chapter 3 - Health , Illness and disparities, Chapter 03: Health, Illness, and Disparities, Chapter 3 PrepU, Chapter 3 - Health, Illness, and Disparities

According to Archer, what are the three general types of communities?

Emotional, structural, and functional

A client has been exposed to bacterial pneumonia. The client has been eating poorly, with limited intake of nutrients. This factor would predispose a client to the development of pneumonia. Poor nutritional intake is classified as the

Environment

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

Exacerbation

The nurse is preparing a plan of care for a client with nutritional deficits. Which is the priority intervention for this client?

teaching about intake of food and vitamins

The definition of chronic conditions can be complex. Which factors would a nurse expect to be included in the definition of chronic conditions? (Select all that apply.)

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

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?

It focuses on what people believe to be true about their health.

Which is an example of tertiary health promotion?

Rehabilitation Tertiary health promotion and illness prevention begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate patients to a maximum level of functioning. Nursing activities on a tertiary level include teaching a patient with diabetes how to recognize and prevent complications, using physical therapy to prevent contractures in a patient who has had a stroke or spinal cord injury, and referring a woman to a support group after removal of a breast because of cancer.

While providing client care, a nurse determines that a client adheres to the health belief model. Which of the following would the nurse need to assess as a factor possibly affecting the client's response to illness

The health belief model provides insight into the connection between the way a person sees his or her state of health, and that person's response to health, illness, and treatment. According to the health belief model, personality characteristics affect the person's response to illness. Nutritional awareness, stress management, and environmental sensitivity are wellness behaviors that promote healthy functioning and help prevent illness

Which intervention performed by the nurse is most appropriate for assisting a client in meeting safety and security needs based on Maslow's Hierarchy of Needs?

Providing the mother the phone number for the Poison Control Center

A nurse is caring for a female client age 17 years whose left leg was amputated after being crushed in a motor vehicle accident. Which of the following interventions might the nurse perform to accommodate the cleint's intellectual dimension

) Teaching her how to care for the stump and explaining the rehabilitation program Explanation: The intellectual dimension encompasses cognitive abilities, educational background, and past experiences. These influence responses to teaching about health, and reactions to nursing care during illness. They also play a major role in health behaviors

Why is health promotion and illness prevention a key responsibility of nurses?

Chronic illnesses are the leading health problem in the world. *Explanation:* Because chronic illnesses are the leading health problem in the world, health promotion and illness prevention activities are vital to nursing care. 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 reason for promoting health and preventing illnesses.

A nurse is evaluating a child for new onset of bedwetting. Which nursing action is the priority?

Collect a urine sample for the prescribed urinalysis (UA).

Risk factors for illness are divided into six categories. Working with carcinogenic chemicals is an example of which type of risk factor?

Environmental risk factor Age Genetic factors Physiologic Factors Health Habits Lifestyle Environment

Which of the following is not a factor in the agent-host-environment model of health and illness, as developed by Leavell and Clark (1965)?

Evil spirit

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 of the following concepts?

Focus on what is possible. *Explanation:* 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 others should not be a focus at this time.

A teenage patient from a rural area has been diagnosed with appendicitis and has been airlifted to a hospital in the nearest urban centre for an appendectomy. What action by the nurse best exemplifies the principles of family-centered care (FCC)?

Helping to facilitate the patient's parents coming to stay with the patient

A nursing student is using the McGill Model of Nursing (MMN) in the care of a family. The student should set what goal during initial interactions with the family?

Identify the family's strengths.

An 83-year-old client has had a stroke and has right hemiparesis. He has an inability to garden and is being cared for by his family. The family states he seems depressed and has no current interests. Based on the family's information, it would be appropriate for the family to allow the client to assist in planning an herb garden in the home. This is an example of

Output

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 of the following dimensions is the nurse referring to?

Physical dimension *Explanation:* The physical dimension includes genetic inheritance, age, developmental level, race, and gender. These components strongly influence the person's health status and health practices. Since lung cancer is more frequent in men, the male client is at a higher risk of developing lung cancer due to his sex.

