Health and Wellness Exam 2
The nurse leader suffers from headaches, hypertension, and gastrointestinal problems. Which affirmative statement by the leader reflects an appropriate way to manage the stress? "I will avoid protein." "I will plan a vacation." "I will get enough sleep." "I will participate in support groups."
"I will get enough sleep." Headache, hypertension, and gastrointestinal problems indicate physical stress in the leader. Stress can be managed by getting enough sleep. The leader should consume protein in moderate amounts. Planning a vacation would help in managing mental stress. Participating in support groups would help in managing emotional/spiritual stress.
Health promotion efforts within the healthcare system should include efforts related to secondary prevention. Which activities reflect secondary prevention interventions in relation to health promotion? Select all that apply. Encouraging regular dental checkups Facilitating smoking cessation programs Administering influenza vaccines to older adults Teaching the procedure for breast self-examination Referring clients with a chronic illness to a support group
Encouraging regular dental checkups Teaching the procedure for breast self-examination Encouraging regular dental checkups is a secondary prevention activity because it emphasizes early detection of health problems, such as dental caries and gingivitis. Teaching the procedure for breast self-examination is a secondary prevention activity because it emphasizes early detection of problems of the breast, such as cancer. Facilitating smoking cessation programs is a primary prevention activity because it emphasizes health protection against heart and respiratory diseases. Administering influenza vaccines to older adults is a primary prevention activity because it emphasizes health protection against influenza. Referring clients with a chronic illness to a support group is a tertiary prevention activity because it emphasizes care that is provided after illness already exists.
The nurse is teaching a client with multiple sclerosis methods to reduce fatigue. Which statement indicates an understanding of the education? Take a hot bath. Rest in an air-conditioned room. Increase the dose of muscle relaxants. Avoid naps during the day.
Rest in an air-conditioned room. Fatigue is a common symptom in clients with multiple sclerosis [1] [2]. Lowering the body temperature by resting in an air-conditioned room may relieve fatigue; however, extreme cold should be avoided. A hot bath or shower can increase body temperature, producing fatigue. Muscle relaxants, prescribed to reduce spasticity, can cause drowsiness and fatigue. Planning for frequent rest periods and naps can relieve fatigue.
The parent of a school-age child tells the nurse, "Sometimes my child is fatigued in the morning." Upon assessment, the nurse finds that the blood and urine reports of the child are normal. What could be the possible cause of the child's fatigue? The child has a brain tumor. The child often stays up late. The child consumes starchy food. The child watches too much television.
The child often stays up late. The school-age child is often tired after various activities throughout the day. Therefore, staying up late at night may lead to fatigue in the child the next day. Brain tumor may be indicated by headache or blurry vision reported by the child. Watching too much television may result in sensory problems. The nurse has already evaluated the child's blood and urine reports, and thus the child's fatigue is not caused by the consumption of starchy food.
The nurse is teaching a client self-management of skin cancer. Which statement made by the client indicates the need for further learning? "I should use sunscreen when going out." "I should limit sun exposure to between 7 am and 12 pm." "I should wear a hat and opaque clothing when going out." "I should go for a monthly examination of cancerous and precancerous lesions."
"I should limit sun exposure to between 7 am and 12 pm." In the self-management of skin cancer, the client should not go out in the sun between 11 am and 3 pm. This is the time when the sunlight is strongest. Using sunscreen protects a client's skin from the sun's rays. The client should wear a hat and opaque clothing when going out. Going for monthly examination of cancerous and precancerous lesions is recommended.
What is a stressor? A stressor is any stimuli that can produce tension and cause instability within the system. A stressor exists within the client system, such as the physiological and behavioral responses to illnesses. A stressor exists outside the client system; external stressors include changes in healthcare policies or increased the crime rates. A stressor is a term, description, or label given to describe an idea or responses about an event, a situation, a process, a group of events, or a group of situations.
A stressor is any stimuli that can produce tension and cause instability within the system. A stressor is any stimuli that can produce tension and cause instability within the system. Internal factors exist within the client system, like the physiological and behavioral responses to illnesses. External factors exist outside the client system; these stressors include changes in healthcare policies or increased crime rates. A phenomenon is a term, description, or label given to describe an idea or responses about an event, a situation, a process, a group of events, or a group of situations.
