Nursing 222 Chapter 3: Health, wellness and health disparities

A client with chronic obstructive pulmonary disease (COPD) is admitted to the hospital for the second time in 2 months with wheezing, dyspnea, and use of accessory muscles when breathing. Which type of situation does the nurse identify is occurring with this client? a. The client is having an exacerbation of the COPD. b. The client is experiencing remission of the COPD. c. The client is experiencing the effects of a terminal illness. d. This is the effect of a secondary illness.

a. The client is having an exacerbation of the COPD.

The nurse is working in a clinic in a rural setting that has a diverse population of clients. Which client will the nurse refer to the case manager to determine eligibility for Medicaid? a. a client with four children who works part-time in a fast food restaurant making minimum wage b. a client who is changing jobs and will be without medical coverage for 60 days c. a client who is disabled from a work-related accident d. a 65-year-old client retiring from a job with the school system

a. a client with four children who works part-time in a fast food restaurant making minimum wage

A nurse is interviewing a family. During the interview, the nurse gathers information about the family's environmental dimension. Which element would the nurse include in this assessment? Select all that apply. a. Coping strategies b. Housing situation c. Local climate d. Race e. Developmental stage

b, c

A group of nurses is participating in a community health fair and is engaged in primary prevention activities. Which activities would these nurses be leading? Select all that apply. Skin cancer screening Family planning services Heart-healthy nutrition services Rehabilitation for relief of low back pain Accident prevention education

b, c, d

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

b. An active state of being healthy

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. Sociocultural dimension b. Emotional dimension c. Intellectual dimension d. Physical dimension

b. Emotional dimension

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? High-level wellness model Health belief model Holistic health model Clinical model

b. Health Belief model

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

b. Primary Prevention

The nurse recognizes that the client who makes the decision to accept a new diagnosis and follow the prescribed treatment plan is in which stage of an illness? Stage 2-Assuming the sick role Stage 3-Assuming a dependent role Stage 1-Experiencing symptoms Stage 4-Achieving Recovery

b. Stage 3-Assuming a dependent role

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

b. Tertiary

A client has had a total knee replacement and is receiving care that includes learning to walk with a walker. What level of prevention is most applicable to this client? Secondary prevention Tertiary prevention Residual prevention Primary prevention

b. Tertiary prevention

Which definition best describes acute illness? A medical condition that is life-threatening and requires surgery The rapid onset of symptoms lasting a relatively short time A condition that causes a permanent change and requires a long period of care The leading health problem in the world

b. The rapid onset of symptoms lasting a relatively short time

The nurse is addressing primary prevention with a group of college students. Which promotional statement by the nurse would be the best example of a developmentally appropriate discussion? a. Testicular examinations for male students can detect early stages of cancer. b. Use of condoms can help prevent sexually transmitted infections and unwanted pregnancy. c. Annual Papanicolaou test can detect cancer earlier. d. HIV screening should be done on an annual basis if you are sexually active.

b. Use of condoms can help prevent sexually transmitted infections and unwanted pregnancy.

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

b. help them maintain independence.

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

c. It has a gradual onset and lasts for a long time.

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? Assessing for risk factors for heart disease Screening for tuberculosis Teaching about adhering to a low-sodium diet Screening for breast cancer every 5 year

c. Teaching about adhering to a low-sodium diet

A client comes to a scheduled appointment with a new flyer from the insurance company (above) and asks the nurse how all these things can be included. How should the nurse respond? This is how Medicare now operates; everyone working together to reduce health care costs. Each of these specialties is all owned by the same company. It must be a large corporation. This is referred to as an integrated delivery system. Everyone is working together to provide their clients the best possible care. The client gets to choose which options he or she wants coverage for. Would you like me to explain the differences?

c. This is referred to as an integrated delivery system. Everyone is working together to provide their clients the best possible care.

