Chapter 30: Major Health Issues and Chronic Disease Management of Adults Across the Life Span Nursing School Test Banks

Stanhope: Public Health Nursing, 8th Edition

Chapter 30: Major Health Issues and Chronic Disease Management of Adults Across the Life Span

Test Bank

MULTIPLE CHOICE

1. Which statement about eating disorders is correct?
a. Individuals with anorexia frequently complain about weight loss.
b. Purging is associated with anorexia.
c. Most women with bulimia are concerned with the shape and weight of their body.
d. Bulimia has more medical complications than anorexia.
ANS: C
Those with bulimia are usually concerned with the shape and weight of their body. Those with anorexia view themselves as normal or overweight; purging is associated with bulimia; and anorexia is considered to have more complications than bulimia.

DIF: COG: Understanding REF: 684 OBJ: 1

2. An older person is in the last stages of dying. Which type of care would be the best for him?
a. Home health
b. Assisted living
c. Nursing home
d. Hospice
ANS: D
Hospice would be the best form of care for a person in the last stages of dying.

DIF: COG: Applying REF: 691-692 OBJ: 1

3. When a client has designated someone else to make health care decisions when he or she is unable to do so, the client is using:
a. An advance directive
b. A living will
c. A durable medical power of attorney
d. The Patient Self-Determination Act
ANS: C
Durable medical power of attorney is the legal way for a client to designate someone else to make health care decisions when he or she is unable to do so.

DIF: COG: Applying REF: 677 OBJ: 2

4. The nurse is caring for an elderly client who has written advance directives. This means that the:
a. Client has made decisions regarding treatment if he becomes incapacitated.
b. Client has a living will.
c. Client has a Do Not Resuscitate order.
d. Clients family has decided on a medical treatment regimen.
ANS: A
Two parts of advance directives are the living will and a durable power of attorney. An advance directive indicates treatment choices if clients become incapacitated.

DIF: COG: Applying REF: 677 OBJ: 2

5. A woman needs to take some time off from work to care for her invalid mother. Which health policy allows her to take an extended leave from work to care for a family member?
a. Personal Responsibility and Work Opportunity Reconciliation Act
b. Womens Health Equity Act (WHEA)
c. Temporary Assistance for Needy Families (TANF)
d. Family and Medical Leave Act (FMLA)
ANS: D
The FMLA provides job protection and continuous health benefits where applicable for eligible employees who need extended leave for their own illness or to care for a family member.

DIF: COG: Applying REF: 676-677 OBJ: 2

6. Which situation may indicate elder abuse?
a. A daughter refuses to visit her mother due to work commitments
b. A child runs around a grandparents house breaking items
c. A young man repeatedly steals money from his grandmother
d. An older person demands that the family come for dinner
ANS: C
Theft or mismanagement of money or resources is an element of abuse.

DIF: COG: Evaluating REF: 677 OBJ: 2

7. Which indicator would a nurse most likely use to learn more about the overall health of a population?
a. Life expectancy
b. Health status
c. Morbidity rate
d. Prevalence
ANS: A
Life expectancy is a measure that is often used to gauge the overall health of a population.

DIF: COG: Analyzing REF: 678 OBJ: 3

8. Which characteristic indicates a man is at a higher risk for developing prostate cancer?
a. Being of Caucasian descent
b. Has not had a PSA test
c. Has a father or brother who has had prostate cancer
d. Has benign prostatic hypertrophy (BPH)
ANS: C
Having a father or brother who has had prostate cancer places a man at higher risk for developing prostate cancer.

DIF: COG: Understanding REF: 688 OBJ: 4

9. Which person would be considered obese?
a. An individual with a body mass index (BMI) of 10
b. An individual with a BMI of 20
c. An individual with a BMI of 30
d. An individual with a BMI of 40
ANS: C
A person is considered obese when the BMI reaches 30.

DIF: COG: Applying REF: 684 OBJ: 4

10. A nurse is educating a community womens group about the importance of monthly breast self-exam and annual mammograms. Why is this community health education important?
a. Increased screening will lead to a decreased incidence of breast cancer
b. Early detection of breast cancer typically leads to a better prognosis
c. The death rate of breast cancer continues to rise
d. The potential harm from screening needs to be discussed
ANS: B
Secondary prevention measures, including screening techniques, makes a difference in the death rates for breast cancer. Early detection often means cure whereas late detection typically results in an unfavorable prognosis.

