Patho Ch-1 Prep U Questions
The nurse is planning care for a client. Which information is most important for the nurse to apply in developing a plan of care? facility's current policy and procedures available on the hosptial unit current peer-reviewed research findings as part of evidence-based practice current clinical practice guidelines combined with the client's health care goals health care provider's currently prescribed treatments for the client
current clinical practice guidelines combined with the client's health care goals Clinical practice guidelines are based on evidence and expert consensus and are most appropriate when informing decisions about health or planning care. However, providers must also consider individual client wishes and impact on quality of life when applying these guidelines, so the client's health goals must also be incorporated. The nurse should not take actions based on isolated published research alone, because these may not yet be accepted into clinical practice. If hospital policy or current prescriptions are contrary to clinical practice guidelines, the nurse should bring this forward for review rather than taking action based on these alone.
A couple is seeking genetic counseling because they want to have a child but are concerned about having the genetic disorder, Tay-Sachs. They both test positive for the trait but have no symptoms themselves. What does the nurse recognize is the outcome of this process? They are both carriers of the disease and can pass the gene on to their unborn child if the woman becomes pregnant. The test must be wrong since neither have signs or symptoms of the disease. Just because they both test positive does not mean the child will get the disease. The couple will eventually have the disease.
They are both carriers of the disease and can pass the gene on to their unborn child if the woman becomes pregnant. Carrier status refers to a person who harbors an organism but is not infected, as evidenced by antibody response or clinical manifestations. This person still can infect others. Carrier status may be of limited duration or it may be chronic, lasting for months or years.
The health care team is attempting to determine the cause of a client's disease. What does the nurse recognize that this will be documented as? Condition Clinical manifestations Etiology Signs
Etiology The causes of disease are known as etiologic factors.
A client states, "I do not know why the health care provider (HCP) bothered discussing the prognosis for my illness with me since the outcome is not certain." How will the nurse respond?
"Being aware of the prognosis helps you make decisions about treatment options." The nurse should answer the client's question which is related to "why" prognosis is shared, even if uncertain. Prognosis is the probable outcome for recovery from a condition or disease. It is often presented in relation to treatment options so the client can make informed treatment decisions. Telling the client the HCP is only focusing on legal reasons does not answer the question accurately. Telling the client to tell the HCP not to discuss the prognosis is not helpful as the HCP has already had this discussion with the client. The nurse's response should be client-centered and not focused on the HCP's desire for treatment adherence.
The nurse is educating a client who will be having a series of diagnostic tests. The clients asks the nurse, "What is the importance of me having all of these tests? I told the physician I know what is wrong with me!" What is the best response by the nurse? "The physician orders a lot of tests to be sure he covers all of the possible illnesses that you could have." "The physician wants to validate what he believes the client problem is."
"The physician wants to validate what he believes the client's problem is." The diagnostic tests are ordered to validate what is thought to be the problem. They are also performed to determine other possible health problems that were not obtained from the history and PE, but may be present given the signs and symptoms identified.
A daycare provides daily services to 60 children from 3 months to 5 years of age. Fifteen of the children have experienced an outbreak of diarrhea within the past week. The incidence rate of diarrhea among the children cared for by this daycare is at what percent? 50% 15% 60% 25%
25
A nurse is conducting a staff educational program on diagnostic tests. The nurse should include that the normal value of a laboratory test represents the test results that fall within which distribution level?
95% The normal value of a laboratory test represents the test results that fall within the 95% distribution level.
A physician is providing care for a number of clients on a medical unit of a large, university hospital. The physician is discussing with a colleague the differentiation between diseases that are caused by abnormal molecules and molecules that cause disease. Which client most clearly demonstrates the consequences of molecules that cause disease? A 30-year-old homeless man who has pneumocystis carinii pneumonia (PCP) and is HIV positive. A 91-year-old woman who has experienced an ischemic stroke resulting from familial hypercholesterolemia A 19-year-old man with exacerbation of his cystic fibrosis requiring oxygen therapy and chest physiotherapy. A 31-year-old woman with sickle cell anemia who is receiving a transfusion of packed red blood cells
A 30-year-old homeless man who has pneumocystis carinii pneumonia (PCP) and is HIV positive PCP is an example of the effect of a molecule that directly contributes to disease. Sickle cell anemia, familial hypercholesterolemia, and cystic fibrosis are all examples of the effects of abnormal molecules.
