PrepU Chapter 3: Health, Wellness, and Health Disparities
A nurse working in a long-term care facility personally follows accepted guidelines for a healthy lifestyle. How does this nurse promote health in the residents of this facility? By being a role model for healthy behaviors By not requiring sick days from work By never exposing others to any type of illness By budgeting time and resources efficiently
By being a role model for healthy behaviors Good personal health enables the nurse to serve as a role model for patients and families.
An exacerbation refers to the reactivation of a disease. Which condition is associated with exacerbation? Congenital illness Acute illness Hereditary illness Chronic illness
Chronic illness Explanation: Exacerbation is the increase in activity of a disease and aggravation of symptoms. This occurs periodically in clients with chronic diseases. It is often a result of physical, chemical, or emotional stress. Congenital illness (such as atrial septal defect), hereditary illness (such as cystic fibrosis), and acute illness (such as influenza) do not have exacerbation and remission stages.
A nurse has volunteered to give influenza immunizations at a local clinic. What level of care is the nurse demonstrating? Tertiary Secondary Primary Promotive
Primary Giving influenza injections is an example of primary health promotion and illness prevention.
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? Tertiary All three levels Secondary Primary
Secondary
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? "Alcohol use while pregnant will predispose my child to idiopathic illness." "Abstaining from alcohol will prevent any type of congenital disorder." "If I drink alcohol while pregnant, my child will have a hereditary disorder." "I should abstain from alcohol to prevent the development of a fetal alcohol spectrum disorder."
"I should abstain from alcohol to prevent the development of a fetal alcohol spectrum disorder." Congenital disorders such as fetal alcohol spectrum disorders may be prevented by the client abstaining from alcohol while pregnant. Fetal alcohol spectrum disorders are congenital disorders caused by an undetermined amount of alcohol ingested by the mother which affects the fetus in the developmental stages of growth. Abstaining from alcohol will not prevent all types of congenital disorders, but clients should be educated about a variety of preventative measures in order to prevent interruption of the growth and development of the fetus. An idiopathic illness is one in which the cause is undetermined. A hereditary disorder is genetic and not altered by substance intake during pregnancy.
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." "If I drink alcohol while pregnant, my child will have a hereditary disorder." "Alcohol use while pregnant will predispose my child to idiopathic illness." "Abstaining from alcohol will prevent any type of congenital disorder."
"I should abstain from alcohol to prevent the development of a fetal alcohol spectrum disorder." Explanation: Congenital disorders such as fetal alcohol spectrum disorders may be prevented by the client abstaining from alcohol while pregnant. Fetal alcohol spectrum disorders are congenital disorders caused by an undetermined amount of alcohol ingested by the mother which affects the fetus in the developmental stages of growth. Abstaining from alcohol will not prevent all types of congenital disorders, but clients should be educated about a variety of preventative measures in order to prevent interruption of the growth and development of the fetus. An idiopathic illness is one in which the cause is undetermined. A hereditary disorder is genetic and not altered by substance intake during pregnancy.
Which scenario accurately depicts the influence of one's religious beliefs? A client who practices Islam requests a baptism for live birth. A client who practices Orthodox Judaism will not eat pork. A client who practices Conservative Catholicism opposes a blood transfusion. A client who practice the Jehovah's Witnesses faith will not eat shellfish.
A client who practices Orthodox Judaism will not eat pork. Spiritual and religious beliefs and values are important components of a person's behaviors both in health and in illness. Examples of such influences include Roman Catholics' requirement of baptism for both live births and stillborn babies; Kosher dietary laws prohibiting the intake of pork and shellfish (practiced by orthodox and conservative Jews), and the opposition to blood transfusions common among Jehovah's Witnesses. Islam do not have a baptism ritual for newborns. Blood transfusion is acceptable in the belief system of the Catholic church. Consumption of shellfish is acceptable in the belief system of those who identify as Jehovah's Witnesses
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 who fell off a roof 2 weeks ago and is experiencing continuous lower back pain A client with chronic obstructive pulmonary disease (COPD) who is wheezing and coughing A client returning for a follow-up visit after a shoulder sprain 1 week ago A client diagnosed with diabetes mellitus (DM) who stubbed the great toe and now has a wound
A client with chronic obstructive pulmonary disease (COPD) who is wheezing and coughing Explanation: Chronic illnesses have expected symptoms, such as the client with COPD who has damage to the lungs that cannot be reversed. Symptoms of this chronic condition include shortness of breath, wheezing, and a chronic cough. The other clients all have new or recent injuries that are acute in nature and require immediate care rather than long-term follow-up (note that diabetes mellitus, although a chronic condition itself, can be associated with complications that are acute, such as an injury to the toes).
