially vulnerable to ozone effects?
asthma
a client is having difficulty sleeping, what should the nurse advise?
avoid alcohol for several hours before bedtime, get up at the same time every day of the week, if unable to sleep get up and do something relaxing, limit naps to 20-30 minutes, stop drinking caffeine during evening hours (before 6pm)
BDSM assessment
bondage, discipline, domination, submission, sadism, masochism; includes biting, whipping, rope bondage, fire, intense pain, multiple partners
Phallic Stage (3-6 years)
boys are more attached to their mother, while girls are more attached to their father
s/sx of fatigue
fatigue, insomnia, snoring/snorts, nocturnal respiratory disturbance
a nurse is teaching a group of teenage clients about the use of condoms for the prevention of STIs. which of the following statements should the nurse include in the teaching?
female condoms can help prevent transmission of sexually transmitted viruses
CDC "heads up" initiative
fitting helmets appropriately, concussion fact sheet for concussions
when putting out a grease fire, use _____
flour/extinguisher, NOT water
safety
freedom from accidental injury; involves the establishment of operational system and processes that minimize the likelihood of errors and maximizes the likelihood of intercepting them when they occur
incident reports do NOT ___
go in the patient's chart
denver developmental screening test II
gross screening tool, not diagnostic
intersex
group of conditions where there is a discrepancy between the external genitals and the internal genitals
HEADSS assessment
home, education, activities, drugs, sex, suicide potential
central disorders of hypersomnolensce
hypersomnia, narcolepsy
restless leg syndrome treatment
massage, walking, stretching, decrease caffeine, tobacco, alcohol, analgesics, heat/cold, relaxation
gonorrhea
may be asymptomatic, dysuria, urinary frequency, vaginal discharge, dyspareunia, endocervicitis, arthritis, PID, rectal infection, painful sex
trichomoniasis
may be asymptomatic, dysuria, urinary frequency, vaginal discharge, dyspareunia, irritation of genital area
chlamydia
may be asymptomatic, vaginal discharge, endocervicitis, inflammations of the return and lining of the eye, can infect throat
a nurse is caring for a toddler who is having difficulty sleeping during hospitalization. which of the following actions should the nurse take to promote sleep?
provide bedtime rituals
adults need ______ hours of sleep
7-9
teenagers need _______ hours of sleep
8-10
it takes ____ minutes to reach REM sleep
90
an older adult client who lives alone tells a clinic nurse that he is unable to drive himself to the store and is afraid to cook on the stove. which of the following community resources should the nurse recommend for this client?
meals on wheels
a nurse is caring for a client who has urinary incontinence. which of the following actions should the nurse implement to prevent the development of skin breakdown?
apply a moisture barrier ointment to the client's skin
a nurse is caring for an 18 month old toddler who has been hospitalized for 10 days. after the toddler's mother leaves the room, the nurse observes the toddler sitting quietly in the corner of the crib, sucking her thumb. when the nurse approaches the crib, the toddler turns away from the nurse. the nurse should understand that these behaviors indicate which of the following developmental reactions?
an anxiety reaction
factors affecting sleep
medications, dietary choices, illness (GERD, pain), stress, etc
just culture
culture where staff are willing to come forward with information about errors so everyone can learn from mistakes; the culture recognizes the need for accountability & at times disciplinary action
incident report
describes the circumstances of the accident or incident, details the patient's response to the examination and treatment of the patient after the incident; must be completed by the nurse immediately after the incident that compromised safety
factors affecting safety
developmental considerations, lifestyle, mobility, sensory perception, knowledge, ability to communicate, physical health state, psychosocial state
a nurse is caring for a client who is experiencing alcohol withdrawal. which of the following findings should the nurse identify as a manifestation of withdrawal?
diaphoresis
warning signs of nurses with substance abuse disorders
discrepancies, increased wasting, increased pain complaints from patients, offering to medicate others' patients, missing from the unit, bathroom frequency, changes in performance
a nurse is caring for a client who has alcohol use disorder. the client is no longer experiencing withdrawal manifestations. which of the following medications should the nurse anticipate administering to assist the client with maintaining abstinence from alcohol?
disulfiram
syphilis
divided into four stages: 1) primary, chancre on place of bacteria entrance, 2) secondary, maculopapular rash, sore throat, lymphadenopathy, flu like symptoms, 3) latent, no symptoms, no longer contagious, 4) tertiary, tumors of the skin, bones, liver, CNS and CV symptoms, usually not reversible
a nurse is caring for a middle adult female client who reports that her menstrual periods have become irregular and she has been having hot flashes. the nurse should expect the client to have which of the following manifestations associated with early menopause?
dryness with intercourse
a nurse is caring for a client in the orientation phase of the nurse-client relationship. which of the following communication techniques should the nurse use during this phase?
elicit information from the client
a nurse is providing teaching to the family of a client who has a substance use disorder. which of the following statements by a family member indicate an understanding of the teaching?
eliminating any codependent behavior will promote her recovery
tertiary prevention of substance abuse
emergency management and prevention of life threatening complications, substance abuse recovery from addictions, prevent relapse
near miss
error of commission or omission that could have harmed a patient, but did not occur as a result of chance
a nurse is teaching a client who is obese and has obstructive sleep apnea how to decrease the number of nightly apneic episodes. which of the following client statements indicates an understanding of the teaching?
if I could lose about 50 pounds, I might stop having so many apneic episodes
a nurse is planning home care for a 9 year old child following an acute exacerbation of asthma. which of the following of Erikson's developmental stages should the nurse consider in the planning?
