TLB-Chapter 3: Health, Wellness, and Health Disparities

The concept of holism is based on the belief that: A. individuals can be seen in an atomistic fashion. B. health is achieved through medical care. C. health is achieved by treatment from physicians. D. individuals cannot be seen apart from the environment.

D. individuals cannot be seen apart from the environment. RATIONALE 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 physicians.

A nurse has volunteered to give influenza immunizations at a local clinic. What level of care is the nurse demonstrating? A. Tertiary B. Secondary C. Primary D. Promotive

C. Primary RATIONALE Giving influenza injections is an example of primary health promotion and illness prevention.

The client is admitted with a gastrointestinal bleed. The physician ordered a colonoscopy. Which level of care encompasses this procedure? A. Primary B. Quanternary C. Secondary D. Tertiary

C. Secondary RATIONALE 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.

A nurse assists the client in the development of a healthy lifestyle. The adoption of these lifestyle changes in the client's life is considered: A. adaptation. B. self-care. C. self-esteem. D. health management.

B. self-care. RATIONALE Self-responsibility is paramount in Dorothea Orem's nursing theory, which focuses on self-care so that the person can maintain life, health, and well-being. Self-esteem is one's own sense of one's worth. Adaptation is how one responds to one's environment and to disease. Heatlh mangagement is one's efforts to maintain one's health.

A 47-year-old woman is traveling overseas on vacation with her husband. He has a sore throat that has been diagnosed as Streptococcus. The woman is the: A. host. B. agent. C. environment. D. reservoir.

A. host. RATIONALE The host is the person who may be at risk for, or is susceptible to, illness.

The nurse uses the agent-host-environment model of health and illness to assess diseases in patients. This model is based on what concept? A. Risk factors B. Demographic variables C. Behaviors to promote health D. Stages of illness

A. Risk factors RATIONALE The interaction of the agent, host, and environment creates risk factors that increase the probability of disease.

The nurse recognizes that the client who makes the decision to accept a new diagnosis and follow the prescribed treatment plan is in which stage of an illness? A. Stage 1-Experiencing symptoms B. Stage 2-Assuming the sick role C. Stage 3-Assuming a dependent role D. Stage 4-Achieving Recovery

C. Stage 3-Assuming a dependent role RATIONALE Stage 3 is characterized by the client's decision to accept the diagnosis and follow the treatment plan. Stage 1 is the beginning of symptoms. Stage 2 is where a client describes himself or herself as being sick and seeks validation from others. Stage 4 is recovery and rehabilitation and is the final stage of the illness.

A client, who has just been diagnosed with a chronic condition, asks the nurse what a"chronic condition" means. What would be the nurse's bestresponse? A. "Chronic conditions usually come on slowly and may have periods of remission and exacerbation." B. "Chronic conditions are diseases that come and go." C. "Chronic conditions involve disabilities that require hospitalization." D. "Chronic conditions require short-term management in extended-care facilities."

A. "Chronic conditions usually come on slowly and may have periods of remission and exacerbation." RATIONALE Chronic conditions usually come on slowly and may have periods of remission and exacerbation. Saying chronic diseases come and go is not the best answer, as they are long-term, permanent conditions. Chronic diseases are usually managed in the home environment, not in extended-care facilities. Chronic conditiions are not always associated with disabilities nor do they always require hospitalization.

What are common sources of stress in family members due to a hospitalization of a family member? Select all that apply. A. Alterations in roles B. Economic problems C. Alterations in lifestyle D. Decrease in social interactions E. Increase in exercise

A. Alterations in roles B. Economic problems C. Alterations in lifestyle D. Decrease in social interactions RATIONALE 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.

An older adult patient 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? A. Assuming a dependent role B. Assuming the sick role C. Experiencing the symptoms D. Achieving recovery and rehabilitation

A. Assuming a dependent role RATIONALE The stage of assuming a dependent role often requires assistance in carrying out activities of daily living. As well, the patient 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 patient's present circumstances.