A client exhibits physical symptoms in response to stress. What nursing intervention may help the client reduce the use of physical symptoms as a response to stress? Limiting discussions about the problem Providing information regarding medical care Teaching the client how to eliminate stress at home Assisting the client in developing new coping mechanisms
Assisting the client in developing new coping mechanisms Until the client learns new ways of coping with anxiety, this pattern of behavior will continue. Learning new ways to operate will break the pattern. Limiting discussion will avoid the problem. Providing information about medical care will reinforce the sick role. A certain amount of stress is present in everyday family situations; the elimination of stress is impossible.
The nurse plans to teach a client to use healthier coping behaviors that can consciously be used to reduce anxiety. What might these include? Eating, dissociation, fantasy Sublimation, fantasy, rationalization Exercise, talking to friends, suppression Repression, intellectualization, smoking
Exercise, talking to friends, suppression Exercise, talking to friends, and suppression are positive coping behaviors that can be used consciously to promote mental health. Eating, dissociation, and fantasy; sublimation, fantasy, and rationalization; and repression, intellectualization, and smoking are not healthy coping behaviors, and their frequent use can lead to distortions of reality. Also, they are usually not under conscious control.
The pediatric nurse compares the sources of stress in preschoolers of different ages. Which source creates stress in both 3-year-olds and 4-year-olds? Nap or Bedtime Insecurity Questions Fears
Fears Fears are a source of stress in children of both age groups. The fears for a 3-year-old may be precipitated by imagination. This child may also fear dogs or other animals. A 4-year-old picks up fears from adults. This child may fear a dark room or anything perceived as "creepy." Insecurity is a source for stress in 4-year-olds. A child in this age group may develop nervous habits, such as nail biting, facial tics, thumb-sucking, and so on. This is not seen in 3-year-olds. Questions and nap or bedtime are sources of stress in 3-year-olds. A 3-year-old continually asks "Why?" and is upset if trusted adults do not respond or do not know the answer. This child may also fear bad dreams, the dark, or missing out on some fun while asleep. These are not sources of stress in 4-year-olds.
The nurse leader finds that a client with a severe vitamin B12 deficiency is extremely fatigued and tends to fall. Which theory does the student nurse think that the nurse leader would find appropriate for prioritizing the need of the client? Role theory Maslow's theory Complexity theory Situational leadership theory
Maslow's theory Maslow's theory prioritizes the needs of the client and, if applying Maslow's theory, the nurse leader would provide for safety needs of the client first. Role theory is associated with an appreciable framework for the development and evaluation of staff. Complexity theory explains that change is an ongoing experience through which a system is adjusted. Situational leadership theory analyzes an individual's knowledge and the work-related task before delegation.
A client is admitted for surgery. Although not physically distressed, the client appears apprehensive and withdrawn. What is the nurse's best action? Orient the client to the unit environment. Have a copy of hospital regulations available. Explain that there is no reason to be concerned. Reassure the client that the staff is available if the client has questions.
Orient the client to the unit environment. Orienting the client to the hospital unit provides knowledge that may reduce the strangeness of the environment. Having a copy of hospital regulations available is part of orienting the client to the unit. This alone is not enough when orienting a client to the hospital. Explaining that there is no reason to be concerned may be false reassurance because no one can guarantee that there is no reason to be concerned. Reassuring the client that the staff is available to answer questions implies that staff members are available only if the client has specific questions.
A nurse concludes that a client has successfully achieved the long-term outcome of mobilizing effective coping responses when the client states the plan to do what when feelings of anxiety begin? Perform a relaxation exercise. Get involved in some type of quiet activity. Avoid the situation that precipitated the anxiety. Examine carefully what precipitated the anxiety.
Perform a relaxation exercise. Relaxation techniques refocus energy and eventually ease physical and emotional stress. Getting involved in some type of quiet activity is not always possible; forced quiet activity may increase stress and anger rather than reduce it. Avoiding the situation that precipitated the anxiety is not always possible; stress can develop from a variety of feelings stimulated by many situations. What precipitated feelings of anxiety is not easy to identify; it is better to learn to deal with feelings once they develop.