A nurse is evaluating findings from the Nurses' Health Study, a study that has followed a group of nurses since 1976 to study the relationship between oral contraceptive use and breast cancer. The nurse evaluates the findings using criteria for which type of study? Cross-sectional Case control Cohort Qualitative
A cohort study, also known as a longitudinal study, follows a group of people over a period of time to observe specific health outcomes. Because the Nurses' Health Study followed the same group of nurses since 1976, it is an example of a cohort, or longitudinal, study.
The nurse observes that blood pressure readings taken by a new unlicensed assistive personnel (UAP) are very different from what other nurses obtain. What does the nurse understand is occurring with these readings?
A lack of reliability in the readings of the UAP. Reliability refers to the extent to which an observation, if repeated, gives the same result. A poorly calibrated blood pressure machine may give inconsistent measurements of blood pressure, particularly of pressures in either the high or low range. Reliability also depends on the person's skill in taking the measurements.
The nurse observes that blood pressure readings taken by a new unlicensed assistive personnel (UAP) are very different from what other nurses obtain. What does the nurse understand is occurring with these readings? The validity of the blood pressure calibration is inconsistent. A lack of reliability in the readings of the UAP.
A lack of reliability in the readings of the UAP. Reliability refers to the extent to which an observation, if repeated, gives the same result. A poorly calibrated blood pressure machine may give inconsistent measurements of blood pressure, particularly of pressures in either the high or low range. Reliability also depends on the person's skill in taking the measurements.
The nurse is performing an assessment on a newly admitted client with asthma and hears wheezes in the upper lobes of the lungs. When the nurse documents this finding, the nurse recognize this to be: a sign. a diagnosis. an objective symptom. a complication.
A sign is a manifestation that is noted by the observer, in this case the nurse auscultating the breath sounds. A symptom is a subjective report by the client. A diagnosis is not formed by the nurse auscultating lung sounds, as wheezes can be a manifestation of other illnesses. A complication is a possible adverse extension of a disease or outcomes from treatment.
When the nurse is assisting with the diagnostic process for a client with an illness, what is a priority when compiling all of the data to have an accurate diagnosis? Select all that apply. A careful history Financial information Diagnostic tests Social data Detailed physical examination
A, C, E The diagnostic process requires a careful history, physical examination, and diagnostic tests. The history is used to obtain a person's account of his or her symptoms and their progression, and the actors that contribute to a diagnosis. The physical examination is done to observe for signs of altered body structure or function. The diagnostic tests are ordered to validate what is thought to be the problem. They are also performed to determine other possible health problems that were not obtained from the history and physical examination, but may be present given the signs and symptoms identified.
An infant has a difficult time passing through the birth canal and the physician uses forceps to deliver the child. In the process, the facial nerve was damaged, resulting in a facial droop. Which condition does the nurse recognize this to be? Pathogenesis Congenital condition Morphologic change Acquired defect
Acquired defect Acquired defects are those that are caused by events that occur after birth. These include injury, exposure to infectious agents, inadequate nutrition, lack of oxygen, inappropriate immune responses, and neoplasia. Congenital conditions are defects that are present at birth, although they may not be evident until later in life or may never manifest. Morphologic changes are concerned with both the gross anatomic and microscopic changes that are characteristic of a disease. Pathogenesis explains how the disease process evolves.
Two years ago, the nurse assisted with a difficult vaginal birth and the infant sustained facial paralysis related to the use of forceps. What form of defect does the nurse recognize this injury is related to? Acute illness Acquired defect Chronic illness Congenital defect
Acquired defects are those that are caused by events that occur after birth. These include injury, exposure to infectious agents, lack of oxygen, inappropriate immune responses, and neoplasia. Many disease are thought to be the result of a genetic predisposition and an environmental event(s) that serve as a trigger to initiate disease development.
As part of a screening program for prostate cancer, men at a senior citizens center are having their blood levels of prostate-specific antigen (PSA) measured. Which statement would best characterize high positive predictive value but low negative predictive value for this screening test? All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer. The test displayed low sensitivity but high specificity. All of the men who had low PSA levels were cancer free; several men who had high levels also remained free of prostate cancer. Men who had low PSA levels also displayed false-positive results for prostate cancer; men with high levels were often falsely diagnosed with prostate cancer.
