Chapter 3 Prep U

A nurse is assessing a client for potential variables that influence the client's health. When assessing the client's self-concept, which area should the nurse include? Select all that apply.

The client's feelings about self as a person The client's view of self physically

Which method, instituted by Medicare in the 1980s, has resulted in controlling health care costs?

Diagnostic Related Group (DRG)

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

Family counseling

The recognition of health as an ongoing process toward a person's highest potential of functioning is defined as:

high-level wellness.

A nurse is taking care of a client who has a new, permanent colostomy. The nurse is talking with the client about the new appliance and asking how the client feels about managing it. Which client response indicates understanding of the relationship between self-concept and health?

"I am developing a set of realistic expectations to help me manage my overall health and quality of life."

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

The nurse is using Leavell and Clark's Agent-Host-Environment Health Model to help plan nursing interventions for clients in a hospital setting. Which examples of nursing actions to prevent hospital-acquired infections (HAIs) best illustrate the principles of this model? Select all that apply.

The nurse should assess the clients for risk factors for infection when planning nursing care. The nurse should consider the client's family history and age when assessing risk factors for infection. The nurse should examine environmental stressors in clients' lives to see how these stressors might affect their recovery and ability to ward off infection.

What is a dynamic balance among the physical, psychological, social, and spiritual aspects of a person's life?

Wellness

The nurse is explaining the purpose of the Healthy People 2030 initiative to a client. Which goal(s) will the nurse point out as included? Select all that apply.

increase the number of people with health insurance decrease incidence of client with new cancer diagnosis increase the number of various medical degrees among the underrepresented racial and ethnic groups improve hearing and visual health with prevention education

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.

Heart-healthy nutrition services Family planning services Accident prevention education

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.

Housing situation Local climate

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.

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

Primary

Which needs are being met when a nurse recommends a senior citizen community center for an older client who is living alone?

Sociocultural needs

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

Secondary

After passage of the Affordable Care Act (ACA) the nurse was able to suggest a new option for health insurance to the clients who were previously uninsured due to the high costs. Which option could the nurse now recommend to the clients?

marketplace

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.

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. 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.

What is a dynamic state in which a person constantly adapts to changes in the internal and external environment?

Health

A nurse is performing health promotion activities for clients at a local health care clinic. Which nursing actions exemplify the focus of secondary preventive care? Select all that apply.

Screening clients for hypertension Scheduling a mammogram for a client Referring a client to family counseling

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

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.

Which nursing activity provides an example of primary prevention?

Teaching a family how to recognize and avoid environments containing lead paint

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

Tertiary

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.

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

The nurse provided teaching to a client newly diagnosed with gout. Which behavior observed by the nurse indicates the client understood the teaching?

orrect response: Selects foods low in purine from the dinner menu

A nurse who admitted a client and performed the necessary admission tasks, notes the comments from the night shift nurse and updates the client's nursing care plan. Which type of nursing care is this facility utilizing?

primary nursing Primary nursing is the process in which the admitting nurse assumes responsibility for planning client care and evaluating the client's progress. The primary nurse may delegate the client's care to someone else in his or her absence but the primary nurse is consulted when new problems develop or the plan of care requires modifications. The primary nurse remains responsible and accountable for specific clients until they are discharged

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

To help health care providers understand health-related behaviors.

When admitting an adolescent to the hospital, the nurse anticipates that the client will respond to questions about the client's health beliefs based primarily on the client's:

age and developmental stage.

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

agent.

The nurse is caring for a client who has recovered from injuries incurred from a motor vehicle accident where two other family members did not survive. The client informs the nurse that he or she will grieve without demonstrating ineffective coping mechanisms. Which type of health behaviors does the nurse identify the client is exhibiting?

emotional health

An older adult client who has been hospitalized due to a stroke is about to be discharged from a rehabilitation center where the client had to relearn how to perform activities of daily living, including feeding and dressing. The client has 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.

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

help them maintain independence.

A community health nurse in a rural area is concerned that the community needs better health care promotion after reading the statistics published by the state health department. Which factor should the nurse find alarming in the report?

increased use of emergency departments for nonemergency issues

The concept of holism is based on the belief that:

individuals cannot be seen apart from the environment.

A nurse is planning a seminar for the local community. Which topic(s) are examples of primary prevention? Select all that apply.

information on smoking cessation examples of heart-healthy diet information on increasing activity and exercise

The nurse should identify the need for further teaching when the client with diabetes who is taking daily insulin and follows a strict diet makes which statement?

"I cannot possibly ever be considered as healthy."

A client who has recently been diagnosed with a chronic illness appears to be depressed. When the nurse asks if there is something wrong, the client states, "Nothing will ever be the same for me since I have this disease." What is the most appropriate response for the nurse?

"If you maintain a positive self-concept, you can live as normally as possible."

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

The Agent-Host-Environment Model

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

Which scenario is an example of a characteristic of Stage 2 of illness?

A person tells his family that he is sick and allows family members to take care of him.

information on smoking cessation examples of heart-healthy diet information on increasing activity and exercise

Assuming the sick role

How can the nurse best demonstrate being a role model for health promotion?

Avoid smoking and drinking alcohol

Which activities would the nurse consider to be lifestyle risk factors for the development of health problems? Select all that apply.

Avoiding exercise Participating in extreme sports Maintaining a stressful job

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

A stressed client who is experiencing paranoid delusions

What is the definition of wellness?

An active state of being healthy

A nurse assists the client in the development of a healthy lifestyle. The adoption of these lifestyle changes in the client's life is considered:

self-care.

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

The nurse is educating a client with diabetes on how to better control blood sugar levels and recognize the symptoms associated with both hyperglycemia and hypoglycemia. The client is frequently admitted to the hospital due to elevated blood sugars. This education is an example of which level of health promotion?