A client with a lump in the breast calls the healthcare provider to schedule an appointment for an evaluation. Based on the client's actions, what stage of illness is the client demonstrating? A. Assuming the sick role B. Experiencing the symptoms C. Assuming the dependent role D. Achieving recovery and rehabilitation

A. Assuming the sick role RATIONALE Seeking out a healthcare provider for diagnosis and treatment is an example of assuming the sick role. Experiencing the symptoms occurs when a person recognizes one or more symptoms. Assuming the dependent role is characterized by the client's decision to accept the diagnosis and follow the prescribed treatment plan. Achieving recovery and rehabilitation is characterized by the client giving up the dependent role and resuming normal activities and responsibilities.

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? A. By being a role model for healthy behaviors B. By not requiring sick days from work C. By never exposing others to any type of illness D. By budgeting time and resources efficiently

A. By being a role model for healthy behaviors RATIONALE Good personal health enables the nurse to serve as a role model for patients and families.

A nurse working in a hospital setting cares for patients with acute and chronic conditions. Which disease states are chronic illnesses? Select all that apply. A. Diabetes mellitus B. Bronchial pneumonia C. Rheumatoid arthritis D. Cystic fibrosis E. Fractured hip F. Otitis media

A. Diabetes mellitus C. Rheumatoid arthritis D. Cystic fibrosis

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? A. Exacerbation B. Morbidity C. Infection D. Risk factor

A. Exacerbation RATIONALE 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. A. Family B. Culture C. Community D. Society E. Music

A. Family B. Culture C. Community D. Society RATIONALE 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.

Which client growth needs are included in the love and belonging level of Maslow's hierarchy? (Select all that apply.) A. Family B. Self-respect C. Intimacy D. Status E. Friendships

A. Family C. Intimacy E. Friendships RATIONALE Love and belonging includes the need for affection, belonging, and meaningful relations with others (family, intimacy, friendships). Self-esteem includes self-respect and status.

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. A. Family planning services B. Accident prevention education C. Heart-healthy nutrition services D. Skin cancer screening E. Rehabilitation for relief of low back pain

A. Family planning services B. Accident prevention education C. Heart-healthy nutrition services RATIONALE 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.

What is a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity? A. Health B. Wellness C. Holism D. Host

A. Health RATIONALE The World Health Organization defines health as "a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity." Wellness is a dynamic and conscious process of making choices to achieve one's highest level of potential. Holism is care that addresses all dimensions of a person, including mind, body, and spirit. Host is the person who experiences an infection.

Which behaviors are necessary for a person to successfully adapt to a chronic illness? Select all that apply. A. Learn to live as normally as possible B. Accept dependence and adjust to it C. Maintain a positive self-concept D. Maintain a sense of hope Give up control of one's life

A. Learn to live as normally as possible C. Maintain a positive self-concept D. Maintain a sense of hope RATIONALE 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.

The nurse provided teaching to a client newly diagnosed with gout. Which behavior observed by the nurse indicates the client understood the teaching? A. Selects foods low in purine from the dinner menu B. Performs range-of-motion exercises on painful joints C. Applies heat to painful, swollen joints D. Orders seafood and red meat from the lunch menu

A. Selects foods low in purine from the dinner menu RATIONALE Gout is arthritic-type pain exacerbated by purine in the diet. As such, selecting foods low in purine while filling out the dinner menu indicates the client understood the teaching. Performing range-of-motion exercises on painful, swelling joints should not be done, as this exacerbates the symptoms. Ice, not heat, should be applied to painful joints. Seafood is high in purine and red meat is high in fat; both should be avoided with gout.

A client has been admitted to the hospital for treatment of pancreatitis secondary to alcoholism. The client states that it is nearly impossible to quit drinking because of the deep entrenchment of alcohol use in the client's circle of friends and line of work. As well, the client claims to have thought that drinking only beer and foregoing hard alcohol would prevent health problems. This client is exhibiting health consequences rooted in which human dimensions? A. Sociocultural and intellectual B. Environmental and spiritual C. Emotional and environmental D. Physical and emotional

A. Sociocultural and intellectual RATIONALE That the patient is situated in a context that normalizes heavy alcohol use is an example of the sociocultural dimension. The client's ignorance of the health consequences of drinking beer rather than spirits is a component of the intellectual dimension.

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? A. The client gives up the dependent role. B. The client assumes a dependent role. C. The client seeks medical attention. D. The client recognizes symptoms of illness.