All of the men who had high PSA levels developed prostate cancer; several men who had low PSA levels also developed prostate cancer. The test's inability to rule out cancer with a low PSA level indicates low negative predictive value. Having a low PSA level suggests high negative predictive value, while men with high levels who remained cancer free indicate a low positive predictive value. High positive predictive value is associated with high sensitivity.
A nurse documenting a client's health history places hypertension under which category? Mortality Acquired Complications Congenital
An acquired condition, such as hypertension, is caused by events that occur after birth.
A client has been diagnosed with a heart attack and has been placed on beta-blockers to reduce the workload on the heart, as well as a statin drug and a low-fat diet to lower cholesterol. Which level of prevention of disease would these therapies be classified?
Because the client has already been diagnosed with an end-point disease, treatment of this disease with medications is tertiary prevention. Secondary prevention could have occurred had the client been tested (screened) for dyslipidemia while asymptomatic and treated to prevent the end point disease of a myocardial infarction (heart attack). Primary prevention would be the use of the lifestyle interventions of diet and exercise to prevent dyslipidemia from developing in the first place. While primary prevention is about treating risk factors to prevent cardiovascular disease, primordial prevention refers to avoiding the development of risk factors in the first place. Primordial prevention is population-based.
A client is diagnosed with Crohn disease and is informed that there is no cure; however, the client will have periods when there are no symptoms and other times when symptoms will be quite severe. What term should the nurse teach the client applies to this disease course? chronic acute carrier state subacute
Chronic A chronic disease implies a continuous, long-term process that is generally thought of as manageable, but incurable. It can run a continuous course or can present with exacerbations (periods of more pronounced symptoms) and remissions (asymptomatic periods). An acute disorder is one that is relatively severe, but self-limiting. A subacute disease is intermediate or between acute and chronic. It is not as severe as an acute disease and not as prolonged as a chronic disease. A carrier state describes having an infectious organism present in the body that could be spread to others, but does not produce any symptoms in the carrier.
When considering the clinical course, a disease that is characterized by remissions and exacerbations is considered to be:
Chronic The clinical course describes the evolution of a disease. A disease can have an acute or chronic course. Chronic disease implies a continuous, long-term process. A chronic disease can run a continuous course or can present with exacerbations (aggravation of symptoms and severity of the disease) and remissions (a period during which there is a decrease in severity and symptoms). An acute disorder is one that is relatively severe, but self-limiting. The terms preclinical and subclinical are used when discussing the severity of the disease.
The nurse is caring for clients with chronic illnesses. Which characteristic of chronic illness will the nurse apply when developing plans of care? Chronic illnesses may have periods of stability and acute exacerbations. Chronic illnesses have a stable and predictable course. Chronic illnesses are adequately managed through lifestyle changes. Chronic illnesses result in systemic manifestations rather than local ones.
Chronic illnesses may have periods of stability and acute exacerbations. Chronic illnesses generally last longer than 6 months and often have insidious, or gradual, onset. With chronic disease, the person can have remissions, or symptom-free periods, and acute exacerbations when symptoms are more pronounced, making the course not always predictable. Chronic illnesses do not necessarily produce more systemic manifestations than local ones; this will depend on the type of illness. Although lifestyle management is often part of treatment, this is not always adequate and medications are often required. Chronic illnesses generally last longer than 6 months and often have insidious, or gradual, onset. With chronic disease, the person can have remissions, or symptom-free periods, and acute exacerbations when symptoms are more pronounced, making the course not always predictable. Chronic illnesses do not necessarily produce more systemic manifestations than local ones; this will depend on the type of illness. Although lifestyle management is often part of treatment, this is not always adequate and medications are often required.
Which client conditions would be considered a congenital defect? Select all that apply. Cleft lip and palate Rheumatoid arthritis Club foot Hypospadias Colon cancer
Cleft lip and palate Club foot Hypospadias Congenital defects are present at birth and occur as a result of neonatal factors and may be influenced by genetic influences, environmental factors, maternal drug use, and radiation. Acquired defects are those that develop as a result of events after birth, including exposure to infectious agents, injury, inadequate nutrition, lack of oxygen, inappropriate immune response, and neoplasia.
A nurse is interpreting the test results of a client's screening test for cancer. If the client's result is negative and the test has a 95% specificity, the nurse should conclude that there a 95% chance of which outcome?
Client does not have cancer. A screening test with a 95% specificity means that the test correctly identifies 95 of 100 normal people as not having the disease. So if the client has a negative result on a test with a 95% specificity, there is a 95% chance that the client does not have the disease.