What is the basic therapeutic tool used by the nurse to foster a client's psychologic coping? Self Milieu Helping process Client's intellect
Self The self is often the most important tool available to the nurse to help a client cope; to be therapeutic, the nurse must be present, actively listening, and attentive. The environment is important, but it is not the most basic tool. The nurse first must use the self before the helping process can begin. The client's intellect is not generally a therapeutic tool used by the nurse.
Which therapeutic communication technique involves using a coping strategy to help the nurse and client adjust to stress? Sharing hope Sharing humor Sharing empathy Sharing observations
Sharing humor Sharing humor is a therapeutic communication technique that involves using a coping strategy that adds perspective and helps the nurse and client adjust to stress. Nurses should recognize that hope is essential for healing and communicate a sense of possibility. Sharing empathy is the ability to understand and accept another person's reality, accurately perceive feelings, and communicate this understanding to the other. Sharing observations often helps a client to communicate without the need for extensive questioning, focusing, or clarification.
The nurse teaches a client methods of coping with anger. The nurse concludes that the client has learned the most effective method when the client states that the client will do what when angry? Go for a long jog. Talk about the anger. Go to the basement to scream. Concentrate on what caused the anger
Talk about the anger. Talking about angry feelings is better than acting them out; this response indicates that the client has learned a positive coping method. Although taking a long jog or going to the basement to scream may help, it is an isolated activity that does not permit sharing of feelings and may not always be possible. Concentrating on what made the client angry may result in an escalation of angry feelings.
A client who has severe rheumatoid arthritis becomes depressed and is admitted to the psychiatric unit. The nurse begins to work with the client in one-on-one sessions to help with coping with the depressive episode. What is the best long-term outcome for this client? The client will eat at least two meals per day with other clients. The client will maintain self-care and attend structured activities. The client will make a positive verbal comment to another client daily. The client will decrease negative thinking about self, others, and life.
The client will decrease negative thinking about self, others, and life. The best long-term goal is that the client attains a positive attitude about the self, others, and life in general; this indicates that treatment has been effective and the client may be discharged. Eating at least two meals per day with other clients is a short-term goal associated with a therapeutic milieu. Maintaining self-care and attending structured activities is a short-term goal and an expected behavior on an inpatient unit. Making a positive verbal comment to another client daily is an intermediate goal that helps the client focus on others; this goal is a step toward achieving long-term goals.
A nurse moves into the working phase of a therapeutic relationship with a depressed client who has a history of suicide attempts. What question should the nurse ask the client when exploring alternative coping strategies? "How have you managed your problems in the past?" "What do you feel that you've learned from this suicide attempt?" "How will you manage the next time your problems start piling up?" "Were there other things going on in your life that made you want to die?"
"How will you manage the next time your problems start piling up?" "How will you manage the next time your problems start piling up?" focuses the interaction toward the future and invites the client to explore alternative coping strategies. "How have you managed your problems in the past?" explores past coping strategies and should have been asked as a part of the initial assessment. "What do you feel that you've learned from this suicide attempt?" is an attempt to explore the client's insight into current coping strategies that should have been made before any discussion of the alternatives. "Were there other things going on in your life that made you want to die?" asks the client once more to ensure that all the precipitating stressors have been identified; this should have been done in the initial assessment.
A female client who physically abused her 9-year-old son is undergoing treatment to help her control her behavior. Which statement indicates that the client has developed a safe coping method to help her deescalate? "I promise that I won't get so angry when my son causes trouble again." "If my son gets straightened out, we shouldn't have these kinds of problems." "I think the root of the problem is when my husband comes home after drinking." "If I get angry at my son again, I'm going to need a pillow in the bedroom to punch."
"If I get angry at my son again, I'm going to need a pillow in the bedroom to punch." Verbalization of the need to take out her anger on an inanimate object indicates the potential for increased impulse control; this is important in the prevention of further abuse. Promising not to get angry is unrealistic because all parents become angry with their children at some time or another. Placing the blame on the child or the spouse, rather than on the mother's own behavior, indicates a lack of progress toward controlling anger.
A nurse is recalling the various levels of preventive care to promote health, wellness, and to prevent illness. Which scenario is a perfect example of primary prevention? An infant receives rotavirus vaccination in the hospital setting. An adult in the early stages of Parkinson's disease is advised to perform adequate exercise. An older adult permanently paralyzed due to brain hemorrhage is transferred to a long-term care facility. An older adult with Parkinson's disease is administered carbidopa-levodopa to slow the progression of the disease.