A. The client gives up the dependent role. RATIONALE 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.

Why do nurses need to care for their own health needs? Select all that apply. A. To allow them to give effective nursing care to others B. To enable them to practice more efficiently C. To help them serve as role models for clients D. To make them look more appealing to the public E. To deemphasize the importance of care provided by physicians

A. To allow them to give effective nursing care to others B. To enable them to practice more efficiently C. To help them serve as role models for clients RATIONALE Nurses must take care of their own health to allow them to provide effective care to others. Good personal health enables the nurse to practice more efficiently and serve as a role model. Looking more appealing and deemphsizing the importance of care provided by physicians are not valid reasons for nurses to take care of their own health.

When providing holistic care to a client, the nurse recognizes that which behaviors are necessary? Select all that apply. A. Understand and respect each person's definition of health. B. Understand and respect each person's responses to illness. C. Focus on a standard definition of health and beliefs. D. Apply the model of health that is most popular. E. Instruct the client that health is an inactive process.

A. Understand and respect each person's definition of health. B. Understand and respect each person's responses to illness.

When admitting an adolescent to the hospital, the nurse anticipates that the client will respond to questions about the client's health beliefs based primarily on the client's: A. age and developmental stage. B. gender and medical history. C. peer influence and education. D. health promotion activities.

A. age and developmental stage. RATIONALE Age and developmental stage are important considerations in the health belief model. Other factors are influential, but age and developmental stage are paramount.

The body's attempt to restore balance through self-regulatory mechanisms is termed: A. homeostasis. B. equilibration. C. self-conception. D. biofeedback.

A. homeostasis. RATIONALE Homeostasis is the organism's attempt to restore balance. Equilibration is a distractor for this question. Self-conception is related to the individual's feelings and attitudes about oneself. Biofeedback is a relaxation technique.

Which scenario accurately depicts the influence of one's religious beliefs? A. A client who practices Islam requests a baptism for live birth. B. A client who practices Orthodox Judism will not eat pork. C. A client who practices Conservative Catholism opposes a blood transfusion. D. A client who practice the Jehovah's Witnesses faith will not eat shellfish.

B. A client who practices Orthodox Judism will not eat pork. RATIONALE 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.

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. A nurse runs an immunization clinic in the inner city. B. A nurse teaches a patient with an amputation how to care for the residual limb. C. A nurse provides range-of-motion exercises for a paralyzed patient. D. A nurse teaches parents of toddlers how to childproof their homes. E. A school nurse provides screening for scoliosis for the students. F. A nurse teaches new parents how to choose and use an infant car seat.

B. A nurse teaches a patient with an amputation how to care for the residual limb. C. A nurse provides range-of-motion exercises for a paralyzed patient.

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. A White male diagnosed with HIV B. An African American teenager who is 6 months pregnant C. A Hispanic male who has type II diabetes D. A low-income family living in rural America E. A middle-class teacher living in a large city F. A White baby who was born with cerebral palsy

B. An African American teenager who is 6 months pregnant C. A Hispanic male who has type II diabetes D. A low-income family living in rural America F. A White baby who was born with cerebral palsy

Which are characteristics of chronic conditions? (Select all that apply.) A. Resolve spontaneously B. Are rarely curable C. Have a rapid onset D. Require lifelong management E. Have a prolonged course

B. Are rarely curable D. Require lifelong management E. Have a prolonged course RATIONALE 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.

How can the nurse best demonstrate being a role model for health promotion? A. Educate others about healthy lifestyles B. Avoid smoking and drinking alcohol C. Prevent exposure to communicable diseases D. Take prescribed medications accordingly

B. Avoid smoking and drinking alcohol RATIONALE 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.

A nurse is caring for a client with end-stage liver failure. Which healthcare agency should the nurse recommend for continuity of care? A. HMO B. Emergency department C. PPO D. Extended care

B. Extended care RATIONALE Extended care services meet the needs of clients who no longer require acute hospital care, including rehabilitation, skilled nursing care in a person's home or nursing home, and hospice for dying clients. HMOs are corporations that provide health care for members in exchange for preset, fixed, or yearly fees. PPOs are agents for health insurance companies that control healthcare costs on the basis of competition. A client with end-stage liver failure would not require emergency care.