Nurses perform health promotion activities at a primary, secondary, or tertiary level. Which nursing actions are considered tertiary health promotion? Select all that apply. A nurse runs an immunization clinic in the inner city. A nurse teaches a patient with an amputation how to care for the residual limb. A nurse provides range-of-motion exercises for a paralyzed patient. A nurse teaches parents of toddlers how to childproof their homes. A school nurse provides screening for scoliosis for the students. A nurse teaches new parents how to choose and use an infant car seat.
A nurse teaches a patient with an amputation how to care for the residual limb. A nurse provides range-of-motion exercises for a paralyzed patient. Tertiary health promotion and disease prevention begins after an illness is diagnosed and treated to reduce disability and to help rehabilitate patients to a maximum level of functioning. These activities include providing ROM exercises and patient teaching for residual limb care. Providing immunizations and teaching parents how to childproof their homes and use an appropriate car seat are primary health promotion activities. Providing screenings is a secondary health promotion activity.
Which nursing activity reflects care given on the tertiary level of healthcare delivery? Educating the client about safe habits Teaching the client about exercise programs Recommending regular exams Assisting with transplant surgery
Assisting with transplant surgery Tertiary care is health services provided at hospitals or medical centers that have complex technology and specialists. Educating the client about safe habits, recommending regular exams, and teaching the client about exercise programs are examples of primary 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 Increase in exercise
Alterations in roles Economic problems Alterations in lifestyle Decrease in social interactions A chronic illness hospitalization can create stress for both the client and family because of alterations in role or lifestyle, frequent hospitalizations, economic problems, and decreased social interactions among family members. An increase in exercise would be more likely to relieve stress rather than increase it.
Despite a national focus on health promotion, nurses working with patients in inner-city clinics continue to see disparities in health care for vulnerable populations. Which patients are considered vulnerable populations? Select all that apply. A White male diagnosed with HIV An African American teenager who is 6 months pregnant A Hispanic male who has type II diabetes A low-income family living in rural America A middle-class teacher living in a large city A White baby who was born with cerebral palsy
An African American teenager who is 6 months pregnant A low-income family living in rural America A middle-class teacher living in a large city A White baby who was born with cerebral palsy National trends in the prevention of health disparities are focused on vulnerable populations, such as racial and ethnic minorities, those living in poverty, women, children, older adults, rural and inner-city residents, and people with disabilities and special health care needs.
What is the definition of wellness? Being without disease An active state of being healthy A desire to be without disease Maximizing the state in which you live
An active state of being healthy Explanation: Wellness, a reflection of health, is an active state of being healthy by living a lifestyle that promotes good physical, mental, and emotional health. It is not simply an absence of disease or a desire to be without disease, nor is it maximizing the state in which one lives.
What is the definition of wellness? Being without disease Maximizing the state in which you live A desire to be without disease An active state of being healthy
An active state of being healthy Wellness, a reflection of health, is an active state of being healthy by living a lifestyle that promotes good physical, mental, and emotional health. It is not simply an absence of disease or a desire to be without disease, nor is it maximizing the state in which one lives.
Which nursing activity reflects care given on the tertiary level of healthcare delivery? Educating the client about safe habits Recommending regular exams Assisting with transplant surgery Teaching the client about exercise programs tờ shí ờ ry
Assisting with transplant surgery Tertiary care is health services provided at hospitals or medical centers that have complex technology and specialists. Educating the client about safe habits, recommending regular exams, and teaching the client about exercise programs are examples of primary care.
An older adult client 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 Achieving recovery and rehabilitation Assuming the sick role Experiencing the symptoms
Assuming a dependent role Explanation: The stage of assuming a dependent role often requires assistance in carrying out activities of daily living. As well, the client often requires care, which may be provided in the home. Experiencing symptoms and assuming a sick role may precede (or accompany) this process. Recovery and rehabilitation are not evident in the client's present circumstances.
How can the nurse best demonstrate being a role model for health promotion? Educate others about healthy lifestyles Avoid smoking and drinking alcohol Prevent exposure to communicable diseases Take prescribed medications accordingly
Avoid smoking and drinking alcohol Explanation: Nurses can best role model health promotion strategies by engaging in behaviors and activities that demonstrate a healthy lifestyle. The other options do not meet the definition for role modeling.
Why are health promotion and illness prevention a key responsibility of nurses? Chronic illnesses are the leading health problem in the world. Treatment of chronic illnesses is very expensive. Chronic illnesses can cause pain and suffering. People do not like to be sick and feel bad.
