Chapter 06: Health Promotion and the Individual Nursing School Test Banks

Chapter 06: Health Promotion and the Individual
Edelman: Health Promotion Throughout the Life Span, 8th Edition

MULTIPLE CHOICE

1. Healthy People 2020 objectives provide a framework for:
a. assessment.
b. diagnosis.
c. prevention.
d. treatment.
ANS: C
The health promotion initiative named Healthy People 2010 provides a framework for prevention.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 128

2. Which of the following best describes a primary prevention method for colon cancer?
a. Hemoccult testing
b. High fiber diet
c. Colonoscopy
d. Laparoscopy
ANS: B
Primary prevention includes generalized health promotion and specific protection from disease. Hemoccult and colonoscopy are forms of screening, not prevention. Eating a healthy diet high in fiber is a preventive measure.

DIF: Cognitive Level: Apply (Application) REF: pp. 128-129

3. Who authored the framework which provides the foundation for nursing assessment and diagnosis using the functional health patterns?
a. Erikson
b. Gordon
c. Newman
d. Nightingale
ANS: B
Gordons framework provides the foundation for most NANDA nursing diagnoses using the functional health pattern. Nurses use the framework to combine assessment skills with subjective and objective data to construct patterns.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 129

4. Over the last week, a person has had finger stick glucose levels of 127, 132, 140, 138, 143, 145, and 140. This information allows the nurse to characterize the persons function pattern by utilizing which area of focus?
a. Age-developmental
b. Functional
c. Individual-environmental
d. Pattern
ANS: D
Pattern focus implies that the nurse explores patterns or sequences of behavior over time. Pattern recognition occurs during information collection. Functional health patterns then provide structure to analyze factors.

DIF: Cognitive Level: Apply (Application) REF: p. 130

5. A nurse is using a functional focus to assess a person. Which of the following the nurse be evaluating?
a. Visual acuity
b. Pupil reactivity
c. Ability to drive
d. The red reflex
ANS: C
Functional focus refers to the individuals performance level. Nurses assess how particular visual patterns affect lifestyle. The ability to drive would affect a persons lifestyle and might require a change in how the person functions.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 131

6. A nurse working with a Hispanic family is explaining the plan for managing a childs asthma to the childs mother, father, and grandmother. To whom should the nurse direct the education?
a. Mother
b. Father
c. Grandmother
d. Parents and grandmother
ANS: D
Culturally competent care is delivered with understanding of and sensitivity to cultural factors influencing health behaviors. Nurses provide culturally competent care when they identify and use cultural norms and values. In the Hispanic population, the male figure is usually the decision maker, and the family elders are highly respected. However, assumptions about cultural norms should not be made. As a result, the nurse should direct education to all three adults because they may all have an impact on the childs health care needs.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 131

7. A 27-year-old woman has not received a Pap test in years. This assessment finding identifies an alteration in which functional pattern?
a. Health-perceptionhealth-management pattern
b. Elimination pattern
c. Activity-rest pattern
d. Self-perceptionself-concept pattern
ANS: A
Assessment objectives for the health-perceptionhealth-management pattern consist of obtaining data about perceptions, management, and preventive health practices. Exploring these values identifies potential health hazards. A 27-year-old woman should receive a Pap test every 2 years. Failing to do so could place her at risk for health problems; thus, this finding identifies an alteration in the health-perceptionhealth-management pattern.

DIF: Cognitive Level: Apply (Application) REF: p. 131

8. A client is experiencing an alteration in the health-perceptionhealth-management pattern and an alteration in the values-beliefs pattern. Which of the following best describes the behavior of this person?
a. Never sees a physician
b. Only sees a physician if not feeling well
c. Sees a physician for screenings only
d. Sees a physician for follow-up care of a chronic disease
ANS: B
Health beliefs and perceptions directly affect participation in care. Dimensions of assessment in the values-beliefs pattern include the individuals values, beliefs, or goals that guide choices or decisions that are related to health. People who do not believe in health promotion activities will likely see a physician only when sick. Thus, someone with an alteration in the health-perceptionhealth-management and values-beliefs patterns will likely only see a physician if not feeling well.