The nurse practitioner is discussing health promotion with a group of senior nursing students. What would be the best example of secondary health promotion

Secondary health promotion and illness prevention focus on screening for early detection of disease with prompt diagnosis and treatment of those found; this includes emotional issues, making family counseling the correct answer. Work place health and safety would be considered a primary health promotion activity, as would a weight loss clinic and an immunization clinic

The nursing instructor identifies the need for further instruction in regards to health and illness when a student makes which statement?

Self-concept does not influences a person's health."

A nurse is working at a community clinic that serves mostly families with young children. What would be a priority intervention for patients in this developmental stage?

Setting up parenting classes

A patient has been admitted to the hospital for treatment of pancreatitis secondary to alcoholism. The patient states that he finds it nearly impossible to quit drinking because of the deep entrenchment of alcohol use in his circle of friends and line of work. As well, he claims that he thought limiting himself to beer and foregoing hard alcohol would prevent health problems. This patient is exhibiting health consequences rooted in which of the following human dimensions?

Sociocultural and intellectual

A nurse is caring for a patient who has COPD, a chronic illness of the lungs. The patient is in remission. Which statement best describes a period of remission in a patient with a chronic illness?

Symptoms are not experienced

The nurse is implementing care for several clients. Which of the following clients is the nurse helping to reach the highest level of Maslow's hierarchy of basic human needs?

The nurse provides privacy for the client and family during times of prayer.

A nurse is applying the HPM in the care of a patient who would benefit from smoking cessation. When assessing the patient's self-efficacy, the nurse should attempt to identify which of the following?

The patient's ability to use the skills and resources that she possesses

Which nursing intervention is an example of tertiary preventive care?

assisting with speech therapy for a client with a traumatic brain injury

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

ordering a mammography *Explanation:* Secondary care involves primary caregivers making referrals for consultation or additional testing, such as mammographies. Discussions about wearing helmets, using seat belts, and drugs and alcohol are all examples of primary care.

A 90-year-old woman has a staphylococcus infection in her decubitus ulcer. Staphylococcus is the:

Agent

A group of student nurses are designing a public health campaign using the HPM. Which of the following principles should inform the student's efforts?

Health and wellness are influenced by a wide variety of factors.

When providing care to a client, the nurse integrates knowledge that a client's beliefs and actions are related and influenced by his personal expectations in relation to health and illness. The nurse is demonstrating understanding of which health model?

Health belief model

A nursing instructor is working with a class of first semester nursing students. The instructor explains the interelatedness of health and wellness. What would be the best definition the nursing instructor could give of health?

Health is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity. *Explanation:* 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.

The nursing instructor is teaching the students about health and wellness and identifies which of the following as the best definition for health?

Health is a state of complete well-being.

The nurse is applying the Health Promotion Model (HPM) in a community and is conducting a workshop with a group of residents. When attempting to foster positive motivation, the nurse should make what statement?

Individuals who exercise regularly report greater happiness and an enhanced sense of well-being

The health belief model is useful when educating individuals about health and illness. Why would this be?

It allows you to assess the client's beliefs and structure goals so he can meet health needs. *Explanation:* The health belief model is useful when educating individuals about health and illness because it allows nurses to assess a client's beliefs and then structure goals so he can meet individual health needs. The health belief model does not foster dependency; it does not encourage giving care based on a client's disability; and it does not encourage or promote interactions with clients that are focused on the cause of a disability.

A nurse caring for patients with diabetes knows that this is a characteristic of a chronic illness:

It requires special patient education for rehabilitation. *Explanation:* Chronic illness is a broad term that encompasses many different physical and mental alterations in health, with one or more of the following characteristics: it is a permanent change; it causes, or is caused by, irreversible alterations in normal anatomy and physiology; it requires special patient education for rehabilitation; and it requires a long period of care or support.

A community health nurse is planning a campaign that has the goal of fostering the wellness of older adults in the community. What goal is most appropriate for this campaign?