Chronic illnesses are the leading health problem in the world. Explanation: Because chronic illnesses are the leading health problems in the world, health promotion and illness prevention activities are vital to nursing care. By endorsing health promotion and illness prevention, the nurse can assist the client to achieve optimal health even with a chronic illness. It is true that treating chronic illnesses can be expensive, they do cause pain and suffering, and people do not like to be sick, but these are not the most important reasons for promoting health and preventing illnesses.
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? Lung cancer Cerebrovascular accidents Emphysema Coronary artery disease
Coronary artery disease Explanation: Heart disease is the leading cause of death in the United States. Lung cancer, emphysema, and cerebrovascular accidents are not the leading causes of death in the United States.
AA nurse working in a hospital setting cares for patients with acute and chronic conditions. Which disease states are chronic illnesses? Select all that apply. Diabetes mellitus Bronchial pneumonia Rheumatoid arthritis Cystic fibrosis Fractured hip Otitis media
Diabetes mellitus Rheumatoid arthritis Cystic fibrosis Diabetes, arthritis, and cystic fibrosis are chronic diseases because they are permanent changes caused by irreversible alterations in normal anatomy and physiology, and they require patient education along with a long period of care or support. Pneumonia, fractures, and otitis media are acute illnesses because they have a rapid onset of symptoms that last a relatively short time.
A parent brings a 2-year-old child for a well-baby visit. Which actions address primary prevention strategies for the nurse to discuss with the parent? Select all that apply. Adhering to the immunization schedule Using a child safety seat appropriately Reviewing appropriate discipline for a 2-year-old child Performing a lead screening Discussing healthy meal choices for a 2-year-old child
Discussing healthy meal choices for a 2-year-old child Adhering to the immunization schedule Reviewing appropriate discipline for a 2-year-old child Using a child safety seat appropriately Discussing healthy meal choices, adhering to the immunization schedule, reviewing appropriate discipline, and using a child safety seat are primary prevention activities. Performing a lead screening is a secondary prevention activity.
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 Sociocultural dimension Intellectual dimension Physical dimension
Emotional dimension Explanation: This is an example of the emotional dimension. Long-term stress affects body systems, and anxiety affects health habits. The intellectual dimension encompasses cognitive abilities and past experiences, whereas the physical dimension includes factors such as genetics, gender, and race. The sociocultural dimension relates to a client's economic level, lifestyle, family, and culture.
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? Morbidity Infection Risk factor Exacerbation
Exacerbation This client has experienced a significant exacerbation of a chronic disease (diabetes mellitus), which has manifested as an acute threat to the client's health. Morbidity is an epidemiological statistic of the frequency of a disease. The client's problem does not have an infectious etiology. A risk factor is any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or injury.
Which are factors that impact how a client defines health? Select all that apply. Family Music Society Culture Community
Family Culture Community Society Each client defines health in terms of the client's own values and beliefs. The person's family, culture, community, and society also influence this personal perception of health. Music does not affect how a person defines health.
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. Accident prevention education Rehabilitation for relief of low back pain Family planning services Skin cancer screening Heart-healthy nutrition services
Family planning services Accident prevention education Heart-healthy nutrition services Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Examples of primary-level activities are immunization clinics, family planning services, providing poison control information, and accident prevention education. Other nursing interventions include teaching about a healthy diet, the importance of regular exercise, safety in industry and farms, using seat belts, and safer sex practices. Screenings are a major activity in secondary health promotion. Rehabilitation is associated with tertiary health promotion.
A nurse working in a primary care facility assesses patients who are experiencing various levels of health and illness. Which statements define these two concepts? Select all that apply. Health and illness are the same for all people. Health and illness are individually defined by each person. People with acute illnesses are actually healthy. People with chronic illnesses have poor health beliefs. Health is more than the absence of illness. Illness is the response of a person to a disease.
Health and illness are individually defined by each person. Health is more than the absence of illness. Illness is the response of a person to a disease. Each person defines health and illness individually, based on a number of factors. Health is more than just the absence of illness; it is an active process in which a person moves toward his or her maximum potential. An illness is the response of the person to a disease.
A nurse incorporates concepts from current models of health when providing health promotion classes for patients. What is a key concept of both the health-illness continuum and the high-level wellness models? Illness as a fixed point in time The importance of family Wellness as a passive state Health as a constantly changing state
Health as a constantly changing state Both these models view health as a dynamic (constantly changing state).
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? Clinical model Holistic health model Health belief model High-level wellness model
Health belief model Explanation: According to the health belief model, a client's beliefs and actions are related and influenced by the client's personal expectations in relation to health and illness. According to the clinical model, health is defined narrowly as the absence of signs and symptoms of disease or injury. The holistic model views individuals as ever-changing systems of energy, and the interaction of a person's mind, body, and spirit within the environment. The high-level wellness model is the recognition of health as an ongoing process toward a person's highest potential of functioning.