A client is experiencing signs and symptoms of congestive heart failure. The client's disease is in which phase of its clinical course? Postclinical Clinical Subclinical Preclinical
Clinical When a client is experiencing signs and symptoms of disease, the disease is considered to be in the clinical phase of its clinical course. Subclinical refers to having a disease that is not producing symptoms and may never progress to being symptomatic while preclinical refers to a condition that is currently not producing symptoms, but will progress to a symptomatic stage. There is no "postclinical" stage.
A nurse who has worked with ostomy clients for several years is adept at measuring and cutting the stoma wafer to the correct size for each client's stoma. This is an example of the nurse using: evidence-based practice. research. clinical expertise. intuition.
Clinical Expertise The term "clinical expertise" refers to proficiency and judgment that individual clinicians gain through clinical experience, such as becoming adept at measuring and cutting stoma wafers for ostomy clients.
Researchers have designed a study where the health of a large group of recent newborns will be followed for several years. What type of study is this? repetition double-blind placebo cohort case-control
Cohort When a certain group of persons are enrolled in study, they are known as a cohort. Cohort members are chosen to have specific similar characteristics. These studies are often longitudinal, following the cohort over time to observe one or more specific health outcomes. A case-control study is done on an individual, case-by-case situation. The double-blind placebo is a drug study. Repetition is a type of study carried out in a laboratory with very tight controls in place.
A client delivers a child born with an extra digit. The client states that she had the same thing when she was born. What term would the nurse document in the record regarding this defect? An acute defect A chronic defect Congenital condition Acquired defect
Congenital Condition Congenital conditions are defects that are present at birth, although they may not be evident until later in life or may never manifest. Congenital conditions may be caused by genetic influences, environmental factors, maternal drug use, irradiation, or gestational problems in utero, or a combination of genetic and environmental factors.
A client diagnosed with chlamydia asks the nurse how this infection has occurred. The explanation by the nurse would involve a description of which aspect of the disease? Histology Pathogenesis Morphology Etiology
Etiology Pathogenesis is the sequence of cellular and tissue events that take place from the time of initial contact with an etiologic agent until the ultimate expression of a disease. The causes of disease are known as etiologic factors. Morphology refers to the fundamental structure or form of cells or tissues. Histology deals with the study of the cells and extracellular matrix of body tissues.
What do morbidity and mortality statistics refer to? Effects a disease has on a person's life and treatment Long-term consequences and recovery rates of a disease Cause of death and impact on the family because of a disease Functional effects and death-producing characteristics of a disease
Functional effects and death-producing characteristics of a disease Morbidity and mortality statistics provide information about the functional effects (morbidity) and death-producing (mortality) characteristics of a disease. Morbidity statistics do address the effects a disease has on a person's life and the long-term consequences of the disease state, but morbidity and mortality statistics taken together have a broader scope. Neither morbidity nor mortality statistics address recovery rates from a disease or treatment modalities for a disease. Although mortality does address the causes of death in a given population, morbidity does not address the impact the disease state has on the family.
Nurses are discussing a new blood test that helps establish a differential diagnosis between shortness of breath with a cardiac etiology and shortness of breath with a respiratory/pulmonary etiology. A positive result is known to indicate a cardiac etiology. The marketers of the test report that 99.8% of clients who have confirmed cardiac etiologies test positive in the test. However, 1.3% of clients who do not have cardiac etiologies for their shortness of breath also test positive. Which statement best characterizes this blood test? High sensitivity, low specificity Low validity, high reliability High specificity, low reliability High sensitivity, low reliability
High sensitivity, low specificity A large number of clients would receive the correct positive diagnosis (high sensitivity), while a significant number would receive a false-positive diagnosis (low specificity). The information given does not indicate low reliability or low validity.
Nurses are discussing a new blood test that helps establish a differential diagnosis between shortness of breath with a cardiac etiology and shortness of breath with a respiratory/pulmonary etiology. A positive result is known to indicate a cardiac etiology. The marketers of the test report that 99.8% of clients who have confirmed cardiac etiologies test positive in the test. However, 1.3% of clients who do not have cardiac etiologies for their shortness of breath also test positive. Which statement best characterizes this blood test? Low validity, high reliability High sensitivity, low reliability High specificity, low reliability High sensitivity, low specificity
High sensitivity, low specificity A large number of clients would receive the correct positive diagnosis (high sensitivity), while a significant number would receive a false-positive diagnosis (low specificity). The information given does not indicate low reliability or low validity.