DIF: COG: Analyzing REF: 686 OBJ: 4

11. Which action would a nurse take when implementing Wagners Chronic Care Model (CCM)?
a. Educate a community group about hypertension control.
b. Create a budget for chronic disease management.
c. Administer immunizations to community members.
d. Conduct depression screenings in the community.
ANS: A
Use of electronic health records, provider reminders for key evidence-based care components, interprofessional teams communicating regularly, and community health classes to educate people with chronic diseases are various ways the CCM is being implemented. Creating a budget is not a way to use CCM. Administration of immunizations and conducting depression screenings do not address the management of the most common and costly chronic diseases: heart disease, diabetes, stroke, cancer, and arthritis.

DIF: COG: Analyzing REF: 680 OBJ: 5

12. Testicular cancer is commonly found in which age-group?
a. 10 to 14 years
b. 15 to 40 years
c. 36 to 50 years
d. 51 to 70 years
ANS: B
Testicular cancer is commonly found in men 15 to 40 years old.

DIF: COG: Remembering REF: 688 OBJ: 6

13. Which type of cancer is the second leading cause of cancer deaths in the United States?
a. Gastrointestinal
b. Prostate
c. Skin
d. Testicular
ANS: B
Prostate is the most common non-skin cancer and second leading cause of cancer deaths in the United States.

DIF: COG: Remembering REF: 688 OBJ: 6

14. Current research on hormone replacement therapy (HRT) has found that it:
a. Does not prevent heart disease
b. Should be used to prevent osteoporosis
c. Is useful with complementary therapies
d. Causes breast cancer
ANS: A
HRT does not prevent heart disease. To prevent heart disease, women should avoid smoking, reduce fat and cholesterol intake, limit salt and alcohol, maintain a healthy weight, and be physically active.

DIF: COG: Understanding REF: 686 OBJ: 6

15. A nurse is educating a client about reducing her risk factors for the development of colorectal cancer. Which lifestyle change should the nurse recommend?
a. Increase in consumption of dairy products
b. Reduction in consumption of processed meats
c. Decrease in exposure to the sun
d. Increase in sedentary lifestyle
ANS: B
Obesity, physical inactivity, smoking, heavy alcohol consumption, a diet high in red or processed meats, and insufficient intake of fruits and vegetables are risk factors for colorectal cancer.

DIF: COG: Applying REF: 683 OBJ: 6

16. When a nurse advises a client who has HIV not to donate blood, plasma, or organs, which level of prevention is being used?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Health promotion
ANS: C
Tertiary prevention includes those interventions aimed at disability limitations and rehabilitation from disease, injury, or disability.

DIF: COG: Applying REF: 682 OBJ: 6

17. Developing a community-based exercise program for a group of women who have cardiovascular disease is an example of which level of prevention?
a. Primary prevention
b. Secondary prevention
c. Tertiary prevention
d. Health promotion
ANS: C
Tertiary prevention includes those interventions aimed at disability limitation and rehabilitation from disease, injury, or disability.

DIF: COG: Applying REF: 682 OBJ: 6

18. Which goal does the nurse plan to obtain when providing contraceptive counseling to a female?
a. Encourage the individual to choose abstinence.
b. Ensure the individual is educated to make an informed choice about reproduction.
c. Advocate for increased funding for reproductive services.
d. Reduce the health risks of the individual.
ANS: B
The goal of contraceptive counseling is to ensure that women have appropriate instruction to make informed choices about reproduction. The nurse should provide a non-judgmental approach during counseling and allow the woman to choose the appropriate contraceptive method. Nurses do advocate for reproductive services for women, but that is not a goal of contraceptive counseling. Reduction in the health risks of the individual is a goal of preconceptual counseling.

DIF: COG: Analyzing REF: 685 OBJ: 6

19. A nurse providing preconceptual counseling to a woman recommends taking which supplement to help prevent neural tube defects?
a. Iron
b. Calcium
c. Folic acid
d. Vitamin C
ANS: C
400 micrograms of folic acid are recommended daily.

DIF: COG: Analyzing REF: 685 OBJ: 6

20. Which activity would a community health nurse most likely implement to reduce the prevalence of sexually transmitted diseases (STDs) in the community?
a. Establish immunization clinics to prevent STDs.
b. Educate people with HIV about the mode of transmission.
c. Explain to women that HIV is transmitted to women usually by IV drug abuse.
d. Develop an STD clinic to increase community access to services.
ANS: D
The goal of Healthy People 2020 is to promote responsible sexual behaviors, strengthen community capacity, and increase access to quality services to prevent STDs and their complications. Nursing activities should align with these goals.