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? Holistic health model High-level wellness model Clinical model Health belief model
Health belief model According to the health belief model, a client's beliefs and actions are related and influenced by the client's personal expectations in relation to health and illness. According to the clinical model, health is defined narrowly as the absence of signs and symptoms of disease or injury. The holistic model views individuals as ever-changing systems of energy, and the interaction of a person's mind, body, and spirit within the environment. The high-level wellness model is the recognition of health as an ongoing process toward a person's highest potential of functioning.
Which definition of health is the best? Health is the absence of disease. Health is the lack of physical symptoms. Health is a state of complete well-being. Health is how people feel.
Health is a state of complete well-being. A classic definition of health is that health is a state of complete physical, mental, and social well-being, not merely the absence of disease or physical symptoms. Health encompasses a state of mind and not just how a client feels.
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 Diagnosis of disease Self-concept Illness prevention
Health promotion Health promotion is the behavior of a person who is motivated by a personal desire to increase well-being and health potential. In contrast, illness/disease prevention, also called health protection, is behavior motivated by a desire to avoid or detect disease or to maintain functioning within the constraints of an illness or disability. Self-concept incorporates both how people feel about themselves (self-esteem) and the way they perceive their physical self (body image). Diagnosis of disease involves a medical aspect such that a disease is traditionally diagnosed—and treatment is prescribed—by a physician or advanced practice nurse, whereas nurses focus on the person with an illness.
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 is a sequela of acute illness. It has a gradual onset and lasts for a long time. It persists for a long time. It takes a long time to cure.
It has a gradual onset and lasts for a long time. Explanation: Chronic illness has a gradual onset and lasts for a long time. It is usually seen in old age. It may or may not be due to acute illness. Chronic diseases are a major cause of morbidity in the population.
Which behaviors are necessary for a person to successfully adapt to a chronic illness? Select all that apply. Give up control of one's life Learn to live as normally as possible Accept dependence and adjust to it Maintain a positive self-concept Maintain a sense of hope
Learn to live as normally as possible Maintain a positive self-concept Maintain a sense of hope To successfully adapt to a chronic illness, the person must learn to live as normally as possible and maintain a positive self-concept and sense of hope, despite symptoms and treatments. It is important that the person maintain a feeling of being in control of his or her life, as well as in control of the prescribed treatments. The client needs to maintain independence and not dependence on chronic illness outcomes.
What are some examples of healthy self-care behaviors everyone should adopt? Select all that apply. Exercising infrequently Maintaining an ideal body weight Eating regular healthy meals Sleeping 7 to 8 hours each night Having a low self-esteem
Maintaining an ideal body weightEating regular healthy mealsSleeping 7-8 hours each night
Which nursing activity reflects secondary prevention? Discussing the use of drugs and alcohol Making a referral for a mammogram Promoting the use of seat belts Promoting the use of helmets while riding motorcycles or bicycles
Making a referral for a mammogram Explanation: Secondary prevention involves screening for early detection of disease, such as a mammogram. Discussions about wearing helmets, using seat belts, and drugs and alcohol are all examples of primary prevention, which focuses on promoting health and preventing disease.
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? Nonmodifiable Secondary Modifiable Primary
Modifiable Risk factors are defined as modifiable (things a person can change, such as quitting smoking) and nonmodifiable (things that cannot be changed, such as a family history of cancer). Primary and secondary are not associated with risk factors.
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 fluid intake and output. Effective infection control measures. Monitoring airway clearance. Effective pain management.
Monitoring airway clearance. Explanation: 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? Preparation Precontemplation Contemplation Maintenance
Precontemplation Explanation: The precontemplation stage is the first stage change, in which the client does not indicate any intention to make a change within the next 6 months. During the precontemplation stage, the client is not even thinking about or considering making a change. During the contemplation stage, the client is considering making a change. During the preparation stage, the client has decided to make a change and is preparing for it. During the maintenance stage, the client attempts to maintain the change in lifestyle begun in an earlier stage.
A nurse is immunizing children against measles. This is an example of what level of preventive care? Primary Secondary Tertiary Chronic
Primary Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Immunizations are an example of primary health promotion. Secondary health promotion and illness prevention focus on screening for early detection of disease, with prompt diagnosis and treatment of any found. Tertiary health promotion and illness prevention begin after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate clients to a maximum level of functioning. The term chronic is not related to health promotion.
A nurse is immunizing children against measles. This is an example of what level of preventive care? Tertiary Chronic Primary Secondary
Primary Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Immunizations are an example of primary health promotion. Secondary health promotion and illness prevention focus on screening for early detection of disease, with prompt diagnosis and treatment of any found. Tertiary health promotion and illness prevention begin after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate clients to a maximum level of functioning. The term chronic is not related to health promotion.
