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Essentials for Nursing Practice 8th Edition by Patricia A. Potter – Test Bank
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Chapter 02: Health and Wellness
Potter: Essentials for Nursing Practice, 8th Edition
MULTIPLE CHOICE
- A nurse is assessing a patient’s stage of behavioral change. Which statement by the patient will indicate to the nurse that the patient is in the preparation stage?
| a. | “I started to exercise regularly, but it didn’t last long. I’ll probably try again in a few weeks.” |
| b. | “I have a problem, and I really think I need to work on it.” |
| c. | “I am really working hard to stop smoking.” |
| d. | “There is nothing that I really need to change.” |
ANS: A
“I started to exercise regularly, but it didn’t last long. I’ll probably try again in a few weeks” is the preparation stage. “I have a problem, and I really think I need to work on it” is the contemplation stage. “I am really working hard to stop smoking” is the action stage. “There is nothing that I really need to change” is the precontemplation stage.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 23
OBJ: Discuss four types of risk factors and the process of risk-factor modification.
TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- A patient is depressed after a divorce and is not eating. The nurse is using Maslow to prioritize care. Which patient need should the nurse address first?
| a. | Nutrition |
| b. | Emotional safety |
| c. | Depression |
| d. | Love and belonging |
ANS: A
According to Maslow, individuals have to meet lower-level needs before they are able to satisfy higher-level needs. The lowest level on the hierarchy consists of very basic physiological needs such as oxygen, water, food (nutrition), sleep, and sex. The second level on the hierarchy consists of safety needs. The third level on the hierarchy is love and belongingness, which is a desire to belong to groups. The fourth level deals with the need for self-esteem. Depression is not a lower need but a higher need.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 17-18
OBJ: Discuss the health belief, health promotion, basic human needs, and holistic health models of health and illness and their relationship to patients’ attitudes toward health and health practices. TOP: Nursing Process: Implementation
MSC: NCLEX: Management of Care
- A nurse is assessing a patient’s risk factors for heart disease and finds that the patient has several risk factors. How should the nurse interpret this finding?
| a. | The patient needs surgery for heart disease. |
| b. | The patient has a genetic disease. |
| c. | The patient will develop the disease. |
| d. | The patient has an increased chance to develop the disease. |
ANS: D
The presence of a risk factor does not mean that a disease will develop, but risk factors increase the chances that the individual will experience a particular disease. Although genetics can be a risk factor, it does not mean the patient has a genetic disease. The patient does not need surgery for heart disease because risk factors only increase the probability of the disease occurring.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 21
OBJ: Discuss four types of risk factors and the process of risk-factor modification.
TOP: Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
- To determine a patient’s external variables for health beliefs and practices, which area should the nurse assess?
| a. | Emotional factors |
| b. | Intellectual background |
| c. | Developmental stage |
| d. | Socioeconomic factors |
ANS: D
External variables for health beliefs and practices include family practices, socioeconomic factors, and cultural background. Emotional factors, intellectual background, and developmental stage represent internal variables.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 20
OBJ: Describe the variables influencing health beliefs and health practices.
TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- Which nursing action best represents primary prevention?
| a. | Instructing a healthy individual to get a flu shot on a yearly basis |
| b. | Instructing a patient to take blood pressure medication every day |
| c. | Instructing a patient to live with a known disability |
| d. | Instructing a patient to undergo physical therapy following a cerebrovascular accident |
ANS: A
A healthy individual getting a flu shot is primary prevention. Primary prevention precedes disease or disability or dysfunction. Primary prevention aimed at health promotion includes health education programs, immunizations, and physical and nutritional fitness activities. Taking blood pressure medication every day is a secondary prevention because the patient is trying to prevent further complications. Physical therapy after a cerebrovascular accident is intended to prevent further complications and deterioration and is tertiary prevention. Instructing a patient to live with a known disability is tertiary prevention.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 21 OBJ: Explain the three levels of prevention.
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
- A married father of four has recently been diagnosed with emphysema resulting from a long history of smoking. At a family counseling session a nurse helps the family to understand that this diagnosis is classified as a(n):
| a. | acute illness. |
| b. | tertiary prevention. |
| c. | chronic illness. |
| d. | internal variable. |
ANS: C
Chronic illness is one that lasts more than 6 months. Acute illness is short term and intense but resolves. Tertiary prevention strives to prevent complications and deterioration. Internal variables include a patient’s developmental stage, and intellectual, emotional, and cultural background.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 24 OBJ: Explain the impact of illness on a patient and family.