Older adults will report improved quality of life after the campaign is launched.

The nurse enters the client's room in the acute care unit immediately after he experiences a generalized tonic-clonic type seizure in bed. What is the first action the nurse should take?

Position the client in a side-lying position.

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

Primary

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?

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

Which of the following theorists supports the developmental framework of family assessment?

Duvall

A nurse is educating women on the need for calcium to prevent bone loss. What level of prevention does this represent?

Primary prevention *Explanation:* Primary prevention or primary health care involves the education of clients in the prevention of disease.

The nurse is giving a talk to a local community group on the harms of smoking. The nurse tells the group that a risk factor is something that increases a person's chances for illness or injury. What type of risk factor is smoking

Risk factors are defined as modifiable (things a person can change, such as quitting smoking) and nonmodifiable (things that cannot be changed, such as a family history of cancer). Primary and secondary are not associated with risk factors.

Nurses promote the needs of clients as an integral part of each person's human dimension. Which needs are being met when a nurse recommends a senior citizen community centre for an older client who is living alone?

Sociocultural needs

A nurse working in the ICU understands that illnesses affect both the client as well as the family members. What are some things that often cause stress in family members due to a hospitalization of a family member? Select all that apply.

•Alterations in roles •Economic problems •Alterations in lifestyle •Decrease in social interactions

After studying concepts of health and wellness, the nursing student realizes that many different things influence a client's personal perception of health. Which of the following influences should the student list as factors that impact how a client defines health? Select all that apply.

•Family •Culture •Community •Society

Health Promotion

The education on lifestyle choices is part of health promotion activity, which focuses on protecting the person's health. 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 man with Alzheimer's disease in a nursing home will follow directions for dressing and feeding better with one nurse than with other staff members. This factor is related to

Therapeutic model of interaction Explanation: The Therapeutic Model of Interaction is client-centered and emphasizes the relationship between the health professional and the client.

Nurses understand the importance of health promotion and illness prevention. They also know that it is just as important for them to care for their own health needs. Which of the following are reasons that nurses need to care for their health needs? Select all that apply.

To enable them to practice more efficiently To help them serve as role models for clients So that they are able to give effective nursing care to others To help clients acquire new behaviors by modeling those same behaviors

What have the models of health promotion and illness prevention been used for?

To help health care providers understand health-related behaviors.

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?

coronary artery disease

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

help them maintain independence.

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

homeostasis.

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 how to use crutches *Explanation:* Tertiary care is used after an injury or sickness to decrease potential risk and further damage, such as instructing the client on how to use crutches. Promoting safety in the home, counseling a client about a low sodium diet, and assessing blood glucose are examples of primary care.

Which client would benefit from the nurse including interventions addressing their social health in the plan of care?

spouse and parent who is angry about no longer being able to work due to a spinal cord injury

Chronic illness may be characterized by periods of remission. Remission is best defined as:

the presence of a disease with the absence of symptoms. *Explanation:* Remission is defined as the presence of a disease, but the person does not experience the symptoms. Exacerbation is the reappearance of symptoms of a disease. Disease is a pathological change in the structure of function of the body or mind. Illness is the response of a person to a disease.

A client makes a decision to quit smoking and joins a smoking cessation class. This is an example of which of Dunn's processes that help a person know who and what he or she is?

Dunn defined processes that help a person know who and what he or she is. These processes, which are a part of each individual's perception of his or her own wellness state, are being (recognizing self as separate and individual), belonging (being part of a whole), becoming (growing and developing), and befitting (making personal choices to befit the self for the future).

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

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

The 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.

It focuses on what people believe to be true about their health. *Explanation:* 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 ever-chaining state, while The Agent-Host-Environment Model explains how certain factors place a person at risk for an infectious disease.

A young couple who have been married less than a year are having difficulty with adjusting to parenting. What is a contributing factor to this level of maladjustment?

Limited time in learning to be a marital partner

Primary prevention

Primary prevention focuses on the health of a person with the goal of preventing disease or illness. Self-breast examination education is primary prevention.