What level of prevention is represented by educating a group of clients on carseat safety? Secondary prevention Primary prevention Educational prevention Tertiary prevention
Primary prevention Primary prevention focuses on the health of a person with the goal of preventing disease or illness. Carseat safety education is primary prevention. Secondary prevention refers to screening and early detection of disease. Tertiary prevention refers to rehabilitation and prevention of complications after diagnosis with a disease. Educational is not a level of prevention.
The nurse uses the agent-host-environment model of health and illness to assess diseases in patients. This model is based on what concept? Risk factors Demographic variables Behaviors to promote health Stages of illness
Risk factors The interaction of the agent, host, and environment creates risk factors that increase the probability of disease.
The client is admitted with a gastrointestinal bleed. The physician ordered a colonoscopy. Which level of care encompasses this procedure? Primary Secondary Quaternary Tertiary
Secondary Explanation: Secondary care delivery is when primary caregivers refer clients for consultation and additional testing. Therefore, this scenario portrays secondary level of care. Primary care delivery is provided by the first healthcare provider or agency a person contacts. Quaternary care is an extension of tertiary care and includes experimental medicine and procedures and highly uncommon, specialized surgeries. Tertiary care is health services provided at hospitals or medical centers that have complex technology and specialists.
Which needs are being met when a nurse recommends a senior citizen community center for an older client who is living alone? Spiritual needs Sociocultural needs Intellectual needs Emotional needs
Sociocultural needs Increased social interaction, as would be provided by visiting a senior citizen community center, would primarily address a client's sociocultural needs. Emotional needs address how the mind affects body functions and responds to body conditions. Long-term stress affects body systems, and anxiety affects health habits; conversely, calm acceptance and relaxation can actually change the body's responses to illness. The intellectual dimension encompasses cognitive abilities, educational background, and past experiences. Spiritual beliefs and values are assessed when addressing spiritual needs.
A patient in a community health clinic tells the nurse, "I have a high temperature, feel awful, and I am not going to work." What stage of illness behavior is the patient exhibiting? Stage 1: Experiencing symptoms Stage 2: Assuming the sick role Stage 3: Assuming a dependent role Stage 4: Achieving recovery and rehabilitation
Stage 2: Assuming the sick role Assuming the sick role. When people assume the sick role, they define themselves as ill, seek validation of this experience from others, and give up normal activities. In stage 1: Experiencing symptoms, the first indication of an illness usually is recognizing one or more symptoms that are incompatible with one's personal definition of health. The stage of assuming a dependent role is characterized by the patient's decision to accept the diagnosis and follow the prescribed treatment plan. In the achieving recovery and rehabilitation role, the person gives up the dependent role and resumes normal activities and responsibilities.
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? New symptoms occur at this time. Symptoms are not experienced. The symptoms of the illness reappear. The disease is no longer present.
Symptoms are not experienced. Chronic illnesses usually have a slow onset and many have periods of remission (the disease is present but the client does not experience symptoms). Exacerbation is when the symptoms of the disea
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 Screening for tuberculosis Screening for breast cancer every 5 years Assessing for risk factors for heart disease
Teaching about adhering to a low-sodium diet Tertiary health promotion and illness prevention begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate the client to a maximum level of functioning. Nursing activities on a tertiary level include teaching a client with heart failure the importance of adhering to a low-sodium diet. Primary prevention is directed toward promoting health and preventing the development of disease processes or injury. This client has a diagnosis. Secondary health promotion and illness prevention focus on screening for early detection of disease with prompt diagnosis and treatment of diseases found.
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? Screening for breast cancer every 5 years Assessing for risk factors for heart disease Teaching about adhering to a low-sodium diet Screening for tuberculosis
Teaching about adhering to a low-sodium diet Explanation: Tertiary health promotion and illness prevention begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate the client to a maximum level of functioning. Nursing activities on a tertiary level include teaching a client with heart failure the importance of adhering to a low-sodium diet. Primary prevention is directed toward promoting health and preventing the development of disease processes or injury. This client has a diagnosis. Secondary health promotion and illness prevention focus on screening for early detection of disease with prompt diagnosis and treatment of diseases found. Reference:
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? Considering the client's developmental stage when planning nursing care Encouraging friends and relatives to visit often and bring games to distract her Providing the opportunity for a counselor to come in and talk to her about her loss Teaching her how to care for the stump and explaining the rehabilitation program
Teaching her how to care for the stump and explaining the rehabilitation program Explanation: The intellectual dimension encompasses cognitive abilities, educational background, and past experiences. These factors influence responses to teaching about health and reactions to nursing care during illness. They also play a major role in health behaviors. Providing a counselor and friends and family focus on the psychosocial element. Considering the developmental stage when planning care focuses on the physical dimension.
