Chapter 6: Health and Wellness Nursing School Test Banks

Potter & Perry: Fundamentals of Nursing, 6th Edition

MULTIPLE CHOICE

1. There are different ways to look on health and illness. When formulating a definition of health, a person should consider that health, within its current definition, is:

a.

The absence of disease

b.

A function of the physiological state

c.

A state of well being involving the whole person

d.

The ability to pursue activities of daily living

ANS: c

c. When formulating a definition of health, a person should consider the total person, as well as the environment in which the person lives. Health generally implies a state of well being, which is ultimately defined in terms of the individual.

a. Health is considered to be more than merely the absence of disease.

b. The definition of health has broadened beyond the physiological state to include mental, social, and spiritual well being.

d. An individual who has the ability to pursue activities of daily living may not define himself or herself as being healthy. Life conditions such as environment, diet and lifestyle practices may negatively affect ones health long before one is unable to perform activities of daily living.

REF: Text Reference: p. 91

2. Which one of the following is one of the main, overreaching goals for Healthy People

2010?

a.

Reduction of health care costs.

b.

Elimination of health disparities.

c.

Investigation of substance abuse.

d.

Determination of acceptable morbidity rates.

ANS: b

b. Two overarching goals for Healthy People 2010 are (1) to increase quality and years of healthy life, and (2) to eliminate health disparities.

a. Reducing health care costs was not a goal for Healthy People 2010.

c. Investigation of substance abuse was not one of the main, overarching goals for Healthy People 2010.

d. Determining acceptable morbidity rates was not one of the main, overarching goals for Healthy People 2010.

REF: Text Reference: p. 91

3. A nurse is using a holistic approach with a client. To incorporate all of the factors that may influence the client, the nurse should respond to the client as follows:

a.

I would like you to perform this exercise once a day.

b.

Your physician has left orders for you to follow.

c.

The laboratory tests reveal the need to reduce your daily percentage of fat grams.

d.

Adapting your diet and activity will lower your blood glucose levels.

ANS: d

d. Using a holistic approach involves consideration of all factors that may affect a clients level of well being in all dimensions, not just physical health. Factors such as diet and exercise can influence ones level of health.

a. Directing the client in exercise does not address the many factors that may affect ones level of health. This response does not facilitate the clients seeing the connection between lifestyle choices and well being.

b. Directing the client to follow physicians orders, although important, does not describe a holistic approach of nursing care. A holistic approach may include a discussion of diet and exercise and the effect these factors have on blood glucose. The aim is for the client to take responsibility for his or her health and choices that may affect their health.

c. Viewing laboratory test results is a part of nursing assessment. To approach the client holistically, the nurse would need also to assess the clients diet and activity level.

REF: Text Reference: p. 96

4. The client states, Heart disease runs in our family. My blood pressure has been high. The nurse determines that this is an example of the clients:

a.

Risk factors

b.

Active strategy

c.

Negative health behavior

d.

Health beliefs

ANS: a

a. Risk factors are anything that increases the vulnerability of an individual or group to an illness or accident. This client is identifying the physical risk factor of genetic predisposition to heart disease.

b. An example of an active strategy would be weight reduction or smoking cessation where the client is actively involved in measures to improve present and future levels of wellness.

c. A negative health behavior is a behavior that may negatively affect ones health. An example of a negative health behavior would be consistently drinking alcohol in excess.

d. Health beliefs are a persons ideas, convictions, and attitudes about health and illness. An example of a health belief would be the client statement, Heart disease runs in our family. I know I will have heart disease anyway, so why exercise?

REF: Text Reference: p. 97

5. A client is discharged from the hospital to his home after a heart attack. The nurse recognizes the restrictions in the clients diet and activity. In using the Stages of Health Behavior Change as a guide, the nurse recognizes that the client is most likely to begin to accept information on diet and exercise during the:

a.

Contemplation stage

b.

Preparation stage

c.

Action stage

d.

Maintenance stage

ANS: a

a. During the contemplation stage, the client is considering a change within the next 6 months. The client may be ambivalent initially, but will more likely accept information as more belief develops in the value of change.

b. During the preparation stage, the client is making small changes in preparation for a change in the next month. At this point, the client believes advantages outweigh disadvantages in behavior change.

c. During the active stage, the client is actively engaged in strategies to change behavior.

d. During the maintenance stage, the client has sustained change over time.

REF: Text Reference: p. 100

6. When assessing the external variables that influence a clients health beliefs and practices, the nurse must consider his:

a.

Religious practices

b.

Reaction to the heart disease

c.

Educational background

d.

Income status

ANS: d

d. External variables influencing a persons health beliefs and practices include family practices, cultural background, and socioeconomic factors, such as income. Economic variable s may affect a clients level of health by increasing the risk for disease and influencing how or at what point the client enters the health care system. A persons compliance with the treatment to maintain or improve health also is affected by economic status.

a. Religious practices are one way in which people exercise spirituality. Spirituality is considered to be an internal variable.

b. An example of an internal variable that can influence health beliefs and practices of a client includes emotional factors, such as the reaction to heart disease.

c. Educational background is an internal variable that can influence the health beliefs and practices of a client.