DIF: Cognitive Level: Apply (Application) REF: p. 131 | p. 142

9. When assessing a persons nutritional-metabolic pattern, which objective finding would have implications for nursing intervention?
a. The persons 24-hour diet diary
b. The persons dentition
c. The persons food preferences
d. The persons financial status
ANS: B
Although all of the assessment parameters listed have implications for nursing diagnosis and planning for this client, the only objective measure is the clients dentition. It is the only one that can be validated with a physical exam.

DIF: Cognitive Level: Apply (Application) REF: p. 134

10. When assessing a clients activity-exercise pattern, which subjective finding has implications for nursing practice?
a. A persons decreased muscle tone
b. A persons amount of leisure time
c. A persons decreased range of motion
d. A persons use of a cane
ANS: B
Although all findings are important in assessing the activity-exercise pattern, the only subjective finding is the amount of leisure time that the person reports having. All others are objective findings and can be validated with a physical exam.

DIF: Cognitive Level: Apply (Application) REF: pp. 135-136

11. During a health history, a person reports getting 5 hours of sleep a night. What does this information indicate to the nurse?
a. The person is not receiving enough sleep.
b. The person is receiving adequate sleep.
c. The nurse must determine where the person sleeps.
d. The nurse must ask additional questions.
ANS: D
The single most important factor assessed in the sleep-rest pattern is probably the perception of adequacy of sleep and relaxation. The objective when assessing the sleep-rest pattern is to describe the effectiveness of the pattern from the persons perspective. Wide variation in sleep time does not necessarily affect functional performance. Different individuals require different amounts of sleep. Thus, without further subjective data, the nurse is not able to make a diagnosis in this functional pattern.

DIF: Cognitive Level: Apply (Application) REF: p. 136

12. A nurse assesses the cognitive-perceptual pattern of a Type 1 diabetic client. Which finding has implications for the individuals nursing plan of care?
a. Decreased sense of hearing
b. Decreased sense of smell
c. Decreased sense of taste
d. Decreased visual acuity
ANS: D
Assessment parameters in the cognitive-perceptual pattern include hearing, vision, smell, and taste. A person with Type 1 diabetes mellitus requires insulin injections. A decrease in visual acuity will make it difficult for the individual to draw up his or her medication and therefore will influence the nurses plan of care.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 137

13. Which scenario indicates a potentially dysfunctional pattern?
a. Adult with frequent urination
b. Woman who lost her job
c. Elderly person with blurred vision
d. Overweight adult with a sweet tooth
ANS: B
A pattern is potentially dysfunctional when sufficient evidence exists or enough risk factors are present to indicate that a pattern of dysfunction will likely occur if interventions are not instituted. A dysfunctional pattern is a problem when it represents a deviation from established norms or from the individuals previous condition or goal. The woman who lost her job indicates a potential dysfunction pattern because the stress of losing her job places her at risk for ineffective coping. The other scenarios are not potentially dysfunctional; by definition, they are dysfunctional.

DIF: Cognitive Level: Apply (Application) REF: p. 144

14. Which scenario represents a dysfunctional pattern?
a. Sexually active teenager who does not use condoms
b. Salesman who sleeps only 5 hours a night
c. Single mother of three children
d. Woman with a small extended family
ANS: A
A pattern is potentially dysfunctional when sufficient evidence exists or enough risk factors are present to indicate that a pattern of dysfunction will likely occur if interventions are not instituted. A dysfunctional pattern is a problem when it represents a deviation from established norms or the individuals previous condition or goal. Dysfunctional patterns may be present in the absence of disease, and nursing care may be necessary for health promotion and maintenance. The teenager, although free of disease, is in need of health promotion and disease prevention strategies because her sexual behavior indicates a dysfunction in her sexuality-reproductive pattern that places her at risk for a sexually transmitted disease and pregnancy.

