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Exam View - Chapter 16 - Test bank
Nursing Iv (NUR 2204C)
Valencia College
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Chapter 16: Health and Wellness
Yoost & Crawford: Fundamentals of Nursing: Active Learning for Collaborative Practice, 2nd Edition
MULTIPLE CHOICE
- The nurse knows the World Health Organization defines health in which of the following terms? a. The absence of disease b. The lack of infirmity c. Complete well-being d. Being independent of fiscal responsibility ANS: C The World Health Organization offers a definition for health: “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Nurses are responsible for helping patients reach their optimal levels of physiologic and mental health, but they also must provide health care in a system that requires cost containment and fiscal responsibility.
DIF: Remembering OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- Several models exist that describe the relationship between health and wellness. Which model is used to understand the interrelationship between elements of basic requirements for survival and the desires that drive personal growth and dev elopment and is represented as a pyramid? a. Maslow’s hierarchy of needs b. Health Belief Model c. Health Promotion Model d. Holistic Health Model ANS: A Maslow’s hierarchy of needs describes the relationships between the basic requirements for survival and the desires that drive personal growth and development. The model is most often presented as a pyramid consisting of five levels. The lowest level is related to physiologic needs, and the uppermost level is associated with self-actualization needs, specifically those re lated to purpose and identity. The Health Belief Model was developed by psychologists Hochbaum, Rosenstock, and Kegels. It explores how patients’ attitudes and beliefs predict health behavior. The Health Promotion Model, developed by Pender and colleagues, defines health as a positive, dynamic state of well-being rather than the absence of disease in the physiologic state. Holistic health models in nursing care are based on the philosophy that a synergistic relationship exists between the body and the envir onment. Holistic care is an approach to applying healing therapies. Holistic models focus on the interrelatedness of body and mind.
DIF: Remembering OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- The nurse is developing a plan of care for a patient with a hip fracture. Which model would the nurse use to prioritize the patient’s care? a. The Health Belief Model b. Pender’s Health Promotion Model c. Maslow’s hierarchy of needs d. The Holistic Health Model
ANS: C Maslow’s hierarchy of needs describes the relationships between the basic requirements for survival and the desires that drive personal growth and development. The model is most often presented as a pyramid consisting of five levels. The lowest level is related to physiologic needs, and the uppermost level is associated with self-actualization needs, specifically those re lated to purpose and identity. The Health Belief Model was developed by psychologists Hochbaum, Rosenstock, and Kegels. It explores how patients’ attitudes and beliefs predict health behavior. The Health Promotion Model, developed by Pender and colleagues, defines health as a positive, dynamic state of well-being rather than the absence of disease in the physiologic state. Holistic Health Models in nursing care are based on the philosophy that a synergistic relationship exists between the body and the envir onment. Holistic care is an approach to applying healing therapies. Holistic models focus on the interrelatedness of body and mind.
DIF: Applying OBJ: 16 TOP: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- The nurse is preparing a patient teaching plan and is seeking a way to determine the patient’s readiness and motivation to act regarding lifestyle changes to best manage diabetes mellitus. Which model would be useful for this nurse? a. Maslow’s hierarchy of needs b. Holistic Health Model c. Health Promotion Model d. Health Belief Model
ANS: D The Health Belief Model was developed by psychologists Hochbaum, Rosenstock, and Kegels. It explores how patients’ attitudes and beliefs predict health behavior. Maslow’s hierarchy of needs describes the relationships between the basic requireme nts for survival and the desires that drive personal growth and development. The model is most often presented as a pyramid consisting of five levels. The lowest level is related to physiologic needs, and the uppermost level is associated with self-actualiza tion needs, specifically those related to purpose and identity. Holistic Health Models in nursing care are based on the philosophy t hat a synergistic relationship exists between the body and the environment. Holistic care is an approach to applying healing t herapies. Holistic models focus on the interrelatedness of body and mind. The Health Promotion Model, developed by Pender and colleagues, defines health as a positive, dynamic state of well-being rather than the absence of disease in the physiolo gic state.
