Chapter 4: Health & illness (prep U1)
A nursing instructor is teaching students about the concept of "continuity of care." Which of the following is the correct definition of this concept?
maintenance of health care from 1 level of health to another & from 1 agency to another
Which nursing activity reflects secondary prevention?
making a referral for a mammogram
The nurse is providing prenatal counseling for a pregnant client regarding the prevention of congenital disorders during pregnancy. Which statement made by the client indicates that the education provided was effective?
"My infant is most vulnerable if I take anything in the first 3 months of. pregnancy."
Health care be viewed as a continuum. Place the following levels of health in order from optimal to worst.
- high level wellness - good health - normal health - illness - critical illness - death
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?
- immune system is functioning poorly - sleep has been disrupted due to family issues - client is facing a potential eviction
Which is a factor upon which the financial stability of health maintenance organizations (HMOs) is based?
keeping clients healthy & out of the hospital through periodic screening, health education, & preventative services
secondary care
Care by a physician (specialist) who can perform out-of-the-ordinary procedures in outpatient facilities
What is an entitlement program designed to serve the poor that is administered by the state?
Medicaid
A clinic-based nurse in a sparsely populated remote area far from a regional hospital is working with other local health care team members on a plan to improve client health and outcomes. The team has decided that which health care delivery system would best meet the population's needs
a health clinic run by an advanced practice registered nurse (APRN)
It is important for members of the nursing profession to understand and be able to interpret managed care to clients and families. The nurse describes managed care as:
a healthcare system that is aimed at controlling healthcare costs while maintaining quality of care
The nurse is providing care to several clients. For which client should the nurse include secondary care in the nursing plan of care?
a middle-aged client who presents with new-onset angina
When conducting an education program for a group preparing for retirement, the nurse would include information about applying for Social Security benefits and Medicare insurance. The nurse would include in the education that Medicare is a federally funded insurance program which bases the fee for payment on what?
a prospective payment plan based on a predetermined fixed cost
Nursing students are reviewing information about the changes in the health care industry and the effects on the scope of nursing practice. The students demonstrate understanding of this information when they identify what as having significantly affected the delivery of home health care?
advances in technology
The nurse is providing care to several clients on a medical-surgical unit. For which client's plan of care should the nurse include information regarding extended care?
an older adult client who fell at home & required a hip replacement
Which nursing intervention is an example of tertiary preventive care?
assisting w/ speech therapy a client with a traumatic brain injury
A preferred provider organization is described as a:
business arrangement between community health care providers & an insurance company
A client believes that to restore optimal health it takes more than treating only the body. The client believes that the mind and spirit must be addressed as well. What is this perspective of health?
holism
Angina
chest pain
What is a misconception about chronic disease?
chronic illnesses cannot be prevented
A nurse is evaluating clients in an outpatient clinic. Which client requires the nurse to include a secondary illness in the care plan?
client w/ a history of chronic obstructive pulmonary disease (COPD) now has symptoms of right side heart failure
Which is the primary reason extended care facilities have proliferated in recent years?
clients being discharged from the hospital while their care requirements remain beyond the scope of home care
A nurse working for a home health agency is scheduled to evaluate a client with worsening heart failure to determine whether the client is a candidate for the new "Hospital at Home" program. Which statement accurately reflects an outcome for this program?
clients in the "Hospital at Home" program have been found to require shower lengths of stay than when admitted to the acute care setting
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 is a current trend in health care consumers?
increased knowledge of health care
The nurse is performing a routine assessment of a client who has a prosthetic arm as a result of a small plane crash many years earlier. How should the nurse best understand this client's health?
despite the loss of a limb, the client may identify as being healthy
The growth in home health care is largely attributed to which factor?
early discharge of clients from the hospital setting
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
The goals of health care reform include which?
focusing on cost containment w/ improved access & quality of services for everyone
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
a state of complete physical, mental, & social well-being
health
Primary Care
health care at a basic rather than specialized level for people making an initial approach to a doctor or nurse for treatment.
What is the primary focus of health care today?
health promotion
A nursing student has learned that an increasing number of individuals now live with one or more chronic illness. What health condition is an example of a chronic illness?
osteoarthritis
An older adult is hospitalized. The client is suffering from poor nutrition. The client does not want to give up his independence, but is living in a neighborhood with an increasing crime rate. The client tells the nurse, "I feel so useless and lonely. My wife died 2 years ago, and my children live out of state. I am afraid to leave the house, but my friends don't want to come visit." Which of the client's problems would the nurse address first?
physiologic
According to Maslow, which category of needs represents the most basic on the hierarchy?
physiologic needs
Managed care organizations (MCOs) are insurers who carefully plan and closely supervise the distribution of health care services. What factor is one of the goals of managed care?
preventing illness through the screening & promotion of health activities
In the 1980s, the nursing care delivery model shifted from a team nursing model to a:
primary nursing model
A client reports that she is in an abusive relationship and does not know how to break it off. Which of Maslow's hierarchy of needs does the nurse need to prioritize most for this client?
safety & security
What is one of the most significant trends in health care today?
shift from hospitals to community-based care
Which lifestyle factor is associated with an increased risk for chronic diseases?
smoking
What is one way in which nurses can help shape health care reform?
support legislation to improve care
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
You are the nurse employed in an acute care hospital. The head nurse states that you will be caring for 12 clients with the help of two nurse assistants. This is considered to be what type of nursing care delivery?
team nursing
The nurse is implementing the principles of the high-level wellness model to plan the care of a client with complex needs. What characteristic of the client will best support their wellness within this model of health?
the client is willing & able to accept responsibility for their own life
A child, age 4 years, has leukemia but is now in remission. What does it mean to be in remission when one has a chronic illness?
the disease is present, but symptoms are not experienced
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
idiopathic
unknown cause
When providing care to a client, what perspective is followed by the nurse?
viewing the client's health as a balance of body, mind, & spirit
an active state of being healthy
wellness
The home care nurse is caring for a client who is receiving chemotherapy for the treatment of advanced cancer. The client wants to attend an out of town wedding, despite being seriously ill. How should the nurse best perform the role of advocate in this situation?
work w/ the care team to remove barriers to the client's travel