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
- Which information by a patient indicates teaching by the nurse was successful for the best definition of health?
| a. | State of complete well-being |
| b. | Absence of disease |
| c. | Vital signs within normal range |
| d. | Maintenance of a normal weight |
ANS: A
The World Health Organization defines health as a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmary. People without disease are not necessarily healthy. Vital signs within normal range and maintenance of a normal weight do not encompass the holistic definition of health.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 15-16 OBJ: Describe health promotion and illness prevention activities.
TOP: Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
- A patient with newly diagnosed diabetes is concerned about the risk for developing foot ulcers because the mother had a foot amputated as a result of the disease. This is an example of which of the following?
| a. | Health promotion |
| b. | Health practices |
| c. | Health beliefs |
| d. | Holistic health |
ANS: C
Health beliefs are a person’s ideas and attitudes about health. Health promotion activities such as routine exercise and good nutrition help patients maintain or enhance their present levels of health and reduce their risks for developing certain diseases. Holistic health generally is a comprehensive view of a person as a biopsychosocial and spiritual being. Health practices are activities that individuals perform to care for themselves.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 19
OBJ: Discuss the health belief, health promotion, basic human needs, and holistic health models of health and illness and their relationship to patients’ attitudes toward health and health practices. TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- A patient with diabetes is diligent about testing blood sugar before meals. Which model is the nurse using when the nurse realizes the patient is taking preventative actions for health and represents the third component of this model?
| a. | Basic Human Needs |
| b. | Health Belief |
| c. | Holistic Health |
| d. | Tertiary Prevention |
ANS: B
The third component of the Health Belief model is the likelihood that a patient will take preventative action. The third component of the Basic Human Needs model (Maslow) is love and belonging. The Holistic Health model focuses on physical, social, psychological, and spiritual health and does not contain distinct “components.” Tertiary prevention is not a health model.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 16
OBJ: Discuss the health belief, health promotion, basic human needs, and holistic health models of health and illness and their relationship to patients’ attitudes toward health and health practices. TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- Which will best assist a nurse in understanding a patient’s use of tying a silver dollar to the stomach of a newborn infant to heal an umbilical hernia?
| a. | Cultural background |
| b. | Maslow’s Hierarchy of Needs |
| c. | World Health Organization’s definition of “health” |
| d. | Primary prevention |
ANS: A
Cultural background influences a person’s beliefs, values, and customs. It influences personal health practices. Maslow’s Hierarchy of Needs will not help the nurse to understand the behavior because this is a model to help prioritize care. The definition of health by the WHO will not help the nurse to understand the behavior because it is a definition. Primary prevention occurs before a sickness or dysfunction and includes immunizations.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 20
OBJ: Describe the variables influencing health beliefs and health practices.
TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- Upon taking a history of a patient, the nurse learns the patient smokes a pack of cigarettes per day. How should the nurse interpret this finding?
| a. | This is an example of a health belief. |
| b. | This is an example of health promotion. |
| c. | This is an example of a negative health behavior. |
| d. | This is an example of a basic physiological human need. |
ANS: C
Negative health behaviors include activities that are harmful to health, including smoking. Health beliefs are a person’s ideas, convictions, and attitudes about health and illness. Health promotion activities such as routine exercise and good nutrition help patients maintain or enhance their present levels of health and reduce their risks for developing certain diseases. The lowest level of needs on the hierarchy consists of very basic physiological needs such as oxygen, water, food, sleep, and sex.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 16
OBJ: Discuss the health belief, health promotion, basic human needs, and holistic health models of health and illness and their relationship to patients’ attitudes toward health and health practices. TOP: Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
- When teaching a 15-year-old patient with diverticulitis about foods that should be avoided, a nurse takes the stage of growth and development into consideration. Which factor or variable did the nurse take into consideration?
| a. | Cultural factor |
| b. | External variable |
| c. | Socioeconomic factor |
| d. | Internal variable |
ANS: D
Internal variables include a person’s stage of growth and development, intellectual background, emotional factors, and spiritual factors. External variables include family practices, socioeconomic factors, and cultural background.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 19-20
OBJ: Describe the variables influencing health beliefs and health practices.