Pathogenesis is the term used to describe the sequence of cellular and tissue events that occur from the time of first contact with an etiologic agent until the disease becomes evident. What is another way of defining pathogenesis? Multiple factors that predispose a person to a particular disease What sets the disease process in motion How the disease process evolves The causes of disease
How the disease process evolves The pathogenesis of a disease is the mechanism by which an etiologic factor causes the disease. It encompasses the period between when the disease process first begins to the point when the disease presents itself. Etiology is what sets the disease process in motion, or what causes the disease. Risk factors are multiple factors that predispose a person to a particular disease.
The nurse is evaluating a client's understanding of the risk factors for heart disease. The nurse corrects the client based on which inaccurate comment? "I will switch from smoking to chewing tobacco." "If I lose as little as 10 pounds, it will help cut my risk." "A healthy blood pressure should be below 120/80." "My hemoglobin A1c should be between 4% and 5.6%."
I will switch from smoking to chewing tobacco The nurse needs to correct the client's misconception. Tobacco use is a strong factor in heart disease no matter which form is used. The other client's comments are accurate. Overweight clients who implement weight reduction experience benefits even if they are still above their ideal weight. For the average individual, a blood pressure between 90/60 and 120/80 is considered healthy. A healthy hemoglobin A1c is between 4% and 5.6%. Clients at increased risk are those with higher levels.
Which attribute is a benefit of health care providers using an evidence-based practice guideline?
It directs research into forming a diagnosis and treatment for a certain condition. Evidence-based practice guidelines often use methods to combine evidence from different studies to produce a more precise estimate of the accuracy of a diagnostic method or the effects of an intervention method. Practice guidelines require continuous updates as new research is conducted and supported. Practice guidelines are developed on numerous research studies. Not all research is directed toward healing time.
Despite using the same screening tools as previous years (which have been confirmed as highly valid, reliable, sensitive, and specific), the public health nurse notes an increase in the number of people in the population testing positive for type 2 diabetes this year. What action should the nurse take? Examine the commonalities of those people who did not test positive for diabetes. Ask all people who tested positive to return to the screening clinic to be retested. Investigate the population for factors that would cause an increase in the prevalence of diabetes. Send all people who test positive to a laboratory for assessment using a different diagnostic test.
Investigate the population for factors that would cause an increase in the prevalence of diabetes. Since the validity, reliability, sensitivity, and specificity of the test has been confirmed, the reason for the increase in prevalence should be investigated. Repeating the same test on the same people would be a measure of reliability; this has already been established. Sending the people for laboratory testing would only be needed if validity was in question. Examining the commonalities of those who did not test positive is not the priority compared to investigating the commonalities of those who did test positive.
The nurse is interested in conducting an epidemiologic research study. Which research question should the nurse choose as appropriate for an epidemiologic study? Which substances in cigarette smoking contribute to heart disease? Which is more effective in the treatment of cardiac disease, metoprolol or atenolol? Does oxygen improve the quality of life for clients living with lung cancer? Is there a relationship between smoking rates and incidence of heart disease?
Is there a relationship between smoking rates and incidence of heart disease? Epidemiologic studies look for patterns of people affected with a particular disorder such as age, race, or lifestyle habits. Epidemiologists are concerned with whether something happens versus how it happens or the best treatment for a particular disease. A study examining the components of cigarette smoke, or the effects of medications would both be examples of biomedical studies. Studies examining quality of life are usually qualitative in nature and may be case-controlled or cohort in design, but are not focused on patterns of disease in a population, so are not related to epidemiology.
Which attribute is a benefit of health care providers using an evidence-based practice guideline? With continued use, it will decrease healing time for clients. It uses one research method for delivery of care. It directs research into forming a diagnosis and treatment for a certain condition. Once a practice guideline is well developed, it does not require modification.
It directs research into forming a diagnosis and treatment for a certain condition. Evidence-based practice guidelines often use methods to combine evidence from different studies to produce a more precise estimate of the accuracy of a diagnostic method or the effects of an intervention method. Practice guidelines require continuous updates as new research is conducted and supported. Practice guidelines are developed on numerous research studies. Not all research is directed toward healing time.