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. A. Health and illness are the same for all people. B. Health and illness are individually defined by each person. C. People with acute illnesses are actually healthy. D. People with chronic illnesses have poor health beliefs. E. Health is more than the absence of illness. F. Illness is the response of a person to a disease.

B. Health and illness are individually defined by each person. E. Health is more than the absence of illness. F. Illness is the response of a person to a disease.

A community health nurse arranges for a dental checkup camp for the local children in the school district. Which of the following would most likely be the nurse's goal for this health camp? A. Illness prevention B. Health promotion C. High-level wellness D. Reversal of self-care deficit

B. Health promotion RATIONALE The education on lifestyle choices is part of health promotion activity, which focuses on protecting the person's health. The goal of the prevention of illness is to detect and prevent the illness. High-level wellness focuses on maximizing the person's highest potential for functioning. Reversal of self-care deficits would involve therapeutic interventions that are directed at contributing factors.

The nurse is working in an acute care setting and performs primary, secondary, and tertiary prevention. Which activity performed by the nurse is classified as tertiary prevention? A. Promoting safety in the home B. Instructing a client on how to use crutches C. Counseling a client about a low-sodium diet D. Assessing a client's blood glucose level

B. Instructing a client on how to use crutches RATIONALE Tertiary prevention is used after an injury or sickness to help rehabilitate the client or to decrease potential risk and further damage, such as instructing the client on how to use crutches. Promoting safety in the home and counseling a client about a low-sodium diet are examples of primary prevention (preventing a disease from occurring in the first place). Assessing blood glucose level is an example of secondary prevention (screening to detect a disease early).

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? A. Nonmodifiable B. Modifiable C. Primary D. Secondary

B. Modifiable RATIONALE 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.

What level of prevention is represented by educating a group of clients on breast self-examination? A. Educational prevention B. Primary prevention C. Secondary prevention D. Tertiary prevention

B. Primary prevention RATIONALE Primary prevention focuses on the health of a person with the goal of preventing disease or illness. Self-breast examination 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 is certified in providing Therapeutic Touch and is preparing to initiate this for a client. What activity should the nurse perform first? A. Calling to rebalance the soul B. Requesting the client's permission to touch the body C. Embracing the client for energy D. Moving the hands 2 to 6 in (5 to 16 cm) away from the client's skin surface

B. Requesting the client's permission to touch the body RATIONALE Prior to touching the client, the nurse should request permission and explain the process of therapeutic touch. All other interventions would be performed after this occurs.

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? A. Primary B. Secondary C. Tertiary D. All three levels

B. Secondary RATIONALE 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.

Consultation and diagnostic tests are included in which level of health care? A. Primary care B. Secondary care C. Tertiary care D. Extended care

B. Secondary care RATIONALE Consultation and diagnostic tests are included in the secondary level of health care. The first contact with a general physician is the primary care, and the reference to a highly specialized facility for desensitization is the tertiary care level. The secondary and tertiary care facilities are equipped to provide highly specialized care. Extended care is care provided to clients who no longer require acute hospital care.

A mammogram represents which level of prevention? A. Primary prevention B. Scondary prevention C. Tertiary prevention D. Medical prevention

B. Secondary prevention RATIONALE Secondary prevention includes screening for those at risk to develop illness, or those who could be diagnosed early in the process, and thus receive prompt treatment. Primary prevention refers to health promotion and illness prevention. Tertiary prevention refers to rehabilitation or prevention of complications after diagnosis with a disease. Medical is not a level of prevention.

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? A. Stage 1: Experiencing symptoms B. Stage 2: Assuming the sick role C. Stage 3: Assuming a dependent role D. Stage 4: Achieving recovery and rehabilitation

B. Stage 2: Assuming the sick role RATIONALE When people assume the sick role, they define themselves as ill, seek validation of this experience from others, and give up normal activities.