industry vs. inferiority
Havighurt's developmental theory
infancy and early childhood (0-5 years), middle childhood (6-12 years), adolescence (13-17 years), early adulthood (18-35 years), middle age (36-60 years), late maturity (over 60 years)
a nurse is caring for several clients who are at various developmental stages. the nurse should explain that, according to Erikson, acceptance of death is a primary task of which of the following stages of psychosocial development?
integrity vs. despair
early identification = early ____
intervention
a nurse is instructing clients in the community about relationship development. the nurse should explain that, according to Eriksson, establishing relationships with commitment is a primary task of which of the following stages of psychosocial development?
intimacy vs. isolation
a nurse is caring for a 12 month old toddler who is hospitalized and confined to a room with contact precautions in place. which of the following toys should the nurse recommend in order to meet the developmental needs of the client?
large building blocks
zero tolerance laws
laws that severely restrict the right to operate motor vehicles for underage drinkers who have been convicted of driving under any influence
perimenopause
leading up to menopause; changes in monthly cycles, hot flashes, decrease in estrogen and progesterone, between ages of 45-55, body begins to use energy differently and typically results in weight gain, bone density decreases
a nurse is educating a client who is experiencing sleep disturbances and desires to decrease caffeine intake. which of the following beverages should the nurse recommend?
lemon lime soda
daytime symptoms of insomnia
lethargy, irritability, decreased concentration, delirium
concussion
milder form of a traumatic brain injury (TBI), usually sports related; symptoms are subtle, but may require emergency treatment if there is headache, vomiting, imbalance, fatigue, dazed, confused, mental fog, difficulty concentrating, forgetting recent activity, irritability, nervousness, emotional, drowsiness, insomnia. evaluate ABCs, indication of cervical spine injury
a nurse is teaching a class of older adults about the expected physiologic changes of aging. which of the following changes should the nurse include in the discussion?
more difficulty seeing due to a greater sensitivity to glare, decreased cough reflex, decreased bladder capacity, dehydration of intervertebral discs
Human Papillomavirus (HPV)
most common viral infection in the U.S. leading to genital warts or condylomata. vaccine available, treat lesions and warts
leading causes of unintentional injury/death in 0-19 year olds
motor vehicle crashes, suffocation, drowning, poisoning, fires, falls, overdoses, self harm, interpersonal violence
CAGE questionnaire assesses patients':
need to cut down, annoyed by others about drinking, guilty about drinking, eye opener experience
NREM sleep
non-rapid eye movement sleep; has 4 stages, accounts for 75% of sleep time
there are some _____ avenues for treating/managing ADHD
nutritional
Kohlberg's moral theory
preconventional (0-6 years) obeys to avoid punishment and have rewards, conventional (7-11 years) conforms to avoid disapproval or censure by authorities, post conventional (11+ years) conforms to maintain communities
when taking a sexual history, assess ____
pronouns, partners, protection from infection, past history of infection, prevention of pregnancy
REM sleep
rapid eye movement sleep; accounts for 25% of sleep time and is the deepest sleep, when dreams occur. includes facial muscle twitching, large muscle paralysis, irregular HR/BP/RR, increase in temperature
the 5 R's for motivation to quit substance abuse
relevance, risks, rewards, roadblocks, repetition
a nurse is caring for a client who is having difficulty sleeping and is pacing the floor. the client's head is down, and he is wringing his hands. which of the following actions should the nurse take?
remain with the client
RACE
rescue anyone in immediate danger, activate the fire code and notify
sleep-related movement disorder
restless leg syndrome
unintentional death rates tend to be higher in ______ areas due to ______
rural; less access to healthcare/help
Hepatitis B spreads through ____
saliva, blood, semen, menstrual blood, vaginal secretions
secondary prevention of substance abuse
screening all adults over age 18 for alcohol misuse, questionnaires (NIAA, CAGE questions)
Gordon's affective health patterns
self perception/self concept, role/relationship, coping/stress
piaget's cognitive theory
sensorimotor (0-2 years), preoperational (2-7 years), concrete operational (7-11 years), formal operational (11+ years)
sleep-related breathing disorders
sleep apnea, obesity hypoventilation syndrome
sleep apnea is diagnosed with a ____
sleep study
parasomnias
sleep walking, night terrors, enuresis
primary prevention of substance abuse
successful models which promote healthy families in healthy communities, customized to past experiences and specific situations
instrumental activities of daily living (IADLs)
tasks necessary to conduct the business of daily life and also requiring some cognitive competence, such as telephoning, shopping, food preparation, housekeeping, and paying bills
a nurse is establishing health promotion goals for a female client who smokes cigarettes, has hypertension, and has a BMI of 26. which of the following goals should the nurse include?
the client will walk for 30 minutes 5 days a week
obstructive sleep apnea
throat muscle intermittently relax and block the upper airway during sleep, causing breathing to repeatedly stop (10-20 seconds up to 2 minutes) and start. results in increased BP, irregular HR, SNS activation
a nurse in an urgent care clinic is studying the developmental stages of various clients. in which of the following clients should the nurse expect to see manifestations of autism?
toddler
a nurse is developing an education program on substance abuse disorders for adolescents. which of the following should the nurse include when discussing nicotine and smoking?
tolerance to nicotine develops quickly
a nurse has accepted a position on a pediatric unit and is learning about psychosocial development. place Erikson's stages of psychosocial development in order from birth to adolescence.
trust vs. mistrust autonomy vs. shame and doubt initiative vs. guilt industry vs. inferiority identify vs. role confusion
erikson's social/emotional theory
trust vs. mistrust (0-18 months), autonomy vs. shame/doubt (18 months-3 years), initiative vs. guilt (3-5 years), industry vs. inferiority (5-13 years), identify vs. confusion (13-21 years), intimacy vs. isolation (21-39 years), generativity vs. stagnation (40-65 years), integrity vs. despair (65+ years)