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
- A nurse working in a rural public health clinic is developing a smoking cessation program for patients in the county. This corresponds with Healthy People 2020’s efforts to provide direction for health care efforts on what level?
| a. | National |
| b. | Community |
| c. | Individual |
| d. | Family |
ANS: B
This is an example of a community program because it is for people in the county. Healthy People 2020 includes 600 objectives written in 42 topic areas to provide direction for health care efforts on an individual, community, and national level. National level would be directed at the entire United States. Individual would focus on one person. Family would focus on families.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 19
OBJ: Discuss the health belief, health promotion, basic human needs, and holistic health models of health and illness and their relationship to patients’ attitudes toward health and health practices. TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- The spouse of a patient with terminal cancer is refusing pain medication for the patient because of previous experiences with soldiers who became addicted to pain medication. A nurse will need to focus on which internal variable when approaching this situation?
| a. | Developmental stage |
| b. | Family practices |
| c. | Intellectual background |
| d. | Spiritual factors |
ANS: C
Intellectual background is a person’s beliefs about health shaped in part by knowledge (or misinformation) about body functions and illnesses, educational background, and past experiences. Spirituality is reflected in how a person lives his or her life, including the values and beliefs exercised, the relationships established with family and friends, and the ability to find hope and meaning in life. A person’s concept of illness depends on his or her developmental stage but this scenario is focused on misinformation, not the developmental stage. Family practices is an external variable, not an internal variable.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 20
OBJ: Describe the variables influencing health beliefs and health practices.
TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
- When assessing what influences a patient’s health beliefs and practices, a nurse should consider both internal and external variables. Which is an example of an external variable?
| a. | Intellectual background |
| b. | Emotional factors |
| c. | Spiritual factors |
| d. | Family practices |
ANS: D
Family practices is an external variable. Intellectual background, emotion factors, and spiritual factors are internal variable.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 20
OBJ: Describe the variables influencing health beliefs and health practices.
TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- A nurse should emphasize health promotion, wellness strategies, and illness prevention activities as important forms of health care. Which is considered a health promotion strategy?
| a. | Routine exercise |
| b. | Stress management class |
| c. | Influenza immunization |
| d. | Tetanus booster |
ANS: A
Routine exercise is done to promote health and is a health promotion strategy. Influenza immunization and tetanus booster are illness prevention strategies, whereas stress management is wellness education.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 20 OBJ: Describe health promotion and illness prevention activities.
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
- A nurse who works in an inner-city health clinic is scheduling a day for student nurses to assist with a flu immunization clinic. Which of the following best describes this type of activity?
| a. | Primary prevention |
| b. | Secondary prevention |
| c. | Tertiary prevention |
| d. | Health prevention |
ANS: A
Primary prevention decreases the vulnerability of an individual (or population) to disease. Secondary prevention focuses on people who are experiencing health problems. Tertiary prevention occurs when a disability is permanent, irreversible, and stabilized. Health prevention is not a concept nurses promote, whereas health promotion or illness prevention are strategies nurses use.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 21 OBJ: Explain the three levels of prevention.
TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
- A patient is drinking milk that has been fortified with vitamin D. Which type of health promotion strategy is the patient using?
| a. | Active |
| b. | Passive |
| c. | Environmental |
| d. | Sociological |
ANS: B
With passive strategies of health promotion, individuals gain from the activities of others without acting themselves. For example, the city puts fluoride in the municipal drinking water, or milk manufacturers fortify homogenized milk with vitamin D. With active strategies of health promotion, individuals adopt specific health programs. Weight reduction and smoking cessation programs require patients to be actively involved in measures to improve their present and future levels of wellness while decreasing the risk for disease. Environmental and sociological do not relate to health promotion strategies.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 20 OBJ: Describe health promotion and illness prevention activities.
TOP: Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
- A nurse teaches a patient about physiological risk factors. Which information by the patient indicates more teaching is needed?
| a. | A physiological risk factor is heredity. |
| b. | A physiological risk factor is environment. |
| c. | A physiological risk factor is pregnancy. |
| d. | A physiological risk factor is obesity. |
ANS: B
The environment is not a physiological risk factor; the other options are physiological risk factors. Physiological risk factors involve the physical functioning of the body. For example, physical conditions such as pregnancy or obesity place increased stress on physiological systems. Heredity or genetic predisposition to specific illness is a major physical risk factor.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 21-22
OBJ: Discuss four types of risk factors and the process of risk-factor modification.