A nurse is caring for a client who has breast cancer. The client tells the nurse: "I don't know why this happened to me, but I'm ready to move on and do whatever I need to do to get healthy again." This client is in which stage of acute illness? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4

C. Stage 3 RATIONALE When a person becomes ill, certain illness behaviors may occur in identifiable stages (Suchman, 1965). These behaviors are how people cope with altered functioning caused by the disease. They are unique to the person and are influenced by age, gender, family values, economic status, culture, educational level, and mental status. By the statement the client made above, the client is in stage 3 of acute illness, assuming a dependent role. This stage is characterized by the client's decision to accept the diagnosis and follow the prescribed treatment plan. Stage 1 is experiencing symptoms. Stage 2 is assuming the sick role. Stage 4 is achieving recovery and rehabilitation. Reference:

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? A. Screening for tuberculosis B. Assessing for risk factors for heart disease C. Teaching about adhering to a low-sodium diet D. Screening for breast cancer every 5 years

C. Teaching about adhering to a low-sodium diet RATIONALE 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 educating a client with diabetes on how to better control blood sugar levels and recognize the symptoms associated with both hyperglycemia and hypoglycemia. The client is frequently admitted to the hospital due to elevated blood sugars. This education is an example of which level of health promotion? A. Primary B. Secondary C. Tertiary D. Chronic

C. Tertiary RATIONALE Tertiary health promotion and illness prevention begin after the illness is diagnosed and treated, with the goal of reducing disability and helping to rehabilitate to a maximum level of functioning. Educating a client with diabetes on how to recognize areas of risk for the disease is one such example of tertiary promotion. Primary promotion is focusing on educating the client to potential risks. Secondary promotion is screening. There is not a chronic promotion component.

A nurse refers an HIV-positive client to a local support group. This is an example of what level of preventive care? A. Primary B. Secondary C. Tertiary D. Chronic

C. Tertiary RATIONALE 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 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? A. The client feels as if she is the cause of her family's dysfunction. B. The client's parents argue a lot. C. The client feels scared that her mother will hurt someone. D. The client is worried about getting a bad grade in school.

C. The client feels scared that her mother will hurt someone. RATIONALE 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).

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? A. Jane, whose best friend had a benign breast lump removed B. Sarah, who lives in a low-income neighborhood C. Tricia, who has a family history of breast cancer D. Nancy, whose family encourages regular physical examinations

C. Tricia, who has a family history of breast cancer RATIONALE 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.

The nurse is planning care for several clients in an outpatient clinic. Which client requires follow-up care due to a chronic condition? A. A client who fell off a roof 2 weeks ago and is experiencing continuous lower back pain B. A client returning for a follow-up visit after a shoulder sprain 1 week ago C. A client diagnosed with diabetes mellitus (DM) who stubbed the great toe and now has a wound D. A client with chronic obstructive pulmonary disease (COPD) who is wheezing and coughing

D. A client with chronic obstructive pulmonary disease (COPD) who is wheezing and coughing RATIONALE 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).

A community health nurse has noticed a large number of women in the community are not getting regular mammograms. This is a rural community with limited access to health care. Which action would be the most appropriate for the nurse to pursue to promote compliance in getting annual mammograms? A. Teach a class that stresses the importance of self-breast examination and regular mammogram screening. B. Arrange busses on a quarterly basis to take women to an urban area for mammogram screening. C. Mail flyers to women in the community offering instruction on where to go in a nearby city for mammograms. D. Arrange for a mobile mammography unit to come to the community several days a month.

D. Arrange for a mobile mammography unit to come to the community several days a month. RATIONALE The purpose of primary health promotion is to promote health and prevent disease or injury. Bringing a needed service into a community will benefit the greatest number of people in the community. Teaching a class, arranging transportation, or distributing flyers will not benefit the same number of people as actually bringing in the needed service.

What is a misconception about chronic disease? A. Almost half of chronic deaths occur prematurely in people under 70 years of age. B. Chronic illness typically does not result in sudden death. C. The major cause of chronic disease is known. D. Chronic illnesses cannot be prevented.

D. Chronic illnesses cannot be prevented. RATIONALE A misconception regarding chronic disease is that chronic illnesses cannot be prevented. Almost half of chronic deaths occur prematurely in people under 70 years of age. Chronic illness typically does not result in sudden death. The major cause of chronic disease is known.

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? A. Illness as a fixed point in time B. The importance of family C. Wellness as a passive state D. Health as a constantly changing state

D. Health as a constantly changing state RATIONALE Both these models view health as a dynamic (constantly changing state).

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? A. It persists for a long time. B. It is a sequela of acute illness. C. It takes a long time to cure. D. It has a gradual onset and lasts for a long time.

D. It has a gradual onset and lasts for a long time. RATIONALE 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.