What level of prevention is noted when the nurse educates a group of mothers of school-age children on self breast examinations

Primary prevention focuses on the health of a person with the goal of preventing disease or illness. Self-breast examination education is primary prevention.

The nurse is assessing the communication style of the client. Communication is an example of which dimension of the individual?

Sociocultural dimension

The nurse is conducting a family assessment of a traditional family. Which assessment data cue describes the socioeconomic status of the family?

The father is an engineer and the mother is an elementary school teacher.

The home health nurse is making an initial assessment visit to a family that consists of two parents and twin 3-year-old boys. During the interview, the nurse is most concerned if the client makes which statement?

The father states, "I don't discuss money matters with my wife because I don't want her to worry."

The nursing instructor is discussing holistic health care with her nursing students. The instructor talks about the different factors the nurse must consider when creating a holistic plan of care. What are these factors? (Mark all that apply.)

The patient's developmental life stage The patient's emotional context The patient's physiologic health condition

The nurse is admitting a 38-year-old male client to the oncology unit whose religious background is different from her own. The nurse is assessing how the client's religion may affect his health care needs. Which question by the nurse is the best way to consider the client's religious practices in the plan of care?

What can we do to help you meet any religious needs you may have?"

An older adult client who has been hospitalized due to a stroke is about to be discharged from a rehabilitation centre where the client had to re-learn how to feed and dress oneself. The client 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 __________.

giving up the dependent role.

A community health nurse arranges for a dental checkup camp for the local children in the school district. Which of the following would most likely be the nurse's goal for this health camp?

health promotion

A client enjoys eating high-calorie carbohydrate meals, but understands her blood sugar can increase sharply, ultimately causing the feeling of butterflies in her stomach as her blood sugar decreases. This is considered

self-concept

A nursing instructor is working with a class of first semester nursing students. The instructor explains the interrelatedness of health and wellness. What would be the best definition the nursing instructor could give of health?

Health is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.

The nurse understands the role that religion and spirituality plays in a client's health. Which of the following is one example of the influence of the spiritual dimension on health care?

Orthodox Jews prohibiting the intake of pork

Research has shown that the incidence of chronic conditions is increasing. Which lifestyle factor is associated with chronic diseases?

Smoking *Explanation:* Lifestyle factors, such as smoking, chronic stress, and sedentary lifestyle, that 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.

Which model is most useful in examining the cause of disease in an individual, based upon external factors?

The Agent-Host-Environment 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.

Which client would benefit from the nurse including interventions addressing emotional health in the plan of care?

stressed client who is experiencing paranoid delusions

A client comes to the emergency room complaining of abdominal pain, fever, chills, and nausea. Upon further examination the client is diagnosed with appendicitis. What type of illness does the nurse identify this client to have?

Acute

A client makes a decision to quit smoking and joins a smoking cessation class. This is an example of which of Dunn's processes that helps a person know who and what he is?

Befitting

An exacerbation refers to the reactivation of a disease. Which condition is associated with exacerbation?

Chronic illness *Explanation:* Exacerbation is the increase in activity of a disease and aggravation of symptoms. This occurs periodically in clients with chronic diseases. It is often a result of physical, chemical, or emotional stress. Congenital illness (such as atrial septal defect), hereditary illness (such as cystic fibrosis), and acute illness (such as influenza) do not have exacerbation and remission stages.

When practicing Therapeutic Touch (TT), the practitioner begins by performing which intervention?

bringing the practitioner's attention to an inward, peaceful consciousness

A client with Crohn's disease in remission is admitted to the nursing unit for follow-up care. The remission state is characterized by:

disappearance of signs and symptoms associated with the disease.

An woman 80 years of age has had a cerebrovascular accident. She has flaccidity of her right side with aphasia. For this client, which of the following activities constitutes tertiary prevention?

gait training and speech therapy

What is the definition of wellness?

an active state of being healthy

A nursing student is performing a health risk assessment of an adult patient who admits to living a sedentary lifestyle. The patient states, "If I'm honest, I'd have to say that I just can't be bothered to exercise." What psychological health risk would the student be most justified in identifying?