DIF: COG: Evaluating REF: 684 OBJ: 6

21. Which statement about health disparities is accurate?
a. African American women have a much higher incidence of breast cancer.
b. Health disparities are the result of negligent health care practices.
c. Health disparities vary among racial/ethnic groups.
d. Men have more obstacles to receiving health care than women.
ANS: C
Improvements have been made in some areas of health disparities among various populations. However, health disparities vary among each racial/ethnic group.

DIF: COG: Understanding REF: 689 OBJ: 7

22. Which factor has the largest impact on health disparities among all populations?
a. Ethnicity
b. Education level
c. Lifestyle choices
d. Poverty
ANS: D
Poverty is a strong and underlying current factor that affects all special groups. Other factors that may also influence disparities are: education, insurance status, segregation, immigration status, health behaviors and lifestyle choices, health care provider behavior, employment, and the nature and operation of the health system in the community.

DIF: COG: Understanding REF: 689 OBJ: 7

23. Which is the best strategy for the nurse to use to combat health disparities in special populations?
a. Increase awareness of ones own views and values.
b. Recognize available community resources.
c. Advocate for health policy changes.
d. Understand special conditions and concerns for various populations.
ANS: A
Cultural competence has been viewed as a strategy to combat health disparities. To increase cultural competence, nurses must continually engage in self-reflective activities that assess his or her world view and values about working with diverse individuals.

DIF: COG: Evaluating REF: 691 OBJ: 7

24. Which nursing intervention would be appropriate for the nurse to implement when working with incarcerated adults who are being released from prison?
a. Connect offenders with community-based mental health programs.
b. Provide community supervision for mentally ill offenders.
c. Advocate for increased prison time to decrease recidivism rates.
d. Educate about available state resources.
ANS: A
Connecting offenders with community-based mental health programs at the time of release from prison can decrease recidivism rates, as many incarcerated adults experience major psychiatric disorders. It would be impossible for the nurse to supervise all mentally ill offenders in the community. Increased prison time is not shown to decrease recidivism rates and education about available state resources is not the most important nursing intervention to provide for this population.

DIF: COG: Evaluating REF: 689 OBJ: 7

25. What is the purpose of adult day health centers?
a. To provide support of life until death occurs
b. To provide assistance to people who may need help with ADLs
c. To provide treatment for those needing rehabilitation
d. To provide respite care relief for caregivers
ANS: D
Some adult health centers provide respite overnight care to relieve caregivers.

DIF: COG: Understanding REF: 691 OBJ: 8

26. An elderly person is living independently in a single room in a full-service life care community. This living arrangement is described as:
a. Adult day care
b. Home care
c. Nursing home
d. Assisted living
ANS: D
An elderly person living independently in a single room in a full-service life care community is a client of an assisted living facility.

DIF: COG: Applying REF: 691 OBJ: 8

MULTIPLE RESPONSE

1. Which factors are cited as obstacles to improving mens health? Select all that apply.
a. Reluctance to consult their primary care provider
b. Emphasis of physical strength and competitiveness on masculinity
c. Lack of a primary care provider
d. Lack of access to health care by African American and Hispanic men
ANS: A, B, C
Obstacles to improving mens health include reluctance to consult their primary care provider, the concept that masculinity emphasizes physical strength and competitiveness, and the fact that many men do not have a primary care provider.

DIF: COG: Understanding REF: 687 OBJ: 4

2. Which considerations should be made by a nurse when caring for an elderly female population? Select all that apply.
a. Postmenopausal women are more likely than men to experience hypertension.
b. Women use more health services than men.
c. Women report lower rates of disability than men.
d. Women and men have similar socialization patterns.
ANS: A, B
Postmenopausal women are more likely than men to experience hypertension; prior to menopause, the rate is higher among men. Women use more health services than men. Women report higher rates of disability than men. Women and men have different socialization, expectations, and lifestyles.

DIF: COG: Analyzing REF: 679 OBJ: 3

3. Which essential elements should be considered by the nurse who is planning to implement Wagners Chronic Care Model (CCM)? Select all that apply.
a. Clinical information systems
b. Evidence-based change
c. Self-management support
d. Community
ANS: A, C, D
The essential elements of CCM are: the community, the health system, self-management support, delivery system design, decision support, and clinical information systems. Evidence-based change concepts are found under each of the essential elements and help to foster productive interactions between clients and providers.

DIF: COG: Applying REF: 680 OBJ: 5

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