PrepU Chapter 3: Health, Wellness, and Health Disparities
Which is the most accurate definition of health?
Health is a state of complete physical, mental, and social well-being. Health is viewed as a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity. The other options would not be the best definition of health.
Which needs are being met when a nurse recommends a senior citizen community center for an older client who is living alone?
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 nurse refers an HIV-positive client to a local support group. This is an example of what level of preventive care?
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.Tertiary
A client with Crohn's disease in remission is admitted to the nursing unit for follow-up care. The remission state is characterized by:
disappearance of signs and symptoms associated with the disease. Remission is a temporary state of disappearance of the signs and symptoms related to a particular disease. It is of short duration, but the duration is unpredictable. It is a condition opposite to exacerbation, which is characterized by reactivation of symptoms. Remission is not permanent, but is rather a temporary relief from signs and symptoms. Exacerbation is the periodic occurrence of disease in clients with chronic diseases.
When chronic illnesses and disabilities are present, individuals benefit most from activities that:
help them maintain independence. Although their chronic illnesses and disabilities cannot be eliminated, adults can benefit most from activities that help them maintain independence and achieve an optimal level of health. The other answers, while beneficial, are not as helpful.
Which nursing intervention is an example of tertiary preventive care?
Assisting with speech therapy a client with a traumatic brain injury Tertiary prevention begins after the illness and is used to help rehabilitate clients. Speech therapy is an example of tertiary preventive care. The administration of immunizations and teaching stress reduction classes are examples of primary preventive care. Blood pressure screening is an example of secondary preventive care.
How can the nurse best demonstrate being a role model for health promotion?
Avoid smoking and drinking alcohol 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.
When caring for a client who has just been diagnosed with a chronic illness, the nurse understands the importance of promoting health by highlighting which concept?
Focus on what is possible. When a client has a chronic illness, the nurse needs to make every effort to promote health with a focus of care that emphasizes what is possible rather than what can no longer be. The focus should not be on the altered functioning or what can no longer be as this does not assist the client to move to promoting health in the current state. The basis for the change or why the client has an illness is not easy to determine.
The nurse in a free clinic caring for clients uses the Health Belief Model, which is based on three components. What is the main focus for this model?
What people believe to be true about their health 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 nurse is taking care of a client who has a new, permanent colostomy. The nurse is talking with the client about the new appliance and asking how the client feels about managing it. Which client response indicates understanding of the relationship between self-concept and health?
"I am developing a set of realistic expectations to help me manage my overall health and quality of life." The statement indicating that the client is developing realistic expectations demonstrates understanding that self-concept is an integral part of overall health. Since self-concept is an important part of overall health, a client statement involving self-perception and self-concept should include an understanding of how the two are related. Spiritual beliefs, intellectual dimension, and physical dimension all are factors that influence a person's health-illness status. The client may be intelligent, but this is only a small component of self-concept. Having help at home is not a component of this client's self-concept. Likewise, realizing overall health is important, but keeping appointments is not a component of self-concept.
The nurse is presenting client teaching to a 48 year old male who was just diagnosed with type 2 diabetes mellitus. The patient has a BMI of 35 and leads a sedentary lifestyle. The nurse gives the client information on the risk factors for his diagnosis and talks with him about changing the behaviors of diet and exercise. The nurse knows that further teaching is necessary when the client says what?
"There is nothing that can be done anyway; chronic diseases cannot be prevented" The major causes of chronic diseases are known, and if these risk factors were eliminated, at least over 80% of heart disease, stroke and Type 2 diabetes would be prevented; over 40% of cancer would be prevented. Of the ten leading causes of death in the United States, seven are the result of chronic illnesses. The remaining options would not indicate the need for further patient teaching.
Which are characteristics of chronic conditions? (Select all that apply.)
Are rarely curable Require lifelong management Have a prolonged course Chronic conditions typically have a slower onset and prolonged course, do not resolve spontaneously, are rarely curable, and require lifelong management. Acute conditions typically have a rapid onset and short course and resolve spontaneously or are curable.