An infant receives rotavirus vaccination in the hospital setting Primary prevention consists of all health promotion efforts and wellness education activities. An infant receiving the rotavirus vaccination is an example of primary prevention. An adult in the early stages of Parkinson's disease is advised to perform adequate exercises; this is an example of secondary prevention. An older adult permanently paralyzed due to brain hemorrhage is transferred to a long-term care facility. This is an example of tertiary prevention. An older adult with Parkinson's disease is administered carbidopa-levodopa to slow the progression of the disease. This is an example of secondary prevention.
The nurse is planning care for the family of a preschool-age child who has a chronic illness. Which activities should the nurse recommend to decrease the risk for compassion fatigue? Select all that apply. Exercising Moving away Developing a hobby Fostering social relationships Sleeping more than twelve hours each night
Exercising Developing a hobby Fostering social relationships The nurse should recommend exercising, developing a hobby, and fostering social relationships as activities that can decrease the risk for compassion fatigue. Moving away is avoidance behavior that does not address exhaustion from overwhelming caregiving responsibilities. Sleeping more than the body requires is also an avoidance behavior.
The parents of a young adult client visit regularly. After one visit the client becomes very agitated. What should the nurse do to relieve the client's distress? Take the client to the coffee shop for a treat. Distract the client by providing a unit activity. Limit the client's future contact with the parents. Explore the client's response to the parents' behavior.
Explore the client's response to the parents' behavior. Helping the client understand the meaning of a family member's behavior and responses to it reduces the family member's emotional control over the client. Taking the client to the coffee shop for a treat ignores the necessity of clarifying the family member's behavior. Distraction is not a therapeutic way to deal with realistic feelings. Limiting the client's future contact with the parents is a temporary measure and does not reduce the emotional conflict with the family member.
In an outpatient mental health clinic a nurse is working with a client who is beginning to address more effective ways to handle stressful situations. The best nursing action to include in the plan of care is to have the client do what? Identify unhealthy habits that need to be altered. Determine the benefits of a rehabilitation program. Learn about the benefits of antianxiety medications. Develop a consistent method for performing self-care.
Identify unhealthy habits that need to be altered. The identification of unhealthy habits or specific problems will allow the client to determine which additional coping skills need to be developed and practiced. A rehabilitation program is more appropriate for clients with psychotic or substance abuse disorders, not clients who are experiencing anxiety. Further assessment is required before initiation of the use of medication. Although a consistent method for performing self-care is important, it is not the priority.
A client complaining of fatigue is admitted to the hospital with a diagnosis of chronic obstructive pulmonary disease (COPD). What should the nurse do to prevent fatigue? Provide small, frequent meals Encourage pursed-lip breathing Schedule nursing activities to allow for rest Encourage bed rest until energy level improves
Schedule nursing activities to allow for rest Rest limits muscle contractions, which diminishes oxygen needs and decreases fatigue. Although small, frequent meals may decrease pressure on the diaphragm and facilitate breathing, this precaution does not address the client's fatigue. Although pursed-lip breathing facilitates gas exchange, it does not reduce the metabolic demand for oxygen. Bed rest promotes pooling of pulmonary secretions, which may aggravate the client's respiratory status.
A nurse is preparing to discharge a client who is partially paralyzed following a stroke. What should the nurse teach the client's family about recognizing caregiver role strain? Select all that apply. The caregiver has disturbed sleep patterns. The caregiver has reduced appetite and weight. The caregiver is more concerned about personal appearance. The caregiver engages in leisure activities as often as possible. The caregiver is fearful about administering medications to the client.
The caregiver has disturbed sleep patterns. The caregiver has reduced appetite and weight. The caregiver is fearful about administering medications to the client. A family should recognize that when the caregiver has disturbed sleep patterns, the caregiver is experiencing strain. Changes in appetite, weight, and sleep patterns are all indicative of caregiver role strain. A caregiver experiences strain while learning about new therapies and administering medications to the client. A caregiver experiencing role strain is not concerned about personal appearance and may withdraw from social groups. A caregiver also does not spend time in any leisure activities if overcome by strain.