Chapter 06: Personal Health Promotion: A Role Model for Patients My Nursing Test Banks

Chapter 06: Personal Health Promotion: A Role Model for Patients

Test Bank

MULTIPLE CHOICE

1. Health promotion for patients is facilitated when the nurse encourages changes based on information that diabetes, heart disease, and breast and colon cancer are causally linked to

a.

environmental toxins.

b.

hypolipidemia.

c.

overactivity.

d.

obesity.

ANS: D

Obesity and lack of exercise are closely associated with the development of diabetes, heart disease, high cholesterol, hypertension, colon cancer, and postmenopausal breast cancer. Environmental toxins have not been linked to these illnesses. Hyperlipidemia is associated with these illnesses. The causal link for heredity is not as strong as for obesity.

DIF: Cognitive Level: Application REF: pp. 57-58 OBJ: 3

TOP: Sequelae of obesity KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

2. When a patient inquires about the 2010 MyPlate recommendations the nurse responds

a.

Protein is the largest part of the plate.

b.

Delete starch from the plate.

c.

Half of the plate should be fruits and vegetables.

d.

2% milk is recommended.

ANS: C

The 2010 MyPlate recommends protein to be the smallest part of the plate, switching to fat free or low fat (1%) milk, make at least half your plate vegetables and fruits, make at least half your grains whole grain, avoid oversize portions, look for lower sodium soup, bread, and frozen meals, and drink water instead of sugary drinks.

DIF: Cognitive Level: Application REF: p. 58 OBJ: 1

TOP: Fats in the diet KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

3. The student nurse states, I dont have time for the bending and stretching routines the textbook advises. A peer student nurse could be most helpful by saying

a.

We each have to decide whats best for ourselves.

b.

I agree; the time could be better spent studying.

c.

You know how textbooks are heavy on theory.

d.

The idea of warm-ups preventing injury seems valid.

ANS: D

Proper warm-up prior to exercise is considered by exercise physiologists as a way to avoid muscular injury. The option deciding what is best for ourselves, although true, does little to help the student nurse adopt a healthier habit. The other options do nothing to help the student nurse adopt a healthier habit.

DIF: Cognitive Level: Application REF: p. 59 OBJ: 4

TOP: Exercise KEY: Nursing Process Step: Implementation

MSC: NCLEX: Health Promotion and Maintenance

4. A student nurse tells a peer, I find myself constantly thinking about patient X and the problems shes experiencing. Sometimes, it makes me want to cry. If only I had a magic wand and could make things better for her! The peer to whom this is revealed can correctly determine that the student nurse is experiencing

a.

empathy for the patient.

b.

sympathy for the patient.

c.

therapeutic involvement.

d.

burnout.

ANS: B

The student nurse describes feelings of sympathy and overinvolvement. Empathy is a respectful, objective concern. Therapeutic involvement suggests overinvolvement, which is not therapeutic. The statements made in the scenario do not constitute burnout; however, sympathetic responses by nurses leave them vulnerable to burnout.

DIF: Cognitive Level: Analysis REF: p. 63 OBJ: 7

TOP: Sympathy vs. empathy

KEY: Nursing Process Step: Assessment (Data Collection)

MSC: NCLEX: Physiological Integrity

5. A nursing assistant tells the nurse, Im feeling negative about my job and just about everything else these days. Like today, I found myself feeling angry with Mrs. X. because shes overweight. I felt like telling her if she didnt eat so much, shed make my life a lot easier. I need a vacation or a new job. The nurse can correctly determine that the nursing assistant is experiencing feelings associated with

a.

spitefulness.

b.

home conflicts.

c.

burnout.

d.

detachment.

ANS: C

Lack of caring about patients, blaming patients for their illnesses, and negative self-views are danger signals of burnout. The scenario describes more than spitefulness; it is not suggestive of home conflicts; and it does not suggest detachment.

DIF: Cognitive Level: Application REF: pp. 62-63 OBJ: 7

TOP: Burnout KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

6. The nurse who works in the ICU leaves the room of a patient and bursts into tears. She tells a co-worker, I have to touch the patient to provide care, but when I was turning her, a big piece of skin just sloughed off her back. How can I justify giving care when it seems to do more harm than good? The nurse is most likely experiencing

a.

burnout.

b.

detachment.

c.

negative outcomes.

d.

secondary traumatic stress.

ANS: D

Secondary traumatic stress occurs from exposure to horrors associated with a patients condition or care the nurse must provide. The nurse experiencing burnout usually becomes angry and cynical about patients. The nurse is not displaying detachment in this situation.