REF: Text Reference: p. 95

7. The client is a paraplegic and is in the hospital for an electrolyte imbalance. Based on the levels of prevention, the client is receiving care at the:

a.

Primary prevention level

b.

Secondary prevention level

c.

Tertiary prevention level

d.

Health promotion level

ANS: b

b. The secondary prevention level focuses on early diagnosis and prompt treatment as well as on disability limitations. Adequate treatment for the electrolyte imbalance is sought to prevent further complications.

a. The primary prevention level focuses on health promotion and specific protection measures such as immunizations and personal hygiene.

c. The tertiary prevention level focuses on restoration and rehabilitation.

d. Health promotion is a focus of the primary prevention level.

REF: Text Reference: p. 97

8. The nurse incorporates the levels of prevention as a basis for the types of client needs that are evident and the nursing care that is provided. Which of the following activities of the nurse is an example of tertiary level preventive care giving?

a.

Teaching a client how to irrigate a new colostomy

b.

Providing a class on hygiene for an elementary school class

c.

Informing a client that immunizations for her infant are available through the health department

d.

Arranging for a hospice nurse to visit with the family of a client with cancer

ANS: d

d. Tertiary prevention occurs when a defect or disability is permanent and irreversible. Care of the hospice nurse at this level aims to help the client and the clients family achieve as high a level of functioning as possible, despite the limitations caused by the cancer.

a. Teaching a client how to irrigate a new colostomy would be an example of secondary prevention. If the colostomy is to be permanent, care may later move to the tertiary level of prevention.

b. Providing a class on hygiene for an elementary school class would be an example of the primary level of prevention.

c. Informing a client about available immunizations would be an example of primary prevention.

REF: Text Reference: p. 97, Text Reference: p. 98

9. Client assessment provides the nurse with necessary information for the development of a plan of care. Risk factors are important to identify to assist the client, if possible, to respond and modify his or her lifestyle. Which one of the following assessment findings indicates a lifestyle risk factor?

a.

Obesity

b.

Sunbathing

c.

Overcrowded housing

d.

Industrial-based occupation

ANS: b

b. Excessive sunbathing is a lifestyle risk factor for skin cancer.

a. Obesity is a physiological risk factor.

c. Overcrowded housing is an environmental risk factor.

d. An industrial-based occupation is an environmental risk factor.

REF: Text Reference: p. 99

10. In the Health Belief Model, the nurse recognizes that the focus is placed on the:

a.

Basic human needs for survival

b.

Functioning of the individual in all dimensions

c.

Relation of perceptions and compliance with therapy

d.

Multidimensional nature of clients and their interaction with the environment

ANS: c

c. In the Health Belief Model, the nurse focuses on the relation between a persons beliefs and health behaviors. By focusing on the clients perceptions of health, the nurse is better able to understand and predict how a client will comply with health care therapies.

a. Basic human need for survival is a component of Maslows hierarchy of needs model.

b. The nurse who focuses on the functioning of the individual in all dimensions is following a holistic health model.

d. In the health promotion model, the nurse focuses on the multidimensional nature of clients and their interaction with the environment.

REF: Text Reference: p. 91, Text Reference: p. 92

11. The client received a kidney transplant and is now unable to work. She is worried about her husbands stress level because of her illness and the need for him to take over her daily activities in the home. The client is in the process of adapting to a change in:

a.

Body image

b.

Illness behavior

c.

Family dynamics

d.

Self-concept

ANS: c

c. The effects of illness on the client and family have created change in family dynamics. Family dynamics is the process by which the family functions, makes decisions, gives support to individual members, and copes with everyday changes and challenges.

a. Body image is the subjective concept of physical appearance. The client did not express concerns regarding body image.

b. Illness behavior refers to how people monitor their bodies, define and interpret their symptoms, take remedial actions, and use the health care system. The client did not express change in illness behavior.

d. Self-concept is a mental self-image of strengths and weaknesses in all aspects of personality. The client did not express a change in self-concept.

REF: Text Reference: p. 103

12. Client assessment provides the nurse with necessary information for the development of an effective plan of care. When determining the influence of an internal variable on the clients health status, the nurse will specifically look for:

a.

Anxiety level present

b.

Family remedies used

c.

Location and type of occupation

d.

Available health insurance coverage

ANS: a

a. Emotional factors, such as the clients degree of anxiety, are internal variables that can influence the clients health status.

b. An example of an external variable that can influence the clients health status is the use of family remedies.

c. Socioeconomic factors, such as location and type of occupation, are external variables that can influence the clients health status.

d. Socioeconomic factors, including available health insurance coverage, are examples of external variables that can influence the clients health status.

REF: Text Reference: p. 95, Text Reference: p. 102

Copyright 2005 by Mosby, Inc. All rights reserved.

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