A disease agent can affect more than one organ of the body, and more than one disease agent can affect the same organ of the body. Which term best describes this aspect of disease etiology? Complicated and hard to diagnose Multifactorial in origin Singular cause Simple and less complex to diagnose
Multifactorial in Origin The majority of diseases are multifactorial in origin. This is especially true of diseases such as cancer, heart disease, and diabetes. Most disease states do not have a single cause but instead stem from a number of factors. Some disease states are complicated and hard to diagnose, such as multiple sclerosis, whereas some are simple, straightforward, and easy to diagnose, such as a broken leg.
When attempting to reach a health diagnosis, the health care provider commonly applies four primary steps. Place the steps for reaching a diagnosis in order. Use all the options. 1Obtain clinical history. 2Conduct a physical examination. 3Perform diagnostic testing. 4Determine the most likely cause of the client's presentation.
Obtain clinical history. Conduct a physical examination. Perform diagnostic testing. Determine the most likely cause of the client's presentation. The client's presentation, including clinical history and any initial complaints, helps to direct the rest of the steps. For example, when a client presents reporting chest pain, this will direct the focus of the examination and diagnostic testing. This course would be different for a client presenting with hip pain. The findings of the physical examination will direct more specific diagnostic testing, though some basic investigations may be done concurrently with the examination. Finally, the health care provider would need to weigh the findings against client characteristics and determine the most likely cause of the clinical findings.
The nurse is caring for a client in the burn unit who has sustained partial and full thickness burns over 16 percent of the body. What type of etiologic factor does the nurse recognize these burns are? Physical forces Biologic agents Chemical agents Psychological factors
Physical Forces The causes of disease are known as etiologic factors. Among the recognized etiologic agents are biologic agents (e.g., bacteria, viruses), physical forces (eg., trauma, burns, radiation), chemical agents (e.g., poisons, alcohol), one's genetic inheritance, and nutritional excess or defects.
A school nurse compares the number of cases of measles in one elementary classroom to the number of students in the school. Which term describes this type of comparison? Risk analysis Morbidity Prevalence Primary Prevention
Prevalence Prevalence is a measure of existing disease in a population at a given point in time. Primary prevention is intervention to avoid disease. Morbidity is the functional effect of a disease, such as missed school days. Risk analysis would evaluate which members of the population were at risk for a disease.
The nurse is providing a prenatal class for a group of women at the local women's center. The nurse informs the group about the importance of taking their folic acid supplements for the prevention of neural tube defects. What type of prevention is the nurse providing? Primary prevention Secondary prevention Initial prevention Tertiary prevention
Primary prevention Primary prevention is directed at keeping disease from occurring by removing all risk factors. Examples of primary prevention include the administration of folic acid to pregnant women and women who may become pregnant to prevent fetal neural tube defects; giving immunizations to children to prevent communicable disease; and counseling people to adopt healthy lifestyles as a means of preventing heart disease. Primary prevention is often accomplished outside the health care system at the community level. Some primary prevention measures are mandated by law.
The nurse is providing a prenatal class for a group of women at the local women's center. The nurse informs the group about the importance of taking their folic acid supplements for the prevention of neural tube defects. What type of prevention is the nurse providing? Secondary prevention Primary prevention Initial prevention Tertiary prevention
Primary prevention is directed at keeping disease from occurring by removing all risk factors. Examples of primary prevention include the administration of folic acid to pregnant women and women who may become pregnant to prevent fetal neural tube defects; giving immunizations to children to prevent communicable disease; and counseling people to adopt healthy lifestyles as a means of preventing heart disease. Primary prevention is often accomplished outside the health care system at the community level. Some primary prevention measures are mandated by law.
The nurse is conducting a community program about removing the risk factors that may predispose clients to hypertension. Which type of prevention is the nurse focusing on? Tertiary prevention Primary prevention Prognosis prevention Secondary prevention
Primary prevention is directed at keeping disease from occurring by removing all risk factors. Secondary prevention detects disease early when it is still asymptomatic and treatment measures can effect a cure or stop the disease from progressing. Tertiary prevention is directed at clinical interventions that prevent further deterioration or reduce the complications of a disease once it has been diagnosed.
Which assessment data would a nurse identify as a complication of a disease or disorder? Weight gain of 1 to 2 pounds per week during pregnancy Pulmonary emboli following deep vein thrombosis (DVT) Reduced range of motion following a fracture Hyperlipidemia in cardiovascular disease
Pulmonary emboli are a dangerous complication of DVT. Sequelae are lesions or impairments that follow or are caused by a disease. Reduced range of motion following a fracture is a common, often temporary, result of the injury. Weight gain of 1 to 2 pounds per week during pregnancy is considered normal. Hyperlipidemia is a common cause of cardiovascular disease, not the result of the disease.