A nurse refers an HIV-positive client to a local support group. This is an example of what level of preventive care? Primary Tertiary Chronic Secondary
Tertiary Tertiary health promotion and illness prevention begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate clients to a maximum level of functioning. Referring an HIV-positive client to a local support group would be an example of tertiary preventive care. Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Secondary health promotion and illness prevention focus on screening for early detection of disease, with prompt diagnosis and treatment of any found. The term chronic is not related to health promotion.
A nurse refers an HIV-positive client to a local support group. This is an example of what level of preventive care? Chronic Primary Tertiary Secondary
Tertiary Explanation: Tertiary health promotion and illness prevention begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate clients to a maximum level of functioning. Referring an HIV-positive client to a local support group would be an example of tertiary preventive care. Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Secondary health promotion and illness prevention focus on screening for early detection of disease, with prompt diagnosis and treatment of any found. The term chronic is not related to health promotion.
Which model is most useful in examining the cause of disease in an individual, based upon external factors? The Health-Illness Continuum The High-Level Wellness Model The Health Belief Model The Agent-Host-Environment Model
The Agent-Host-Environment Model Explanation: The Agent-Host-Environment Model is useful for examining the cause of disease in an individual. The agent, host, and environment interact in ways that create risk factors. The Health-Illness Continuum is a way to measure a person's level of health. The High-Level Wellness Model is characterized by functioning to one's maximum potential while maintaining balance and purposeful direction in the environment. The Health Belief Model is used to describe health behaviors.
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 is worried about getting a bad grade in school.. The client's parents argue a lot. The client feels as if she is the cause of her family's dysfunction. The client feels scared that her mother will hurt someone.
The client feels scared that her mother will hurt someone. According to Maslow's hierarchy of human needs, physiologic needs come first, followed by safety (threatened by the mother throwing things), then love and belonging (threatened by the parents constantly arguing), then esteem (threatened by a sense of guilt over feeling like the cause of family dysfunction), and then self-actualization (threatened by making a bad grade).
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 seeks medical attention. The client assumes a dependent role. The client gives up the dependent role. The client recognizes symptoms of illness.
The client gives up the dependent role. Explanation: In the recovery and rehabilitation stage, known as Stage 4, the person gives up the dependent role and resumes normal activities and responsibilities. The client would not seek medical attention, assume a dependent role, or recognize symptoms of illness in this stage. Stage 1 is when the client would recognize symptoms of the illness. Stage 2 is when the client would seek medical attention. Stage 3 is when the client would assume a dependent role.
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 experiencing the effects of a terminal illness. The client is having an exacerbation of the COPD. This is the effect of a secondary illness. The client is experiencing remission of the COPD.
The client is having an exacerbation of the COPD. Explanation: COPD is a chronic illness that has periods when the client goes from a chronic state to an acute state such as an acute onset of symptoms. The client will experience periods of exacerbation according to certain precipitating circumstances. Remission occurs in illnesses such as cancer when the symptoms or clinical manifestations disappear. A secondary illness is caused by complications from a primary illness. Clients with a terminal illness have no hope of recovery.
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 experiencing remission of the COPD. The client is having an exacerbation of the COPD. This is the effect of a secondary illness. The client is experiencing the effects of a terminal illness.
The client is having an exacerbation of the COPD. Explanation: COPD is a chronic illness that has periods when the client goes from a chronic state to an acute state such as an acute onset of symptoms. The client will experience periods of exacerbation according to certain precipitating circumstances. Remission occurs in illnesses such as cancer when the symptoms or clinical manifestations disappear. A secondary illness is caused by complication
The nurse is preparing to talk to a local community group regarding chronic illness. The nurse informs the group that both external and internal factors influence a person's health. When discussing the fact that the male client has a higher chance of developing lung cancer due to his gender, which dimension is the nurse referring to? Physical dimension Emotional dimension Intellectual dimension Environmental dimension
The physical dimension includes -genetic inheritance, -age, -developmental level, -race, and gender. These components strongly influence the person's health status and health practices. Since lung cancer is more frequent in men, the male client is at a higher risk of developing lung cancer due to his gender. Emotional dimension refers to feelings. Intellectual dimension is cognitive ability. Environmental dimension is related to a client's environment, including work and school.
What have the models of health promotion and illness prevention been used for? To define a medical framework for the care of the disabled. To create a forum for improving rehabilitative care. To help health care providers understand health-related behaviors. To formulate care plans for the disabled population.