DIF: Understanding OBJ: 16 TOP: Evaluation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- According to the Health Belief Model, which of the following patients would be most likely to change health behavior? a. The person who perceives that he is at risk for colon cancer b. The person who recognizes that colon cancer is easily cured c. The person who believes that behavior can change outcomes d. The patient who faces multiple social barriers ANS: A In the three primary components of the Health Belief Model, six main constructs influence an individual’s decision to take action about disease prevention, screening, and controlling illness. The model suggests that individuals are motivated to take action if they believe that they are susceptible to the condition (i., perceived susceptibility), that the condition has serious cons equences (i., perceived severity), that taking action would reduce the susceptibility or severity of the condition (i., perceived be nefit), that the costs of taking action (i., perceived barriers) are outweighed by the benefits, that those who are exposed to factors (e., media campaigns, postcard reminders, and advice from others) will be prompted to action (i., cues to action), and that those who have confidence in their ability to perform an action will do so (i., perceived self-efficacy).
DIF: Analyzing OBJ: 16 TOP: Evaluation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- The nurse recognizes that intentional behaviors to circumvent illness, detect it early, and maintain the best possible l evel of mental and physiologic function within the boundaries of illness is the definition of which term? a. Health promotion b. Self-actualization c. Health protection d. Self-transcendence ANS: C Health protection includes intentional behaviors aimed at circumventing illness, detecting it early, and maintaining the best possible level of mental and physiologic function within the boundaries of illness. Health promotion is behavior motivated by the desire to increase well-being and optimize health status. Maslow considered self-actualization the highest level of optimal functi oning and involves the integration of cognition, consciousness, and physiologic utility in a single entity. In later years, Maslow described a level above self-actualization called self-transcendence. He refers to self-transcendence as a peak experience, in which analysis of reality or thought changes a person’s view of the world and his or her position in the greater structure of life.
DIF: Remembering OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- The nurse caring for a patient with chronic pain uses guided imagery, therapeutic touch, and relaxation techniques as in terventions for pain. The nurse is using what type of approach? a. Holistic b. Eastern holistic c. Risk factor reduction d. Health protection
ANS: A Nurses participate in holistic care through the use of natural healing remedies and complementary interventions. These include the use of art and guided imagery, therapeutic touch, music therapy, relaxation techniques, and reminiscence. Eastern holistic therapists have been using techniques such as acupuncture, yoga, and tai chi for thousands of years as methods of healing and, more recently, in conjunction with modern allopathic medical therapies. Risk factor reduction is step-by-step improvement of individual health factors. These combined improvements lower the likelihood of developing a disease. Health protection includes intentional behaviors aimed at circumventing illness, detecting it early, and maintaining the best possible level of mental and physiologic function within the boundaries of illness.
DIF: Remembering OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- A 40-year-old patient presents to her provider for a yearly physical. The provider notes a family history of breast cancer in the patient’s mother. The provider schedules the patient for a mammogram. The nurse recognizes this as what level of prevention? a. Tertiary b. Primary c. Secondary d. Holistic
ANS: C Secondary prevention is undertaken in cases of latent (hidden) disease. Although the patient may be asymptomatic, the disease process can be detected by medical tests. Nurses may use screening tests to assess for latent disease in vulnerable populations. Examples of screening tests used as secondary prevention strategies include the purified protein derivative (PPD) skin t est for tuberculosis, fecal occult blood test for colorectal cancer, and mammograms for breast cancer. Primary prevention is instituted before disease becomes established by removing the causes or increasing resistance. Examples include the use of seatbelts and airbags in automobiles, helmet use when riding bicycles or motorcycles, and the occupational use of mechanical devices when lifting heavy objects. Tertiary prevention, also known as the treatment or rehabilitation stage of preventive care, is i mplemented when a condition or illness is permanent and irreversible. The aim of care is to reduce the number and impact of complications and disabilities resulting from a disease or medical condition. Interventions are intended to reduce suffering caused by poor health and assist the patients in adjusting to incurable conditions. Nursing care is focused on rehabilitation efforts in the terti ary stage of prevention. Holistic care is an approach to applying healing therapies. Nurses participate in holistic care through the use of natural healing remedies and complementary interventions. These include the use of art and guided imagery, therapeutic touch, music therapy, relaxation techniques, and reminiscence.