TOP: Nursing Process: Evaluation MSC: NCLEX: Reduction of Risk Potential
- Upon taking a health history from a patient, the nurse notices the patient uses positive health behaviors. Which behavior did the nurse find?
| a. | Smokes |
| b. | Eats poorly |
| c. | Has sedentary lifestyle |
| d. | Maintains proper sleep patterns |
ANS: D
Positive health behaviors are activities related to maintaining, attaining, or regaining good health and preventing illness. Common positive health behaviors include getting immunizations, maintaining proper sleep patterns, getting adequate exercise, and eating healthy foods. Negative health behaviors include activities that are harmful to health such as smoking, abusing drugs or alcohol, following a poor diet, and refusing to take necessary medications.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 16 OBJ: Describe health promotion and illness prevention activities.
TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- A nurse must take into consideration illness behaviors of patients. Which is an internal variable the nurse should assess?
| a. | Social support |
| b. | Visibility of symptoms |
| c. | Accessibility of the health care system |
| d. | Nature of the illness |
ANS: D
Internal variables influence the way patients behave when they are ill. These are a patient’s perceptions of symptoms and the nature of the illness. External variables influencing a patient’s illness behavior include the visibility of symptoms, social group, cultural background, economic variables, accessibility of the health care system, and social support.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 25 OBJ: Describe the variables influencing illness behavior.
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Adaptation
- A nurse allows a patient to place pictures of the family in the room. Which need is being met?
| a. | Basic needs |
| b. | Physiological needs |
| c. | Self-actualization |
| d. | Love and belongingness |
ANS: D
In Maslow’s hierarchy of needs, the third level on the hierarchy is love and belongingness, which is a desire to belong to groups. It consists of the need to feel love by others and to be accepted. The highest level of needs on the hierarchy is self-actualization, which is the desire to become everything that one is capable of becoming. The lowest level of needs on the hierarchy consists of very basic physiological needs such as oxygen, water, food, sleep, and sex.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 18
OBJ: Discuss the health belief, health promotion, basic human needs, and holistic health models of health and illness and their relationship to patients’ attitudes toward health and health practices. TOP: Nursing Process: Assessment
MSC: NCLEX: Basic Care and Comfort
- Which model exemplifies a patient who states the following, “I am responsible for my own health and well-being and I will partner with you (my nurse) to make sure I am ready to be discharged after surgery”?
| a. | Basic Human Needs Model |
| b. | Absence of Disease Model |
| c. | Holistic Health Model |
| d. | Healthy People 2020 Model |
ANS: C
The intent of the holistic health model is to empower patients to engage in their own recovery, thereby assuming some responsibility for health maintenance. Basic human needs are related to a hierarchy of needs involving lower needs to self-actualization. Healthy People 2020 provides evidenced-based objectives to: (1) achieve increased quality and years of healthy life, and (2) eliminate health disparities. There is no absence of disease model.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 19
OBJ: Discuss the health belief, health promotion, basic human needs, and holistic health models of health and illness and their relationship to patients’ attitudes toward health and health practices. TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- A nurse is preparing to help patients with health promotion, wellness education, and illness prevention activities. Which action should the nurse take first?
| a. | Explore available support groups. |
| b. | Identify risk factors. |
| c. | Provide patient teaching. |
| d. | Implement risk factor modification. |
ANS: B
Identifying risk factors is the first step in health promotion, wellness education, and illness prevention activities. Once you identify risk factors, implement appropriate and relevant health education programs that help a person to change a risky health behavior. Support groups, teaching, and risk factor modification follow after identifying risk factors.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 23
OBJ: Discuss four types of risk factors and the process of risk-factor modification.
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
- A smoker has confided to the nurse that he or she feels like a failure because he or she began smoking again after not having had a cigarette for more than a week. What is the nurse’s best response?
| a. | “Let’s discuss what triggered you to start smoking again so you can avoid it in the future.” |
| b. | “You understand that smoking is the number one cause of death in the United States, correct?” |
| c. | “Did you know that your insurance premiums will increase if you continue to smoke?” |
| d. | “My mother died last year of lung cancer.” |
ANS: A
Relapse often feels like a failure, but the person needs to view it as a learning process. Discussing possible triggers will allow learning to take place. What he or she learns from relapse can be applied to the next attempt to change. Saying that smoking is the number one cause of death and insurance premiums will increase do not allow for learning to take place. Saying that your mother died last year of lung cancer does not focus on patient learning, but rather focuses on the nurse, which is inappropriate.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 23-24
OBJ: Discuss four types of risk factors and the process of risk-factor modification.