To help health care providers understand health-related behaviors. Several models of health promotion and illness prevention have been used to help health care providers understand health-related behaviors and adapt care to people from diverse economic and cultural backgrounds. The models include the health belief model, the health promotion model, the health-illness continuum model, and the agent-host-environment model. These models do not define a medical framework in the care of the disabled; these models do not create a forum for improving rehabilitative care; and these models do not formulate care plans for use with the disabled.
Based on the components of the physical human dimension, the nurse would expect which clinic patient to be most likely to have annual breast examinations and mammograms? Jane, whose best friend had a benign breast lump removed Sarah, who lives in a low-income neighborhood Tricia, who has a family history of breast cancer Nancy, whose family encourages regular physical examinations
Tricia, who has a family history of breast cancer The physical dimension includes genetic inheritance, age, developmental level, race, and biological sex. These components strongly influence the person's health status and health practices. A family history of breast cancer is a major risk factor.
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. Focus on a standard definition of health and beliefs. Apply the model of health that is most popular. Instruct the client that health is an inactive process.
Understand and respect each person's definition of health. Understand and respect each person's responses to illness. To give holistic care, the nurse must understand and respect each person's own definition of health and responses to illness and should be familiar with models of health and illness. Health is an active process in which a person moves toward maximum potential. Focusing on a standard definition of health and beliefs does not address the individuality of the client. Applying the model of health that is most popular does not address the individuality of the client.
The nurse is addressing primary prevention with a group of college students. Which promotional statement by the nurse would be the best example of a developmentally appropriate discussion? Use of condoms can help prevent sexually transmitted infections and unwanted pregnancy. Annual Papanicolaou test can detect cancer earlier. HIV screening should be done on an annual basis if you are sexually active. Testicular examinations for male students can detect early stages of cancer.
Use of condoms can help prevent sexually transmitted infections and unwanted pregnancy. Safer sex practices, which include the use of condoms, are an example of primary prevention measures. HIV screening, annual Papanicolaou test, and testicular examinations are secondary prevention measures, which are usually screening measures. The nurse should discuss health practices that are most relevant to the developmental level of the audience, in this case college age students.
A student nurse is preparing a poster for a health fair which will compare the various types of methods used to pay for health care. Which factor(s) should the student include in the managed care section? Select all that apply. uses resources efficiently provides education to reduce risk of disease bargains with providers for reasonably priced quality care implements Diagnostic Related Groups (DRGs) for all hospital stays offers providers a preset fee schedule
Uses resources efficiently provides education to reduce risk of disease bargains with providers for reasonably priced quality care explanation Managed care uses several techniques including using resources efficiently, providing education to reduce risk of disease, and bargaining with providers for reasonably priced quality care. Medicare instituted the DRG technique. Capitation is the process of the insurance company providing the health care provider a set amount per member whether the services are used or not.
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? Factors that predispose a person to infectious diseases What people believe to be true about their health How people interact with their environments How health is a constantly changing state
What people believe to be true about their health The Health Belief Model focuses on what people perceive or believe to be true about themselves in relation to their health. The Health Promotion Model focuses on how people interact with their environments, as they pursue health. The Health-Illness Continuum Model focuses on health as a constantly changing state, whereas The Agent-Host-Environment Model explains how certain factors place a person at risk for an infectious disease.
A client has a Staphylococcus infection in a decubitus ulcer. In this case, Staphylococcus is the: host. agent. environment. disease.
agent. The agent is any factor that leads to illness. The client is the host of the infection. The environment is setting in which the infection occurs. The disease is a pathological process that can result from the infection.
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 they can tolerate and provide information for health counseling. Assure the client that there is nothing to be worried about because many people are diagnosed with this disease, and alert the family to the possibility of depression. 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. Review possible outcomes of the diagnosis with the client, allowing the client to express concerns while providing support. Assure the client that they will be able to live a full life, provide education on how to adjust to the new diagnosis, and include the family in any life-changing decisions.
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. - Assure the client that there is nothing to be worried about because many people are diagnosed with this disease, and alert the family to the possibilities off depression.
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? spiritual health social health physical health emotional health
emotional health The client is exhibiting the holistic concept of emotional health since the client is demonstrating an ability to cope with a stressor effectively. Physical health is an optimal state of physical functioning when body organs function normally. Social health is an outcome of feeling accepted and useful. Spiritual health is the feeling that one's life has a purpose and function.