An underestimation of the risks associated with inactivity

Which of the following is an example of tertiary health promotion

Tertiary health promotion and disease prevention begins after an illness is diagnosed and treated to reduce disability and to help rehabilitate patients to a maximum level of functioning. Therefore, rehabilitation is an example of tertiary health promotion. Family counseling and Pap tests are examples of secondary health promotion. Water treatment is an example of primary health promotion.

A nursing student is performing an assessment of a patient on a hospital unit. What component of the patient assessment will allow the student to document data relating to a subjective way of knowing?

Asking the patient to describe the character of her abdominal pain

The charge nurse is assigning client care for the upcoming shift. Which is the priority evaluation when performing this task?

Determine the level and intensity of client care needed according to physical and psychosocial factors.

The nurse is preparing a sterile field for a procedure. While opening an instrument, the outer wrapper of the sterilized instrument touchs the extreme edge of the field. Which of the following should the nurse do next.

Discard the sterile field and prepare a new one

The nurse is preparing a sterile field for a procedure. While opening an instrument, the outer wrapper of the sterilized instrument touches the extreme edge of the field. Which of the following should the nurse do next.

Discard the sterile field and prepare a new one *Explanation:* Adhering to proper sterile technique can help eliminate breaks in sterile procedure, but if breaks in technique do occur, replace sterile equipment before resuming the procedure.

The nurse has developed a strong therapeutic partnership with a 44-year-old electrician who suffered severe burns while working on an industrial site. Which of the nurse's following actions most directly addresses the patient's self-actualization needs?

Discussing the patient's strengths and dialoguing with him about his body image

The nurse is holding a cholesterol screening at a local pharmacy this Saturday morning. What level(s) of health promotion is this screening an example of?

Secondary

A woman over the age of 40 years has an annual mammogram. What level of prevention does this represent?

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.

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

consume a diet low in fat. *Explanation:* Nurses focused on wellness advocate the use of lifestyle modification skills that alleviate stress and promote a state less susceptible to disease.

The nursing student who has diarrhea before every test and every clinical understands that this is not a healthy behavior. The student is aware that this negative effect can impact overall health. The nurse recognizes that this student needs to focus on which of the following dimensions of health?

Emotional dimension *Explanation:* This is an example of the emotional dimension. How the mind affects body functions and responds to body conditions also influences health. Long term stress affects body systems, and anxiety affects health habits. Intellectual dimension encompasses cognitive abilities and past experiences, while the physical dimension includes things like genetics, sex, and race. Sociocultural dimensions relate to a client's economic level, lifestyle, family, and culture.

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?

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

Health

What is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity

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. What level(s) of health promotion is this an example of?

Primary In book: Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Nursing activities at the primary level may focus on people or groups. Examples of primary-level activities are immunization clinics, family planning services, providing poison-control information, and accident-prevention education. Other nursing interventions include teaching about a healthy diet, the importance of regular exercise, safety in industry and farms, using seat belts, and safer sex practices. Secondary : Secondary health promotion and illness prevention focus on screening for early detection of disease with prompt diagnosis and treatment of any 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.

A client experiencing symptoms of cold is referred to the specialist for diagnosis and consultation. Consultation and diagnostic tests are included in which level of the health care system?

Secondary care

A nurse refers an HIV-positive client to a local support group. This is an example of what level of preventive care?

Tertiary *Explanation:* 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.

Which model is most useful in examining the cause of disease in an individual, based upon external factors?

The Agent-Host-Environment Model *Explanation:* The Agent-Host-Environment 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.

The nurse is addressing primary prevention with a group of college students. Which is an example of a primary prevention measure?

use of condoms and safer sex practices *Explanation:* Safer sex practices, which include the use of condoms, is an example of primary prevention measures. HIV screening, annual Pap smears, and testicular examinations are secondary prevention measures.