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

c. To help health care providers understand health-related behaviors

health disparity

a specific difference that is closely linked to social, economic, and/or environmental disadvantage

Consultation and diagnostic tests are included in which level of health care? Secondary care Primary care Extended care Tertiary care

a. secondary care

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

b. Requesting the client's permission to touch the body

health promotion

behavior of an individual motivated by a personal desire to increase well-being and health potential

The nurse is caring for a very active, athletic adolescent recently diagnosed with multiple sclerosis. The client appears to be withdrawn and depressed when the nurse asks how the client is doing today. Using the health belief model, what step(s) will the nurse take to create a plan of care for this client? Select all that apply. Assure the client that he or she will be able to live a full life, provide education on how to adjust to the new diagnosis, and include the family in any life-changing decisions. Assure the client that there is nothing to be worried about because many people are diagnosed with this disease, and alert the family to the possibility of depression. Conduct an in-depth interview of the client's previous health issues, how the client reacted to the illness, and what support system the client has. Encourage the client to participate in as many activities as he or she can tolerate and provide information for health counselling. Review possible outcomes of the diagnosis with the client, allowing the client to express concerns while providing support.

c, d, e

social determinants of health

conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks

morbidity

frequency that a disease occurs

The nurse's community outreach class is giving a presentation on seat belts and child safety seats at the local firehouse every weekend in October. Which level of health promotion is this an example of? Primary Secondary Medical Tertiary

Primary

Which are characteristics of chronic conditions? (Select all that apply.) a. Are rarely curable b. Have a prolonged course c. Have a rapid onset d. Require lifelong management e. Resolve spontaneously

a, b, d

A mammogram represents which level of prevention? Secondary prevention Tertiary prevention Medical prevention Primary prevention

a. secondary prevention

illness

abnormal process in which any aspect of the person's functioning is altered (in comparison to the previous condition of health)

wellness

an active process in which an individual progresses toward the maximum possible potential, and regardless of current state of health

health equity

attainment of the highest level of health for all people

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

b. secondary

A pregnant client at 10 weeks' gestation is receiving education by the nurse about the importance of abstaining from alcohol while pregnant. What statement made by the client demonstrates an understanding of the education provided? "If I drink alcohol while pregnant, my child will have a hereditary disorder." "Abstaining from alcohol will prevent any type of congenital disorder." "I should abstain from alcohol to prevent the development of a fetal alcohol spectrum disorder." "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."

An exacerbation refers to the reactivation of a disease. Which condition is associated with exacerbation? a. Hereditary illness b. Acute illness c. Chronic illness d. Congenital illness

c. Chronic illness

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

c. Coronary artery disease

acute illness

rapidly occurring illness that runs its course, allowing a person to return to one's previous level of functioning

risk factor

something that increases a person's chance for illness or injury

health

state of optimal functioning or well-being

chronic illness

irreversible illness that causes permanent physical impairment and requires long-term health care

A hospital nurse assesses clients in various stages of illness. Which statements accurately describe client responses to illness based on Suchman's stages of illness? Select all that apply. In stage 1, pain is the most significant symptom indicating illness, although other symptoms, such as a rash, fever, bleeding, or cough, may be present. In stage 1, the person defines himself or herself as being sick, seeks validation of this experience from others, and gives up normal activities. In stage 2, most people focus on their symptoms and bodily functions. When help from a health care provider is sought, the person becomes a client and enters stage 3, assuming a dependent role. When a client decides to accept a diagnosis and follow a prescribed treatment plan, he or she is in stage 4, achieving recovery and rehabilitation. Most clients complete the final stage of illness behavior in the hospital or a long-term care setting.

a, c, d

Which are factors that impact how a client defines health? Select all that apply. Family Community Culture Music Society

a,b,c,d

Risk factors for illness are divided into six categories. Working with carcinogenic chemicals is an example of which type of risk factor? a. Environmental risk factor b. Health habits risk factor c. Lifestyle risk factor d. Physiologic risk factor

a. Environmental risk factor

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. Diagnosis of disease c. Self-concept d. Illness prevention

a. Health Promotion

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? Instructing a client on how to use crutches Assessing a client's blood glucose level Promoting safety in the home Counseling a client about a low-sodium diet

a. instructing a client on how to use crutches

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

c. individuals cannot be seen apart from the environment.