DIF: Cognitive Level: Apply (Application) REF: p. 144

15. A nurse is counseling a person with a dysfunctional sleep pattern. Which of the following recommendations would the nurse most likely give the person?
a. Read in bed until he falls asleep.
b. Avoid fluids after 7 PM.
c. Exercise immediately before bedtime.
d. Watch television in the recliner in the evening.
ANS: B
Etiological factors of most dysfunctional patterns often lie within another pattern or patterns. Outcomes and plans are based on probable cause. Exercising before bed, watching television, and reading in bed are not considered appropriate sleep hygiene. Frequent urination may be the cause of his dysfunctional sleep pattern and, if so, avoiding fluids before bed would be an appropriate plan.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 144

16. A nurse is caring for a person with a potential dysfunction in the health-perceptionhealth-management pattern. Which of the following nursing interventions would most likely be performed?
a. Arranging for home delivery of medication from the pharmacy
b. Providing education regarding the dangers of smoking
c. Instituting visiting nurse services for blood pressure checks
d. Providing direct observed therapy for tuberculosis medications
ANS: B
Potential problems are risk states. Nursing interventions are directed toward risk reduction through education. Health promotion requires the individual to participate in his own care, and he cannot do this if he does not recognize his susceptibility to an impending health problem. Providing education addresses the risk and provides the person with information needed to change beliefs. The other options make the person a passive participant rather than an active one.

DIF: Cognitive Level: Apply (Application) REF: p. 144

17. The nurse has determined that a person has a dysfunction in the nutritional-metabolic pattern. Which action would be the next step for the nurse to take?
a. Weigh the person.
b. Set a goal weight with the person.
c. Ask the person what her favorite foods are.
d. Develop a plan for weight loss.
ANS: B
The individuals goals and the determined diagnosis provide the basis for planning. Before developing a plan, a goal must be set. Clarity of the goals and diagnosis is critical to the development of an effective plan. In this case, the diagnosis has already been established and thus assessment of this pattern has occurred (weight, favorite foods). The next step before developing a plan is to set a goal weight with the client.

DIF: Cognitive Level: Apply (Application) REF: p. 145

18. A nurse weighs a person who has been diagnosed with a dysfunction in the nutritional-metabolic pattern. Which aspect of the nursing process is being performed?
a. Assessment
b. Implementation
c. Planning
d. Evaluation
ANS: D
The nursing process consists of assessment, diagnosis, planning, implementation, and evaluation. A person who has been diagnosed with a dysfunction has already been assessed. The process of analyzing changes experienced by a person after a plan has been implemented occurs in the evaluation phase. In this question, a weight will determine whether or not the person is moving toward her goals of weight loss.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 145

19. A nurse administers the T-ACE test to a pregnant woman. The womans responses result in a score of 3. This score indicates that the woman:
a. requires interventions for problem drinking.
b. lacks evidence of problem drinking.
c. requires interventions for sexually transmitted disease risks.
d. lacks evidence of sexually transmitted disease risks.
ANS: A
The T-ACE provides a sensitive measure of alcohol-intake pattern in pregnant women. A score of 2 or more indicates evidence of problem drinking. This client had a score of 3, which would require an intervention for problem drinking.

DIF: Cognitive Level: Apply (Application) REF: p. 128 (Think About It Box)

20. A Hispanic mother tells the nurse that she has been using home remedies for her childs asthma. Which home remedy might this mother be using?
a. Acupuncture
b. Cupping
c. Hot tea
d. Massage
ANS: C
In the Hispanic population, asthma is viewed as a cold disease (hot-cold imbalance) and thus is treated with warm therapies. Diet is often used to maintain equilibrium. Thus, warm tea added to the childs diet might be used to restore equilibrium between hot and cold in this child who has asthma.