Tertiary

Meeting which type of needs is essential for physiological health and survival?

Basic human needs

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 Dunn defined processes that help one know who and what one 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).

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 mammogram represents which level of prevention?

Secondary prevention

What are some examples of healthy self-care behaviors everyone should adopt? Select all that apply.

Sleeping 7 to 8 hours each night Eating regular healthy meals Maintaining an ideal body weight

Which lifestyle factor is associated with an increased risk for chronic diseases?

Smoking

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 3-Assuming a dependent role

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

Health

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

Which behaviors are necessary for a person to successfully adapt to a chronic illness? Select all that apply.

Learn to live as normally as possible Maintain a positive self-concept Maintain a sense of hope

Which is the goal of tertiary prevention of illness?

Minimizing complications

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?

What people believe to be true about their health

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

Which scenario accurately depicts the influence of one's religious beliefs?

A client who practices Orthodox Judaism will not eat pork.

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

Which client growth needs are included in the love and belonging level of Maslow's hierarchy? (Select all that apply.)

Family Intimacy Friendships

Which are factors that impact how a client defines health? Select all that apply.

Community Family Society Culture

The client experienced a stroke with left-sided weakness. The case manager determines that the client no longer requires acute care but currently is unable to return to the home environment. Which health care environment will be the appropriate referral option for this client?

extended care

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?

functional nursing Functional nursing is the process where each nurse on the shift is assigned a specific task, such as passing medications or performing wound care. Team nursing involves a team of nurses working together to provide care to a specific group of clients. One nurse is the team leader and responsible for delegating the care to the rest of the care unit and ensures the clients receive appropriate care. The case method is most often used in home health, public health and community mental health nursing. In this group one nurse manages all the care of a client or group of clients' needs for a designated period of time. Nurses involved in this type of care are often referred to as case managers.

A 47-year-old woman is traveling overseas on vacation with her husband. He has a sore throat that has been diagnosed as Streptococcus. The woman is the:

host.

The nurse instructor has completed a session detailing major factors differentiating exacerbations from remissions. The instructor determines the session is successful when the students point out which factor(s) can contribute to exacerbations? Select all that apply.

immune system is functioning poorly sleep has been disrupted due to family issues client is facing a potential eviction

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?

"I should abstain from alcohol to prevent the development of a fetal alcohol spectrum disorder."

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 client would most benefit from the nurse including in the plan of care interventions addressing the client's social health?

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

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

A client with a lump in the breast calls the healthcare provider to schedule an appointment for an evaluation. Based on the client's actions, what stage of illness is the client demonstrating?

Assuming the sick role

What is a misconception about chronic disease?

Chronic illnesses cannot be prevented.

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

Personality characteristics

A nurse is implementing secondary-level interventions for a group of hospitalized clients. With which activity(ies) would the nurse be involved? Select all that apply.

Administering medications Providing wound care

What are common sources of 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

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

Chronic illness

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

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?

Exacerbation

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 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. 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.

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

The nurse is caring for a client admitted to the hospital with pneumonia and associated pleuritic chest pain. Which would be a priority when creating the nursing care plan?

Monitoring airway clearance. Priority management, according to Maslow's hierarchy, starts at physiological needs, such as the need for oxygen, food, water, rest, and elimination. Therefore, difficulty breathing is the priority issue that the nurse must manage because it affects the ability of the client to get adequate oxygen. Symptoms such as pain, thirst, and needing to urinate, although important, are not a priority over difficulty breathing. Likewise, infection control is important but is not priority.

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

What level of prevention is represented by educating a group of clients on carseat safety?

Primary prevention

The nurse is certified in providing Therapeutic Touch and is preparing to initiate this for a client. What activity should the nurse perform first?

Requesting the client's permission to touch the body

Which are characteristics of chronic conditions? (Select all that apply.)

Require lifelong management Have a prolonged course Are rarely curable

Consultation and diagnostic tests are included in which level of health care?

Secondary care Consultation and diagnostic tests are included in the secondary level of health care. The first contact with a general physician is the primary care, and the referral to a highly specialized facility for desensitization is the tertiary care level. The secondary and tertiary care facilities are equipped to provide highly specialized care. Extended care is care provided to clients who no longer require acute hospital care.

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 3

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 is caring for a 17-year-old client whose left leg was amputated after being crushed in a motor vehicle accident. Which intervention might the nurse perform to address the client's intellectual dimension?

Teaching her how to care for the stump and explaining the rehabilitation program

When first diagnosed with cancer, a client was depressed and complained of feeling sick. Now the client has adapted to the diagnosis, recently returned to work, and, since undergoing chemotherapy, reports feeling better than ever. The nurse recognizes that which model of health promotion is most effective in explaining this client's situation?

The Health-Illness Continuum Model

A 13-year-old client with cystic fibrosis who is being discharged confides in the nurse that her parents argue a lot. Sometimes, her mother has too much to drink and starts throwing things at people. At times she gets scared her mom will hurt someone. She feels as if she is causing her parents to fight and her mom to drink because she is always in the hospital. She also worries about getting a bad grade in school due to her many absences and not getting into a good college. According to Maslow's hierarchy of human needs, which issue should take priority when caring for this client?

The client feels scared that her mother will hurt someone.

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?

The client is having an exacerbation of the COPD.

When providing holistic care to a client, the nurse recognizes that which behaviors are necessary? Select all that apply.

Understand and respect each person's definition of health. Understand and respect each person's responses to illness.

The nurse working in the community is assigned to the care of several clients. Which client(s) may require assistance to overcome barriers to accessing adequate care? Select all that apply.

a client who has been unemployed for 6 months a client who is a migrant and works on a farm

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?

applying for Children's Health Insurance Program (CHIP)