Which statement is an example of a prognosis? Folic acid during pregnancy may prevent fetal neural tube defects. The leading cause of death is cancer. The client's chance of a full recovery is 50%. Pressure injuries occur in 2% of hospitalized clients.
The client's chance of a full recovery is 50%. A prognosis refers to the probable outcome and prospect of recovery from disease as demonstrated by "The client's chance of a full recovery is 50%." Stating the occurrence of a disease in a given population is the incidence. Statements that relate information about causes of death refer to mortality.
The nurse notes that a colleague neglects to wipe away the first drop of blood from the sample during point-of-care blood glucose testing; this in contradiction of the unit policy. What action should the nurse take first? Remind the colleague that by failing to adhere to unit policy, the colleague will be at risk of disciplinary action. Remind the colleague that the purpose of discarding the first drop is to improve the reliability of the results. Report the colleague to the nurse in charge so that retraining on using the glucometer can be arranged. Retake the blood glucose on the client to ensure a more accurate result for guiding treatment decisions.
Remind the colleague that the purpose of discarding the first drop is to improve the reliability of the results. Reliability of a diagnostic result depends on a combination of the tools being used and the person's skill in taking the measurements. If the colleague does not perform the steps correctly, the reliability of the results are in question. The nurse should remind the colleague as to why the step of wiping away the initial drop is important for reliability. This approach is the most direct and professional of the options provided. Reporting the colleague to the nurse in charge would only be needed if the colleague did not heed the nurse's direction. Retaking the sample without first explaining to the colleague why the nurse was taking the action would be confusing for the colleague and the client. Threatening the nurse regarding disciplinary action is not necessary in this scenario.
There are three fundamental types of prevention used in health care: primary, secondary, and tertiary. Which statement accurately describes secondary prevention? Secondary prevention takes place within health care systems and involves the services of a number of different types of health care professionals. Secondary prevention goes beyond treating the problem with which the person presents. Secondary prevention detects disease early, and most is done in clinical settings. Secondary prevention is often accomplished outside the health care system at the community level.
Secondary prevention detects disease early, and most is done in clinical settings. Secondary prevention detects disease early in its course when it is still asymptomatic and treatment measures can effect a cure or stop the disease from progressing. Most secondary prevention is undertaken in clinical settings. Tertiary prevention goes beyond treating the presenting problem. Tertiary prevention programs are located within health care systems and involve the services of a number of different types of health care professionals. Primary prevention is often accomplished outside the health care system at the community level.
A client has been diagnosed with a heart attack and has been placed on beta-blockers to reduce the workload on the heart, as well as a statin drug and a low-fat diet to lower cholesterol. Which level of prevention of disease would these therapies be classified? secondary primoridal primary tertiary
Tertiary Because the client has already been diagnosed with an end-point disease, treatment of this disease with medications is tertiary prevention. Secondary prevention could have occurred had the client been tested (screened) for dyslipidemia while asymptomatic and treated to prevent the end point disease of a myocardial infarction (heart attack). Primary prevention would be the use of the lifestyle interventions of diet and exercise to prevent dyslipidemia from developing in the first place. While primary prevention is about treating risk factors to prevent cardiovascular disease, primordial prevention refers to avoiding the development of risk factors in the first place. Primordial prevention is population-based.
A client has been admitted to the intensive care unit with a myocardial infarction. After the client recovers from the acute course of the event and ready for discharge, the nurse provides information about the beta adrenergic blocker, atenolol, that the client will take to prevent complications after the MI. What type of prevention is the nurse providing? Primary prevention Tertiary prevention Initial prevention Secondary prevention
Tertiary prevention is directed at clinical interventions that prevent further deterioration or reduce the complications of a disease once it has been diagnosed. An example is the use of beta adrenergic drugs to reduce the risk of death in people who have had a heart attack. The boundaries of tertiary prevention go beyond treating the problem with which the person presents.
The Framingham cohort study examined characteristics of people who would later develop which disease? Seizures Coronary disease Chronic obstructive pulmonary disease (COPD) Lung cancer
The Framingham cohort studied examined the characteristics of the people who would later develop coronary disease. The study was set up in 1950 by the U.S Public Health Service.