DIF: Cognitive Level: Apply (Application) REF: p. 133 (Box 6-2)

21. Which classification system fulfills needs that are exclusive to nursing?
a. The International Classification of Nursing Practice (ICNP)
b. The International Classification of Functioning, Disability, and Health (ICF)
c. The International Nursing Diagnoses Classification (NANDA-I)
d. The Nursing Diagnostic System (NDS)
ANS: C
The NANDA-I system includes diagnostic criteria, and related etiologies in addition to the description. The NANDA-I fulfills needs that are exclusive to nursing.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 144 (Box 6-5)

22. Eriksons task of autonomy vs. shame and doubt occurs during which stage of development?
a. Infancy
b. Early childhood
c. Late childhood
d. Early adolescence
ANS: B
Eriksons task of autonomy vs. shame and doubt occurs during early childhood.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 139 (Table 6-3)

23. A young couple is deciding if they should get married and start a family. Which of Eriksons life stages are they experiencing?
a. Identity vs. role confusion
b. Intimacy vs. isolation
c. Generativity vs. stagnation
d. Ego integrity vs. despair
ANS: B
During early adulthood individuals experience Eriksons life stage of intimacy vs. isolation. Examples of life events in this stage include committing to a mate and family responsibilities and selecting a career. Identity vs. role confusion occurs during adolescence. Intimacy vs. isolation occurs during middle adulthood. Ego integrity vs. despair occurs during maturity.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 139 (Table 6-3)

24. Which cultural group defines illness as a price that is being paid for the past or the future?
a. African
b. Native American
c. Arabian
d. Asian
ANS: B
American Indians define illness as a price that is being paid for the past or the future.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 133 (Box 6-2)

25. A man is telling a nurse that he feels that his health is a gift from God. This statement most closely coincides with beliefs of which cultural group?
a. African
b. Alaska Native
c. Asian
d. Hispanic
ANS: D
Hispanics define health as a gift from God.

DIF: Cognitive Level: Apply (Application) REF: p. 133 (Box 6-2)

26. Which of the following is the leading cause of death among women?
a. Accidents
b. Cancer
c. Coronary artery disease
d. Stroke
ANS: C
The leading cause of death in women is coronary artery disease.

DIF: Cognitive Level: Remember (Knowledge) REF: p. 144 (Hot Topics Box)

MULTIPLE RESPONSE

1. A client who fails to take his insulin on a regular basis may have a conflict in which of the following functional health patterns? (select all that apply)
a. Health-perceptionhealth-management
b. Cognitive-perceptual
c. Elimination
d. Values-beliefs
ANS: A, B, D
A problem in one area serves as a clue to dysfunction in other areas. Cognitive patterns include the ability of the individual to understand and follow directions, retain information, make decisions, solve problems, and use language appropriately. As a result, this person may not understand how to give himself the insulin properly. The values-beliefs pattern describes values including the individuals spiritual values, beliefs, and goals. This person may not believe in the use of medications unless he is symptomatic. The health-perceptionhealth-management pattern involves the individuals health status and health practices used to reach the current level of health or wellness, with a focus on perceived health status and meaning of health to the individual. This person may not believe in health promotion and prevention. Thus, a person who fails to take his insulin on a regular basis may have a conflict in the health-perceptionhealth-management, cognitive-perceptual, and values-beliefs patterns.

DIF: Cognitive Level: Apply (Application) REF: p. 131 | p. 137 | p. 142

2. Which individual is at risk for a dysfunction in elimination pattern? (select all that apply)
a. 46-year-old mother of two
b. 32-year-old African American man
c. 15-year-old girl
d. 72-year-old white woman
ANS: A, B, C, D
When evaluating elimination patterns, nurses must consider age, developmental level, and cultural considerations. A 46-year-old mother of two is at risk for urinary stress incontinence because of the two vaginal births; an older adult is at risk for urinary control problems; African Americans often have a diet low in fiber, which can lead to constipation; and teenagers, especially girls, may have problems with body image, leading to abuse of laxatives. Thus, all persons listed are at risk for a dysfunction in elimination patterns.

DIF: Cognitive Level: Analyze (Analysis) REF: p. 134

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