DIF: Understanding OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- The patient asks the nurse to explain collaborative health care partnerships. The nurse gives a correct description when making which statement regarding collaborative care? a. Does not require participation of the patient. b. Is individual and cannot be mandated or legislated. c. Education needs are delegated to assistive personnel. d. Is designed to provide care to the patient as a whole. ANS: D Collaborative health care partnerships are designed to deliver well-balanced care to the patient as a whole, rather than rendering fragmented care involving a single element of a disease process. Prevention is not solely the responsibility of the nurse; it involves active participation by the individual and the combined services of practitioners in a spectrum of health care disciplin es as varied as nutrition, physical therapy, exercise physiology, and pharmacy. Collaborative preventive care can be mandated in the form of health care legislation, with rates for reimbursement of practitioners determined by the individual provider’s ability t o collaborate and develop innovative methods for delivering high-quality, cost-effective health care services. The role of the professional nurse is to collaborate and communicate health education to the patient and family, care provider, or surrogate. Patient education responsibilities are not delegated to assistive personnel or other members of the health care team and are considered a cornerstone of nursing care.
DIF: Understanding OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- A patient is diagnosed with pneumonia after an abrupt onset of fever, cough, and malaise. The patient is started on antibiotic therapy and is expected to improve in 2 to 3 weeks. Which statement by the nurse correctly identifies this illness? a. Acute b. Chronic c. Remission d. Exacerbation ANS: A Acute illness is typically characterized by an abrupt onset and short duration (<6 months). Clinical manifestations of a cute illness appear quickly. They may be severe or lethal, or they may soon resolve because they respond to treatment or are self-limiting. Chronic illness is characterized by a loss or abnormality of body function that lasts longer than 6 months and requires ongoing long-term care. Chronic health conditions may be controlled with lifestyle management or drug therapy, but they are considered to be irreversible. Chronic illness may be characterized by periods of wellness (i., remission) and exacerbation (worseni ng) of clinical manifestations, which can be life threatening. Individuals learn to adjust their lifestyles accordingly.
DIF: Understanding OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- The nurse needs to consider which approach when caring for patients with chronic illness? a. Help the patient face the reality that he will not get better. b. Emphasize to the patient that the illness is not his fault. c. Focus on improving quality of life through preventive behaviors. d. Acknowledge the limitations placed on the patient by his suffering.
ANS: C Nurses can help patients establish a daily routine of care by educating them about how to manage their care and the symptoms associated with the condition, including emergency or life-threatening situations. Emphasis is on improving quality of life through preventive behaviors. The attitude of being a victim, suffering with, or being afflicted by a chronic illness is viewed by nurses as a counterproductive behavior that needs positive intervention. Nurses can assist patients with strategies that help them c ope with their chronic conditions and associated feelings of anger, frustration, and depression. Encouragement and positive support from a professional nurse can help individuals gain control over the alternating periods of health and illness and improve thei r quality of life.
DIF: Applying OBJ: 16 TOP: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- A patient presents to the clinic for illness, and the sick role is legitimized by the provider. The nurse recognizes thi s as what stage of illness according to Suchman’s Model? a. I b. II c. III d. IV ANS: C In stage III (Medical care contact), professional advice from health care providers is sought by the individual. A profe ssional health care provider identifies and validates the illness and legitimizes the sick role. During stage II (Assumption of the sic k role), the person decides that the illness is genuine and that care is necessary. This stage gives an individual permission to act sick and to be excused temporarily from typical social and personal obligations. During stage I (Symptom experience), a clinical manifestation of disease is experienced, and the person acknowledges that something is wrong and seeks a cure. The outcome of stage I is that the person accepts the reality of symptoms and decides to take action in seeking care. During stage IV (Dependent patient role), the person, who is designated as a patient, usually undergoes treatment. During this stage, patients often feel dependent on others and may experience ambivalent or fearful thoughts that cause them to reject treatment, the advice of health care providers, and the illness.
DIF: Remembering OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- When considering factors influencing health and the impact of illness, specifically age, the nurse would correctly identify which patient as having the greatest risk? a. 10-year-old girl b. 23-year-old woman c. 47-year-old man d. 85-year-old woman ANS: D Assessment of the patient begins with risk factors that take into account the person’s age and the associated level of i mmune system function. The very young, especially neonates and infants born prematurely, are more susceptible to infections because of the immaturity of their immune systems. Likewise, older adults have decreased immune system function because of the aging process. Older patients are at risk for opportunistic infections resulting from harmless organisms that become pathogenic and illness from the spread of community-acquired disease. Complications from comorbidities of chronic disease may also increase suffering in the aged population.