DIF: Cognitive Level: Application REF: p. 64 OBJ: 8

TOP: Secondary traumatic stress KEY: Nursing Process Step: Implementation

MSC: NCLEX: N/A

7. The LPN/LVN notices that another nurse has made errors in practice and judgment over the past few weeks. In addition, the nurses personality has undergone changes, such as irritability and unpredictability when responding to others. A patient mentioned to the LPN/LVN that when the nurse administered medication for pain relief, it didnt work as well as it had earlier in the day. Based on this information the LPN/LVN should

a.

notify the state board of nursing.

b.

confront the nurse with the observations.

c.

call Employee Health and discuss the matter.

d.

report these findings to the nurse in charge.

ANS: D

The observations suggest signs of chemical dependency but are not entirely diagnostic. The LPN/LVN must work within the structure of the agency. This would require involving the individual who is the direct supervisor of the staff member, who will pursue the problem according to agency policy. The LPN/LVN has a duty to report suspected use or abuse of alcohol or other drugs.

DIF: Cognitive Level: Application REF: p. 65 OBJ: 9

TOP: Chemical dependency KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment

8. The LPN/LVN tells the charge nurse, You can be glad Im on duty today to pick up the slack for the staff member who called in sick. Its lucky that I came in early. Oh, and by the way, I can stay late, if necessary. You know how the next shift is. They expect everything to be caught up, even if they arent that efficient themselves. These remarks suggest that the LPN/LVN may be

a.

a chronic complainer.

b.

a team player.

c.

co-dependent.

d.

chemically dependent.

ANS: C

Co-dependent individuals feel the fate of nursing care rests on their shoulders, feel responsible for solving the problems of others (in this case, the charge nurses problems), engage in one-upmanship and intershift rivalries. These behaviors are evident in the scenario. Chronic complainer is incorrect because the scenario is more than an example of chronic complaining. The verbalizations do not suggest that the LPN/LVN is a team player. The verbalizations do not suggest chemical dependency.

DIF: Cognitive Level: Application REF: pp. 65-66 OBJ: 10

TOP: Co-dependence KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

9. During report, the LPN/LVN relates that although her assigned patient was ambulatory, she provided a bed bath, special foot care, and nail care; she justified the care by saying that the patient seemed very tired. The nurse also mentioned that the patient had a number of personal problems for which she provided counseling. The charge nurse recognizes these behaviors as suggesting

a.

conscientious nursing.

b.

empathetic response.

c.

conflict avoidance.

d.

co-dependence.

ANS: D

Co-dependent individuals have a pathological need to be needed by others. They are often controlling, robbing patients of autonomy and opportunities to problem-solve. These behaviors go beyond conscientious nursing to the pathological; they do not suggest use of empathy; and they do not suggest conflict avoidance.

DIF: Cognitive Level: Application REF: pp. 65-66 OBJ: 10

TOP: Co-dependence KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

10. The key to modifying co-dependent behavior is

a.

recognition.

b.

recreation.

c.

intensive therapy.

d.

establishing vulnerability.

ANS: A

In order to change or modify co-dependent behavior, the individual must recognize that the behavior is co-dependent and must come to understand its effects on patients and peers. Recreation is not the key to modifying co-dependent behavior. Intensive therapy may not be required to modify co-dependent behavior. Establishing vulnerability has nothing to do with modifying co-dependent behavior.

DIF: Cognitive Level: Analysis REF: p. 66 OBJ: 10

TOP: Co-dependence KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

11. A student nurse asks a peer, Whats the difference between recreation and relaxation? The best response would be

a.

Theyre essentially the same.

b.

Relaxation usually lowers stress, but recreation can create stress.

c.

Relaxation exercises and recreation activities always lower stress.

d.

Relaxation requires knowledge of special techniques, but recreation takes no special skills.

ANS: B

Relaxation, by definition, interferes with the stress response. Recreation may create stress, especially if one engages in competitive activity. The statement, Theyre essentially the same, is incorrect. Relaxation exercises elevate stress for about 3% of the population. Relaxation requires knowledge of special techniques, but recreation takes no special skills is an untrue statement.

DIF: Cognitive Level: Comprehension REF: p. 67 OBJ: 11

TOP: Relaxation-recreation KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

12. A patient tells a student nurse, I unwind by going to a quiet place, sitting in a comfortable chair, closing my eyes, and concentrating on my breathing. The patient is describing use of

a.

imagery.

b.

meditation.

c.

relaxation.

d.

recreation.

ANS: B

Meditation uses the techniques described. Imagery requires the patient to focus on a pleasant scene. The scenario does not describe relaxation or recreation, although the end result of meditation should be relaxation.

DIF: Cognitive Level: Comprehension REF: p. 67 OBJ: 12

TOP: Meditation KEY: Nursing Process Step: Assessment (Data Collection)

MSC: NCLEX: Physiological Integrity

13. How can nurses avoid burnout?

a.

Put patients needs before their own needs.

b.