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

d. Assisting with speech therapy a client with a traumatic brain injury

vulnerable propulation

disadvantaged subsegment of a community requiring utmost care, specific ancillary considerations, and augmented protection in research; includes those living in poverty, women, children, older adults, rural and inner city residents, new immigrants, the homeless, mentally ill patients, and people with disabilities and special health care needs

holistic health care

health care that takes into account the whole person interacting in the environment

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? Sociocultural and intellectual Environmental and spiritual Emotional and environmental Physical and emotional

a. Sociocultural and intellectual

The nurse is preparing to talk to a local community group regarding chronic illness. The nurse informs the group that both external and internal factors influence a person's health. When discussing the fact that the male client has a higher chance of developing lung cancer due to his gender, which dimension is the nurse referring to? a. Physical dimension b. Environmental dimension c. Intellectual dimension d. Emotional dimension

a. Physical dimension

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? Precontemplation Maintenance Preparation Contemplation

a. Precontemplation

The nurse is counseling a newly pregnant woman who is concerned about developing infections during her pregnancy. The pregnant woman states, "I'm so afraid something will happen to my baby. My friend developed an infection while she was pregnant and the baby died." Which of the following responses by the nurse would be most appropriate? "What kind of infection did your friend have?" "Don't worry, your baby will be fine." "Your chances of developing an infection are very small." "Early prenatal care like you are receiving is very beneficial in reducing chances of infection." "Maybe your friend was not consistent in washing her hands frequently."

d. "Early prenatal care like you are receiving is very beneficial in reducing chances of infection."

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? Morbidity Infection Risk factor Exacerbation

d. Exacerbation

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

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

A nurse is immunizing children against measles. This is an example of what level of preventive care? Chronic Tertiary Secondary Primary

d. Primary

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

d. Primary prevention

A nurse is caring for a client who has breast cancer. The client tells the nurse: "I don't know why this happened to me, but I'm ready to move on and do whatever I need to do to get healthy again." This client is in which stage of acute illness? Stage 1 Stage 2 Stage 4 Stage 3

d. Stage 3

A nurse is caring for a client who has COPD, a chronic illness of the lungs. The client is in remission. Which statement best describes a period of remission in a client with a chronic illness? New symptoms occur at this time. The symptoms of the illness reappear. The disease is no longer present. Symptoms are not experienced.

d. Symptoms are not experienced.

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

d. The Agent-Host-Environment Model

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? How health is a constantly changing state Factors that predispose a person to infectious diseases How people interact with their environments What people believe to be true about their health

d. What people believe to be true about their health

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

d. agent

The emergency department nurse is preparing a care plan for a young child who has suffered a fractured arm after a bicycle accident. Which factor should the nurse consider including in the care plan for this child to best address this issue? schedule visits from home health nurse update immunizations assess nutritional needs applying for Children's Health Insurance Program (CHIP)

d. applying for Children's Health Insurance Program (CHIP)

As the staff reports for duty, each nurse and unlicensed assistive personnel (UAP) checks the assignment board (above) to see what he or she will be responsible for during that shift. Which method of nursing is this facility utilizing to provide care to the clients? a. team nursing b. primary nursing c. case method d. functional nursing

d. functional nursing

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? high-level wellness reversal of self-care deficit illness prevention health promotion

d. health promotion

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

d. high-level wellness

mortality

number of deaths

disease

pathologic change in the structure or function of the body or mind

remission

period in a chronic illness when the disease is present, but the person does not experience symptoms of the disease

exacerbation

period in chronic illness when the symptoms of the disease reappear