DIF: Understanding OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- When discussing immunizations for infants and children with new parents, the nurse should focus on which approach? a. Providing scientific evidence to parents b. Stressing that nonimmunization is a crime c. Acknowledging that immunizations are not needed d. Informing the parents that they have no choice
ANS: A Parents need to have scientific, evidence-based information about immunizations and their consequences before choosing to accept or reject immunizations for their children. The parent’s ability to make an informed decision is the primary goal for nurses educating people about childhood immunizations.
DIF: Applying OBJ: 16 TOP: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- Self-concept refers to the way in which individuals perceive unchanging aspects of themselves, such as social character, cognitive abilities, physical appearance, and body image. Which additional point does the nurse the nurse recognize as part of the definition of self-concept? a. If negative, self-concept will allow the patient to compensate for weaknesses. b. If positive, self-concept will cause the patient to see challenges as devastating. c. Self-concept is a concept that is derived from the patient internally. d. Self-concept depends on relationships with family and friends.
ANS: D Self-concept refers to the way in which individuals perceive unchanging aspects of themselves, such as social character, cognitive abilities, physical appearance, and body image. It is a mental image of self in relation to others and the surroundings. If the image is positive, the person will develop strengths, compensate for weaknesses, and experience life in a healthy way. If the image is negative (e., frail), the person will find life’s challenges devastating and sometimes insurmountable. The impact of illness on the self-concept of a patient and the patient’s family members depends on how secure the parties’ relationships are with one another.
DIF: Understanding OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
MULTIPLE RESPONSE
- Which recommendations would the nurse identify as appropriate screening guidelines? ( Select all that apply. ) a. Women ages 21 to 29 should have a Pap test every 3 years. b. Self-breast exams should be addressed with male and female patients. c. Adolescent males should perform monthly self-testicular exams. d. Women ages 30 to 65 should receive Pap tests every 10 years. e. After a total hysterectomy, Pap testing should be more frequent. ANS: A, B, C All women should begin cervical cancer screening at the age of 21 years. Women between the ages of 21 and 29 years should have a Papanicolaou (Pap) test every 3 years. A priority assessment task for nurses in a variety of care settings is to ask female and male patients about breast self-examination. An adolescent male should be assessed for testicular self-examination habits, and older males should have an annual prostate examination. Women between the ages of 30 and 65 years should have a Pap test plus a human papillomavirus (HPV) test (i., co-testing) every 5 years. Women 65 years of age or older who have had normal results for previous Pap tests should no longer be screened. Women who have had a total hysterectomy (i., removal of the uterus and cervix) should not be tested, unless the surgery was done as a treatment for cervical cancer or pre-cancer.
DIF: Understanding OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- The nurse recognizes which of the following to be a benefit of regular physical exercise? ( Select all that apply. ) a. Enhances the immune system. b. Decreases bone density. c. Limits joint mobility. d. Improves mental health. e. Helps to prevent type 2 diabetes.
ANS: A, D, E Exercise is essential for the prevention of illness and promotion of wellness. Physical exercise is any bodily activity or movement that enhances or maintains physical fitness levels and overall health. Exercise strengthens muscles, improves cardiovascular performance, hones athletic skills and endurance, and reduces or maintains weight, and it is performed for enjoyment (Powers and Howley, 2012). Regular physical exercise enhances the immune system, builds and maintains healthy bone density, increases joint mobility, and helps to prevent cardiovascular disease, type 2 diabetes, and obesity. Exercise also improves mental health and helps to prevent depression through the release of endorphins and other neurotransmitters that are responsible for exercise-in duced euphoria (Powers and Howley, 2012).
DIF: Remembering OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotion
- The economic stability of individuals or families can determine whether they are willing to seek preventive care or screening examinations. The nurse knows which statements about screening examinations to be true? ( Select all that apply. ) a. Free or low-cost screening ensures patient screening. b. People may not screen due to fear of testing positive. c. Early screening ensures minimal treatment costs. d. Employment stability is enhanced by early screening. e. Treatment of disorders often means lost wages. ANS: B, E The economic stability of individuals or families can determine whether they are willing to seek preventive care or screening examinations. Even if screening is free or low cost, the patient or family members may decline because of the potential for testing positive for a disease. Treatment of a disorder often requires time spent away from work, lost wages, and expensive drug therapies and diagnostic tests. The financial impact can be devastating to families or individuals who have a limited or fixed income and fear that employment stability may be compromised.
DIF: Understanding OBJ: 16 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Health Promotions
Exam View - Chapter 16 - Test bank
Course: Nursing Iv (NUR 2204C)
University: Valencia College
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