Chapter 3 Health, Wellness, and Health Disparities
Why are health promotion and illness prevention a key responsibility of nurses?
Chronic illnesses are the leading health problem in the world.
The nurse is preparing a sterile field for a procedure. While the nurse is opening an instrument, the outer wrapper of the sterilized instrument touches the extreme edge of the field. What should the nurse do next?
Discard the sterile field and prepare a new one
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?
Emotional dimension
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
A nurse incorporates concepts from current models of health when providing health promotion classes for patients. What is a key concept of both the health-illness continuum and the high-level wellness models?
Health as a constantly changing state
The nurse uses the agent-host-environment model of health and illness to assess diseases in patients. This model is based on what concept?
Risk factors
A client is admitted to the mental health center with attempted suicide. Which of the client's problems is the priority for the nurse to manage?
Risk of self-harm
A nurse provides interventions for clients in a long-term care facility to help them meet their intellectual needs. Which nursing actions promote these needs? Select all that apply.
-A nurse provides education about foot care to a client with diabetes. -A nurse explains to an obese client the benefits of following a healthy diet. -A nurse shows residents a video discussing modified activities for older adults.
Which are factors that impact how a client defines health? Select all that apply.
-Culture -Community -Family -Society
A nurse working in a primary care facility assesses patients who are experiencing various levels of health and illness. Which statements define these two concepts? Select all that apply.
-Health and illness are individually defined by each person. -Health is more than the absence of illness. -Illness is the response of a person to a disease.
The nurse is planning care for several clients in an outpatient clinic. Which client requires follow-up care due to a chronic condition?
A client with chronic obstructive pulmonary disease (COPD) who is wheezing and coughing
What is the definition of wellness?
An active state of being healthy
Which nursing intervention is an example of tertiary preventive care?
Assisting with speech therapy a client with a traumatic brain injury
Which nursing activity reflects care given on the tertiary level of healthcare delivery?
Assisting with transplant surgery
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 one know who and what one is?
Befitting
A nurse working in a long-term care facility personally follows accepted guidelines for a healthy lifestyle. How does this nurse promote health in the residents of this facility?
By being a role model for healthy behaviors
An exacerbation refers to the reactivation of a disease. Which condition is associated with exacerbation?
Chronic illness
A nurse is caring for a client with end-stage liver failure. Which healthcare agency should the nurse recommend for continuity of care?
Extended care
When caring for a client who has just been diagnosed with a chronic illness, the nurse understands the importance of promoting health by highlighting which concept?
Focus on what is possible.
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?
Health belief model
A nurse has volunteered to give influenza immunizations at a local clinic. What level of care is the nurse demonstrating?
Primary
A nurse is immunizing children against measles. This is an example of what level of preventive care?
Primary
A patient in a community health clinic tells the nurse, "I have a high temperature, feel awful, and I am not going to work." What stage of illness behavior is the patient exhibiting?
Stage 2: Assuming the sick role
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?
Use of condoms can help prevent sexually transmitted infections and unwanted pregnancy
A client has a Staphylococcus infection in a decubitus ulcer. In this case, Staphylococcus is the:
agent
When chronic illnesses and disabilities are present, individuals benefit most from activities that:
help them maintain independence.
The recognition of health as an ongoing process toward a person's highest potential of functioning is defined as:
high-level wellness.
A client enjoys high-calorie carbohydrates but understands that they raise the blood glucose level sharply and ultimately cause a feeling of butterflies in the stomach as the blood glucose level decreases. This is considered:
self-awareness.
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 client with Alzheimer disease in a nursing home is more compliant in following directions for dressing and feeding with one nurse than with other staff members. This phenomenon is best explained by
the Therapeutic Model of Interaction.
Chronic illness may be characterized by periods of remission. Remission is best defined as:
the presence of a disease with the absence of symptoms.
A client, who has just been diagnosed with a chronic condition, asks the nurse what a"chronic condition" means. What would be the nurse's best response?
"Chronic conditions usually come on slowly and may have periods of remission and exacerbation."
Which is the goal of tertiary prevention of illness?
Minimizing complications
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?
Modifiable
What have the models of health promotion and illness prevention been used for?
To help health care providers understand health-related behaviors.
What is a misconception about chronic disease?
Chronic illnesses cannot be prevented.
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
Which definition of health is the best?
Health is a state of complete well-being.
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?
Health promotion
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
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
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.
Which is an example of tertiary health promotion?
Rehabilitation
A nurse refers an HIV-positive client to a local support group. This is an example of what level of preventive care?
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?
Tertiary prevention
Which model is most useful in examining the cause of disease in an individual, based upon external factors?
The Agent-Host-Environment Model
Nurses perform health promotion activities at a primary, secondary, or tertiary level. Which nursing actions are considered tertiary health promotion? Select all that apply.
-A nurse teaches a patient with an amputation how to care for the residual limb. -A nurse provides range-of-motion exercises for a paralyzed patient.
A nurse working in a hospital setting cares for patients with acute and chronic conditions. Which disease states are chronic illnesses? Select all that apply.
-Diabetes mellitus - Rheumatoid arthritis -Cystic fibrosis
The client is admitted with a gastrointestinal bleed. The physician ordered a colonoscopy. Which level of care encompasses this procedure?
Secondary
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
Consultation and diagnostic tests are included in which level of health care?
Secondary care
A mammogram represents which level of prevention?
Secondary prevention
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
Which needs are being met when a nurse recommends a senior citizen community center for an older client who is living alone?
Sociocultural needs
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?
Symptoms are not experienced.
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?
Teaching about adhering to a low-sodium diet
A nurse observes that a client who has pneumonia is in the recovery and rehabilitation stage of the illness. Which statement describes the client response that the nurse would expect at this stage of the illness?
The client gives up the dependent role.
Based on the components of the physical human dimension, the nurse would expect which clinic patient to be most likely to have annual breast examinations and mammograms?
Tricia, who has a family history of breast cancer
Despite a national focus on health promotion, nurses working with patients in inner-city clinics continue to see disparities in health care for vulnerable populations. Which patients are considered vulnerable populations? Select all that apply.
-An African American teenager who is 6 months pregnant -A Hispanic male who has type II diabetes -A low-income family living in rural America -A White baby who was born with cerebral palsy
An older adult patient has been recently diagnosed with vascular dementia. Because the client lives alone and has poorly controlled hypertension, the client has begun to receive home healthcare. This new aspect of the client's care is characteristic of which stage of illness?
Assuming a dependent role