The World Health Organization (WHO) defines health as: the absence of disease and infirmity. what an individual defines as his or her health. the ability to perform activities of daily living. a state of complete physical, mental, and social well-being.
The WHO has defined health as the state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity. The other statements do not define health according to the WHO.
A client has been admitted for exacerbation of his chronic obstructive pulmonary disease (COPD), and a respiratory therapist (RT) is assessing the client for the first time. Which aspect of the client's current state of health would be best characterized as a symptom rather than a sign? The client's respiratory rate is 31 breaths per minute. The client notes that he has increased work of breathing when lying supine. The client's oxygen saturation is 83% by pulse oximetry. The RT hears diminished breath sounds to the client's lower lung fields bilaterally.
The client notes that he has increased work of breathing when lying supine. Symptoms are subjective reports by the person experiencing the health problem, such as reports of breathing difficulty. Oxygen levels, breath sounds, and respiratory rate are all objective, observable signs of disease.
A nurse researcher is collecting data on the number of people who have a current diagnosis of diabetes in a local population. Which term categorizes the aspect of epidemiology the nurse is collecting? prevalence mortality incidence morbidity
The prevalence rate is a measure of an existing disease in a population at a given point in time. An incidence rate reflects the number of new disease cases arising in an at-risk population, not all clients currently living with the diagnosis. Therefore, incidence helps predict the risk of being diagnosed with a certain condition in a population. Morbidity and mortality statistics provide information about the functional effects (morbidity) and death-producing (mortality) characteristics of a disease.
A client with anemia has a regularly scheduled hemoglobin test result of 10 g/dL (100 g/L). While traveling a week later, the client went to urgent care where a hemoglobin level of 15 g/dL (150 g/L) was reported. For which reason will the nurse question the findings of the second result? Reliability Specificity Validity Sensitivity
Validity Validity is the extent to which a tool measures what it is designed to measure. Without intervention, the client's two hemoglobin values should be very similar to each other, and the nurse should doubt the accuracy of the second result. Reliability is the expectation that a repeated action will produce the same result. Because this is a different lab, it is not the identical action. Sensitivity refers to the proportion of a population that tests positive for a disease. Specificity is the proportion of a population without disease that will test negative.
When the nurse questions the blood glucose level obtained via a glucometer, a serum blood level is ordered. This protocol is directed toward ensuring which measure of standardization?
Validity refers to the extent to which a measurement tool measures what it is intended to measure, and is assessed by comparing a measurement method with the best possible method of measure that is available. Thus, the validity of a fingerstick method of testing blood glucose is compared with serum testing in the laboratory. Reliability refers to the extent to which an observation, if repeated, gives the same result. Predictive value is the extent to which an observation or test result is able to predict the presence of a given disease or condition. In the field of clinical laboratory measurements, standardization is aimed at increasing the accuracy and reliability of measured values.
A client with hypertension is given an IV medication and has an anaphylactic reaction. This is considered to be:
a complication. Complications are possible adverse extensions of a disease or outcome from treatment. An example is an anaphylactic reaction to a medication.
Facility policies on wound dressing selection refer the nurse to a dressing algorithm. The nurse anticipates that the algorithm will include: a pictorial representation of various dressings. standing orders for wound care. guidelines for staging pressure injuries. a step-by-step decision-making tree for dressing selection.
a step-by-step decision-making tree for dressing selection Algorithms are step-by-step methods for solving problems. An example would be a decision tree for selection of wound care dressings based on type of wound.
A client comes to the clinic stating, "I feel terrible. I feel feverish and it hurts when I cough." The nurse documents this report to be: a disease. an objective complaint. a symptom. a sign.
a symptom A symptom is a subjective complaint that is noted by the person with a disorder, whereas a sign is a manifestation that is noted by an observer. A disease has not been recognized at this point and should not be documented as such by the nurse. The complaint is subjective, not objective.
In 2014, an outbreak of Ebola virus disease began in West Africa in which there was a sharp increase in the number of people being diagnosed with this disease. At the same time, a very high proportion of those who were diagnosed died from the disease. The epidemiologic characteristics of this disease include: high prevalence and increased incidence. increased morbidity and high prevalence. increased incidence and high mortality. high morbidity and mortality.
increased incidence and high mortality. Incidence is the rate of new cases of a disease and mortality is the death rate associated with it; Ebola is associated with high incidence and mortality. Morbidity consists of the functional effects of a disease and prevalence is the proportion of the population currently living with a disease.