An exacerbation refers to the reactivation of a disease. Which condition is associated with exacerbation?
Chronic illness 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.
Why are health promotion and illness prevention a key responsibility of nurses?
Chronic illnesses are the leading health problem in the world. 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?
Coronary artery disease 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.
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 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.
Which of these is not a factor in the Agent-Host-Environment Model of health and illness, as developed by Leavell and Clark (1965)?
Evil spirit In the Agent-Host-Environment Model of health and illness as developed by Leavell and Clark (1965), an agent is an environmental factor or stressor that must be present or absent for an illness to occur. The factor may be bacteria, virus, chemical substance, or a form or radiation whose presence, excessive presence, or absence is necessary for an illness to take hold. Evil spirits do not play into this particular model of health and illness.
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.
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.
Which definition of health is the best?
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 states, "I must be in poor health because I am a senior citizen. That's what my neighbor says, and she is older than I am." This statement is an example of which type of influence on a person's health beliefs?
Peers This is an example of peer influence. Other influences on health beliefs include culture, religion, and family.
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 Primary health promotion and illness prevention is directed toward promoting good health and preventing the development of disease process or injury. Primary-level activities include immunization clinics, providing poison-control information, and education about seat belt and child-safety seat use. Secondary-level activities include screening programs and 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.
The nurse is holding a cholesterol screening at a local pharmacy this Saturday morning. What level(s) of health promotion is this screening an example of?
Secondary Screenings, such as those for blood pressure, cholesterol, glaucoma, HIV, and skin cancer, are considered nursing activities that fall under the category of secondary health promotion. Secondary health promotion and illness prevention focus on screening for early detection of disease, with prompt diagnosis and treatment of those found. Secondary health promotion involves measures that actually help prevent disease from occurring in the first place, such as a presentation to school children about healthy food choices and the importance of being active. Tertiary health promotion involves rehabilitation following the development of a chronic condition, to help prevent further progression and associated complications of the condition, such as cardiac exercise classes for clients recovering from a heart attack.
Which model is most useful in examining the cause of disease in an individual and is based upon external factors?
The Agent-Host-Environment Model The AgentHostEnvironment 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 HealthIllness 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.
When first diagnosed with cancer, a client was depressed and complained of feeling sick. Now the client has adapted to the diagnosis, recently returned to work, and, since undergoing chemotherapy, reports feeling better than ever. The nurse recognizes that which model of health promotion is most effective in explaining this client's situation?
The Health-Illness Continuum Model The Health-Illness Continuum is a model that views health as a constantly changing state, with high-level wellness and death at opposite ends of a scale. This continuum illustrates the ever-changing state of health as a person adapts to changes. For example, a person with cancer may view self at different points on the continuum at any given time. The Health promotion model is widely used to plan and implement interventions to change unhealthy behaviors and promote health. The Health Belief Model is a psychological model that attempts to explain and predict health behaviors. This is done by focusing on the attitudes and beliefs of individuals. The traditional model for infectious disease (Agent-Host-Environment Model) is a triad that consists of an external agent, a susceptible host, and an environment that brings the host and agent together.
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. 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.
To be an effective change agent for wellness, the nurse must:
consume a healthy diet. Nurses focused on wellness advocate the use of lifestyle modification skills that alleviate stress and promote a state less susceptible to disease, such as eating a healthy diet. Skipping breakfast, drinking caffeinated beverages, and being sedentary are not associated with improved health or wellness.
The nurse is preparing a plan of care for a client with nutritional deficits. Which is the priority intervention for this client?
teaching about intake of food and vitamins Priority management, according to Maslow's hierarchy, starts at physiological needs and includes the need for oxygen, food, water, rest, and elimination. Therefore, teaching the client about intake of food and vitamins is most appropriate for the client who has nutritional deficits. Teaching about weight loss programs, teaching about binge eating, and acknowledging the client's weight problem are examples of other needs that are not the priority.