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
- A nurse is teaching the staff about the stages of change. Which information should the nurse include in the teaching session?
| a. | Precontemplation, contemplation, preparation, action, maintenance |
| b. | Contemplation, preparation, action, maintenance, postmaintenance |
| c. | Contemplation, procrastination, preparation, action, maintenance |
| d. | Precontemplation, contemplation, preparation, action, engagement |
ANS: A
Precontemplation, contemplation, preparation, action, and maintenance are the five phases of change. Postmaintenance, procrastination, and engagement are not included in the five stages of change.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 23
OBJ: Discuss four types of risk factors and the process of risk-factor modification.
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
- A nurse is caring for a patient who smokes two packs a day. The nurse knows that the patient is in the contemplation stage regarding smoking cessation. What is the nurse’s best response to help the patient move into the preparation stage?
| a. | “You need to stop smoking as soon as possible.” |
| b. | “Smoking will kill you if you don’t stop.” |
| c. | “The negative effects of smoking can be reversed.” |
| d. | “Tobacco use killed 435,000 people in 2000.” |
ANS: C
The fact that the negative effects can be reversed may prompt the patient to think about the benefits of quitting and move the patient into the preparation stage of change. You need to stop smoking is a directive and not appropriate. Tobacco use killed 435,000 does not allow the patient to think about quitting; it just relates facts. Giving an ultimatum by saying that smoking will kill you if you don’t stop is inappropriate.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 24 OBJ: Discuss the nurse’s role in health and illness.
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
- Which patient should a nurse consider as being the most ill?
| a. | A 25-year-old patient with cystic fibrosis who is attending yoga classes |
| b. | A 13-year-old adolescent with newly diagnosed diabetes who does not want to check blood sugar at school |
| c. | A 43-year-old patient with breast cancer who has recently adopted a vegetarian diet |
| d. | A 77-year-old patient with alcohol hepatitis who attends weekly Alcoholics Anonymous meetings |
ANS: B
A 13 year old who does not want to check blood sugar is the most ill out of the patients listed because illness is not synonymous with disease; it includes not only the disease, but also the effects on functioning and well-being in all dimensions. Illness is a state in which a person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired compared with previous experience. The 25 year old, the 43 year old, and the 77 year old are taking actions to improve their overall health.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 24 OBJ: Describe the variables influencing illness behavior.
TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Adaptation
- A registered nurse is working in a community clinic that provides services for chronically ill patients. Which condition would be considered chronic?
| a. | Appendicitis |
| b. | Pneumonia |
| c. | Flu |
| d. | Diabetes |
ANS: D
A chronic illness usually lasts longer than 6 months; diabetes is a chronic illness. Appendicitis, pneumonia, and the flu are considered acute: The symptoms appear abruptly, are intense, and often subside after a relatively short period.
PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)
REF: 24 OBJ: Explain the impact of illness on a patient and family.
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Adaptation
- A nurse is planning to care for a patient with a disease that is a major cause of death and disability in the United States. The nurse is caring for which patient?
| a. | One with an acute disease |
| b. | One with a chronic disease |
| c. | One with an infectious disease |
| d. | One with an exotic disease |
ANS: B
Because of successes in public health, medicine, and biomedical technology, acute and infectious diseases are no longer major causes of death, disease, and disability in the United States. Many health care analysts believe that the heaviest burden of illness today is caused by chronic diseases. Exotic diseases are rare.
PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)
REF: 24 OBJ: Explain the impact of illness on a patient and family.
TOP: Nursing Process: Planning MSC: NCLEX: Physiological Adaptation
- A public health nurse knows that for those patients who already have a chronic disease, the best way to help them manage their illness is to take which action?
| a. | Provide holistic patient education. |
| b. | Consult with a disease specialist. |
| c. | Review their long-term health insurance policy. |
| d. | Provide disease-specific patient education. |
ANS: A
The nurse should use a holistic approach to patient education to help patients manage their disease. This education enhances wellness and improves quality of life for patients living with chronic illnesses or disabilities. Consulting with a disease specialist, reviewing insurance, and providing disease-specific education are too narrow a focus.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 24 OBJ: Discuss the nurse’s role in health and illness.
TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Adaptation
- A registered nurse in a rehabilitative unit is working with a veteran with chronic back pain that was caused as a result of an injury received while in military service in Iraq. The nurse’s goal is to assist the veteran to learn self-management skills to help promote health. Which statement by the nurse will best support this goal?
| a. | “Do you have plans to return to active duty?” |
| b. | “You need to take your pain medication as prescribed.” |
| c. | “Perhaps you need to consider going to a different health care provider.” |
| d. | “Why don’t you keep a log of what causes the pain to become worse?” |
ANS: D
Self-management involves learning about responses to illnesses through daily life experiences and as a result of trial and error. Plans to return to active duty and going to a different health care provider do not focus on responses to the illness (chronic back pain). Just focusing on taking pain medication does not focus on the goal of self-management skills.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 24 OBJ: Discuss the nurse’s role in health and illness.
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
- A pregnant mother of two children has been experiencing severe morning sickness and fatigue. Friends and family members have been providing her family with meals, and her husband has been taking responsibility for the housework. This is an example of which type of behavior?
| a. | Illness |
| b. | Wellness |
| c. | Social |
| d. | Antisocial |
ANS: A
Illness behavior often results in patients being released from roles, social expectations, or responsibilities. Wellness behaviors focus on improving health, like jogging. Social behaviors involve groups. Antisocial behavior involves socially unacceptable actions.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 24-25 OBJ: Describe the variables influencing illness behavior.
TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity
- A patient states, “I will avoid social situations where people are drinking alcohol so I am not tempted to start drinking again.” The nurse assesses the patient to be in which stage of change?
| a. | Contemplation |
| b. | Precontemplation |
| c. | Maintenance |
| d. | Engagement |
ANS: C
Maintenance is the ability for sustained change over time. This stage begins 6 months after action has started and continues indefinitely. It is important to avoid relapse. “I have a problem with drinking, and I really think I need to work on it” is an example of the
contemplation stage. “There is nothing that I really need to change” is an example of the precontemplation stage. There is no such stage as engagement.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 23
OBJ: Discuss four types of risk factors and the process of risk-factor modification.
TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- Which order should the nurse prioritize care for the patient using Maslow’s theory from lower-level needs to higher-level needs?
- Self-esteem
- Physiological needs
- Self-actualization
- Love and belonging
- Safety and security
| a. | b, e, d, a, c |
| b. | d, b, c, a, e |
| c. | b, e, d, c, a |
| d. | d, b, a, c, e |
ANS: A
Maslow’s (1987) model describes human needs using a hierarchical pyramid divided into five levels: physiological needs, safety and security, love and belonging, self-esteem, and self-actualization.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 17-18
OBJ: Discuss the health belief, health promotion, basic human needs, and holistic health models of health and illness and their relationship to patients’ attitudes toward health and health practices. TOP: Nursing Process: Assessment
MSC: NCLEX: Management of Care
MULTIPLE RESPONSE
- Using the health promotion model while rendering care enables a nurse to do which of the following? (Select all that apply.)
| a. | Help the patient pursue health. |
| b. | Detect the presence of illness. |
| c. | Promote health behaviors in a patient. |
| d. | Assess a family’s response to illness. |
| e. | Plan interventions to achieve self-actualization. |
ANS: A, C
The purpose of the health promotion model is to explain the reasons that individuals engage in health activities and is not for use with families or communities. You will use this model to help your patients carry out healthy behaviors in their daily lives. This model helps the patient pursue health. Self-actualization is the final stage in Maslow’s hierarchy and does not relate to the health promotion model. This model does not focus on illness.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 17
OBJ: Discuss the health belief, health promotion, basic human needs, and holistic health models of health and illness and their relationship to patients’ attitudes toward health and health practices. TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
Chapter 04: Community-Based Nursing Practice
Essentials for Nursing Practice, 8th Edition
MULTIPLE CHOICE
- A student nurse is beginning the community-based primary care rotation. The student nurse anticipates that the assignment in community-based health care will most likely be at which organization?
| a. | An acute care hospital |
| b. | A rehabilitation hospital |
| c. | A nursing home |
| d. | A high school |
ANS: D
High schools focus on primary rather than acute care and provide knowledge about health and health promotion that occurs outside traditional health care institutions, such as hospitals, rehabilitation hospitals, and nursing homes.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 50 | 51
OBJ: Explain the relationship between public and community health nursing.
TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
- A nurse is practicing as a community health nurse. What is the primary focus of care for this nurse?
| a. | Providing care to subpopulations |
| b. | Practicing care in existing services |
| c. | Being a specialist in public health science |
| d. | Having a case management certification |
ANS: A
The community health nurse provides direct care services to subpopulations within that community. Community health nursing is nursing care provided in the community, with the primary focus on the health care of individuals, families, and groups in the community. A community health nurse is not the same thing as a specialist in public health nursing. A community health nurse does not have to have case management certification. Although the community health nurse may practice care in existing services, the primary focus is on the subpopulation’s care.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 52
OBJ: Differentiate community health nursing from community-based nursing.
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
- A community health nurse is using the goals of the Healthy People 2020 to focus care. Which goal is the priority?
| a. | To increase the life expectancy of people in the United States |
| b. | To increase the health status of people throughout the world |
| c. | To eradicate the human immunodeficiency virus (HIV) |
| d. | To reduce health care costs |
ANS: A
The overall goals of Healthy People 2020 are to increase the life expectancy and quality of life and to eliminate health disparities through an improved delivery of health care services to people in the United States. The focus is on the United States, not the world. It does not focus on one disease or on reducing health care costs.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 51 OBJ: Describe the role of the community health nurse.
TOP: Nursing Process: Planning
MSC: NCLEX: Health Promotion and Maintenance
- The teen pregnancy rate in one community significantly increased; as a result, the school system was seeing an increase in the dropout rate of teenage mothers. A nurse recently worked with the local school system to develop a day care program for the children of high school students so that they could return to school. Which technique did the nurse use?
| a. | Incorporating immunizations for the infants and mothers |
| b. | Responding to changes within the community |
| c. | Influencing chronic environmental factors |
| d. | Managing disease |
ANS: B
Successful community health nursing practice involves building relationships with the community and responding to changes within the community. No immunizations were given. There was no mention of managing disease in this scenario. The nurse did not influence chronic factors.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 53 OBJ: Describe the role of the community health nurse.
TOP: Nursing Process: Evaluation
MSC: NCLEX: Health Promotion and Maintenance
- A nurse notices that a particular area of the community had food poisoning. The nurse collected data from the people who were affected, identified a local restaurant that served all the people, and determined it was the chicken dish that caused the poisoning. Which community health nurse competency did the nurse demonstrate?
| a. | Public health |
| b. | Educator |
| c. | Epidemiologist |
| d. | Case manager |
ANS: C
As epidemiologist, community health nurses use basic principles of epidemiology such as tracking health problems; collecting and analyzing data to identify disease trends, outbreaks of illnesses, and disease incidence rates; and planning strategies to prevent or contain outbreaks. With the goal of helping patients assume responsibility for their own health care, the role of educator is important in a community-based setting. Case management means making an appropriate plan of care based on assessment of patients and families and coordinating needed resources and services for the patient’s well-being across a continuum of care. A community health nurse is not the same thing as a public health nurse and is not a competency of community health nursing.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 58
OBJ: Describe selected competencies important for success in community-based nursing practice. TOP: Nursing Process: Evaluation
MSC: NCLEX: Safety and Infection Control
- Upon assessment the nurse finds the following: a 46-year-old immigrant patient from the Czech Republic has diabetes and hypertension and just recently moved in to live with a family member who must travel frequently. The patient speaks English very well. The community health nurse knows that this patient may be vulnerable because of which assessment finding?
| a. | Age |
| b. | Immigration status |
| c. | Diabetes |
| d. | Language |
ANS: B
Vulnerable populations include individuals living in poverty, elderly people, homeless individuals, those in abusive relationships, people with substance abuse problems and/or mental illnesses, and new immigrants. For some immigrants access to health care is limited because of legal status, language barriers and lack of benefits, resources, and transportation. Being 46 years old does not place the patient in the elderly category. Diabetes does not make the patient vulnerable. The patient speaks English, so that is not an issue.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 54
OBJ: Explain the characteristics of patients from selected vulnerable populations that influence a nurse’s approach to care. TOP: Nursing Process: Assessment
MSC: NCLEX: Management of Care
- A nurse wants to use the most important competency in community nursing. Which competency should the nurse use?