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 case method team nursing primary nursing
functional nursing Explanation: This method is referred to as functional nursing. Each member is assigned a specific task or function. The case method is a pattern in which one nurse manages all the care for a specific client(s) for a designated period of time. Team nursing involves a specific team of nurses working together to provide care for a specific group of clients. The team leader coordinates and delegates tasks to the various team members. Primary nursing occurs when the admitting nurse is responsible for planning client care and evaluating the client's progress. The nurse may delegate the client's care in his or her absence but remains responsible until the client is discharged.
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 dietary log shows improvement on food choices skin turgor indicates good hydration status client is facing a potential eviction sleep has been disrupted due to family issues
immune system is functioning poorly sleep has been disrupted due to family issues client is facing a potential eviction Exacerbations of illnesses are often related to how poorly the immune system is functioning, the stressors the client is facing and overall health status (e.g., nutrition, sleep, hydration). Remission is the opposite and usually indicates how well the immune system is acting, how well the client is handling stressors, and his or her overall health status. Improving food choices and good hydration status are indications the individual is recovering and showing improvement in his or her health status.
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. client is facing a potential eviction skin turgor indicates good hydration status immune system is functioning poorly dietary log shows improvement on food choices sleep has been disrupted due to family issues
immune system is functioning poorlyb. sleep has been disrupted due to family issuesc. client is facing a potential eviction Exacerbations of illnesses are often related to how poorly the immune system is functioning, the stressors the client is facing and overall health status (e.g., nutrition, sleep, hydration). Remission is the opposite and usually indicates how well the immune system is acting, how well the client is handling stressors, and his or her overall health status. Improving food choices and good hydration status are indications the individual is recovering and showing improvement in his or her health status.
The concept of holism is based on the belief that: individuals can be seen in an atomistic fashion. health is achieved through medical care. health is achieved by treatment from physicians. individuals cannot be seen apart from the environment.
individuals cannot be seen apart from the environment. Holism is based on the belief that people cannot be fully understood if examined solely in pieces apart from their environment. The opposite of holism is the view that individuals can be treated atomistically or can achieve health through medical care or phys
A nurse is planning a seminar for the local community. Which topic(s) are examples of primary prevention? Select all that apply. information on the importance of Papanicolaou (Pap) test and mammograms blood pressure control and screening information on smoking cessation examples of heart-healthy diet information on increasing activity and exercise
information on smoking cessation examples of heart-healthy diet information on increasing activity and exercise Primary prevention focuses on intervening before health effects occur. Examples include information on smoking cessation, heart-healthy diets, exercise, and activity. Secondary prevention focuses on trying to prevent getting a disease. Examples include screenings for blood pressure, Papanicolaou (Pap) test and mammograms.
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 Tricare Medicare Medigap
marketplace Explanation: Health insurance marketplaces are state organizations that provide a means for individuals or certain employers to purchase affordable private health insurance under ACA provisions. This insurance lowered premiums and out-of-pocket expenses for people with low or modest incomes by providing financial assistance subsidies. Tricare is a plan available for individuals in the military. Medigap is an additional plan to help with costs not covered by Medicare. Medicaid is a federally-funded, state-run insurance program for low-income individuals.
The nurse's community outreach class is giving a presentation on seat belts and child safety seats at the local firehouse every weekend in October. Which level of health promotion is this an example of? Primary Secondary Tertiary Medical
primary Explanation Primary health promotion and illness prevention is directed toward promoting good health and preventing the development of disease process or injury. Primary-level activities -immunization clinics, -providing poison-control information, and -education about seat belt and child-safety seat use. Secondary-level activities -screening programs -early identification of disease. Tertiary-level prevention is concerned with returning the client to the optimal function after diagnosis. Medical is not a level of health promotion or illness prevention.
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? functional nursing case method primary nursing team nursing
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. 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 nurse is providing care for client who experienced a stroke. Which nursing intervention reflects the tertiary level of prevention? discuss family history of hypertension assess blood pressure every 4 hours conduct mental status assessment every 2 hours provide care transition at discharge for speech therapy
provide care transition at discharge for speech therapy Explanation: Tertiary prevention minimizes the consequences of a disorder through aggressive rehabilitation or appropriate management of the disease. An example is speech therapy to help restore ability. Blood pressure and mental status exams are examples of secondary prevention associated with the acute stroke. Discussing family history is also secondary prevention in terms of assessing for further risk factors.
Chronic illness may be characterized by periods of remission. Remission is best defined as: a pathologic change in the structure of function of the body or mind. the response of a person to a disease. the reappearance of symptoms of a disease. the presence of a disease with the absence of symptoms.
the presence of a disease with the absence of symptoms. Explanation: Remission is defined as the presence of a disease, but the person does not experience the symptoms. Exacerbation is the reappearance of symptoms of a disease. Disease is a pathologic change in the structure of function of the body or mind. Illness is the response of a person to a disease.