| a. | Caregiver |
| b. | Case manager |
| c. | Educator |
| d. | Epidemiologist |
ANS: A
The most important role is caregiving. Using the nursing process and critical thinking skills, a nurse develops appropriate, individualized nursing care for specific patients and their families. Case management means making an appropriate plan of care based on assessment of patients and families and coordinating needed resources and services for the patient’s well-being across a continuum of care. Community-based nurses teach their patients individually or in groups. Community health nurses use basic principles of epidemiology, such as tracking health problems; collecting and analyzing data to identify disease trends, outbreaks of illnesses, and disease incidence rates; and planning strategies to prevent or contain outbreaks.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 56
OBJ: Describe selected competencies important for success in community-based nursing practice. TOP: Nursing Process: Implementation
MSC: NCLEX: Management of Care
- A community health nurse is assessing the structure of a community. Which component will the nurse assess?
| a. | Available health systems |
| b. | Available colleges and schools |
| c. | Geographical boundaries |
| d. | Predominant religious groups |
ANS: C
Geographical boundaries are a component of the structure of a community. Health systems, and available colleges and schools are social systems. Predominant religious groups are a component of the population of a community.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 58 OBJ: Describe elements of a community assessment.
TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
MULTIPLE RESPONSE
- A nurse in community-based practice needs a variety of skills and talents while rendering care to patients in the community. Which are competencies of the community health nurse? (Select all that apply.)
| a. | Case manager |
| b. | Care giver |
| c. | Educator |
| d. | Advocate |
| e. | Counselor |
ANS: A, B, C
Selected competencies, such as caregiver, case manager, epidemiologist, and educator, are used in the community-based setting. Advocate and counselor are not competencies.
PTS: 1 DIF: Cognitive Level: Applying (Application)
REF: 56 | 58
OBJ: Describe selected competencies important for success in community-based nursing practice. TOP: Nursing Process: Implementation
MSC: NCLEX: Management of Care
- A community health nurse is caring for vulnerable populations. The nurse is caring for which patients? (Select all that apply.)
| a. | Patients living at home |
| b. | Patients with abusive habits |
| c. | Immigration patients |
| d. | Middle-aged patients |
| e. | Patients living in poverty |
ANS: B, C, E
Individuals living in poverty, elderly people, homeless individuals, those in abusive relationships, people with substance abuse problems and/or mental illnesses, and new immigrants are examples of vulnerable populations. Living at home and being middle-aged are not examples of vulnerable populations.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 54 | 56
OBJ: Explain the characteristics of patients from selected vulnerable populations that influence a nurse’s approach to care. TOP: Nursing Process: Implementation
MSC: NCLEX: Safety and Infection Control
- A nurse is performing a community assessment. Which areas should the nurse include? (Select all that apply.)
| a. | Structure |
| b. | Population |
| c. | Social systems |
| d. | Environment |
| e. | Vital signs |
ANS: A, B, C
A complete assessment examines structure or locale, population or people, and social systems. The principles of public health practice aim at achieving a healthy environment in which all individuals may live. Environment and vital signs are not components of a community assessment.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 58 OBJ: Describe elements of a community assessment.
TOP: Nursing Process: Assessment
MSC: NCLEX: Health Promotion and Maintenance
- A community-based nurse is working with a family. The nurse needs to be knowledgeable in what key areas? (Select all that apply.)
| a. | Family theory |
| b. | Group dynamics |
| c. | Political affiliations |
| d. | Cultural diversity |
| e. | Communication principles |
ANS: A, B, D, E
The context of community-based nursing is family-centered care within the community. This focus requires the nurse to be knowledgeable about family theory, principles of communication, and group dynamics and cultural diversity. Political affiliations are not a key component of family-centered care.
PTS: 1 DIF: Cognitive Level: Analyzing (Analysis)
REF: 54 OBJ: Discuss the role of the nurse in community-based practice.
TOP: Nursing Process: Implementation
MSC: NCLEX: Health Promotion and Maintenance
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