Accept that as nurses, their vocational and personal lives are one.

c.

Understand their own needs and maintain balance between work and personal life.

d.

Use sympathy for the patient as a key to personal growth and professional development.

ANS: C

Understanding ones own needs and maintaining balance between work and personal life is the only strategy listed that is a recommendation for avoiding burnout.

DIF: Cognitive Level: Knowledge REF: p. 64 OBJ: 7

TOP: Burnout KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

14. The nurse in the workplace has little opportunity to receive positive feedback from peers or supervisors. What can be substituted?

a.

A revisit from a former nursing instructor

b.

Self-evaluation

c.

Seeking compliments from the patient

d.

An alcoholic beverage after work

ANS: B

Learning to objectively review and evaluate ones own performance, remembering to include positive outcomes, is an effective strategy for replacing the positive feedback one becomes accustomed to as a student nurse. A revisit from a former nursing instructor and seeking compliments from the patient are ineffective. Having an alcoholic beverage after work is counterproductive.

DIF: Cognitive Level: Analysis REF: p. 63 OBJ: 7

TOP: Preventing burnout KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

15. A telltale sign of a chemically impaired nurse is

a.

an increasing number of practice errors.

b.

an objective, assertive manner.

c.

willingness to admit to substance abuse.

d.

an effort to seek treatment.

ANS: A

Making errors in practice is common if a nurse suffers from chemical impairment. An objective, assertive manner is not consistent with chemical impairment. Willingness to admit substance abuse and seeking treatment are also inconsistent, because the impaired nurse usually uses denial.

DIF: Cognitive Level: Knowledge REF: p. 65, Box 6-2

OBJ: 9 TOP: Chemically impaired nurse KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

16. A nurse is overheard telling a patient, No, you do not need to bathe yourself. It doesnt make any difference if thats what the other nurses have you do. I will do that for you. I enjoy doing things for others, and I know youll appreciate my taking this time with you. The most accurate assessment of this nurses behavior is that shes

a.

weird.

b.

a good nurse.

c.

hoping for a raise.

d.

co-dependent.

ANS: D

Co-dependent behaviors by the nurse interfere with patient autonomy. There are insufficient data to choose one of the other options.

DIF: Cognitive Level: Analysis REF: pp. 65-66 OBJ: 10

TOP: Co-dependence KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity

17. How does co-dependence relate to nursing?

a.

It is a necessary quality to develop a mutually rewarding relationship with the patient.

b.

It is potentially destructive, because the nurses co-dependency may prevent meeting the patients needs.

c.

Co-dependent nurses find nursing a healthy way to expand on nursing learned during school.

d.

Co-dependency is the long-term goal of nursing instructors for nursing students.

ANS: B

Nurse co-dependence may interfere with patient autonomy (e.g., learning self-care skills). Co-dependency is not necessary, nor is it a healthy way to expand on nursing learned during school. Co-dependence is not a goal of nursing instructors for nursing students.

DIF: Cognitive Level: Comprehension REF: pp. 65-66 OBJ: 10

TOP: Co-dependence KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

18. Which cycle is associated with being a co-dependent individual?

a.

Experience fear, resort to manipulation, develop angry feelings toward victim

b.

Rescue someone, view the rescued individual disrespectfully, experience feelings of victimization

c.

Abuse a loved one, feel remorse, try to undo, experience increasing tension, abuse again

d.

Express love, experience dissatisfaction, engage in violence

ANS: B

Co-dependent people need to be needed. They become overinvolved with patients and go to extremes to rescue them by trying to solve their problems. Next, they devalue the rescued individual by implying that the individual cannot participate in his or her own care. Finally, they feel angry, unappreciated, and used as a result of the additional work and responsibility they have assumed.

DIF: Cognitive Level: Knowledge REF: pp. 65-66 OBJ: 10

TOP: Co-dependence KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

MULTIPLE RESPONSE

1. Which statements are relevant to the problem that use of proper body mechanics does not wholly protect nurses from back injuries? (Select all that apply.)

a.

Small workspaces may contribute to injuries.

b.

There is increased obesity among nurses and patients.

c.

Some musculoskeletal injuries are the result of cumulative stress.

d.

Body mechanics studies were performed on men, providing results that may not be true for women.

e.

Some nursing tasks require unnatural positions, such as bending from the torso, twisting, and so on.

ANS: A, B, C, D, E

All of these statements are true and help to explain the reason back injuries continue to occur among nurses who have been taught the use of proper body mechanics.

DIF: Cognitive Level: Analysis REF: pp. 60-61 OBJ: 6

TOP: Back injury KEY: Nursing Process Step: N/A

MSC: NCLEX: Safe, Effective Care Environment

2. The nurse is to present a mini-class on burnout prevention strategies at a nursing team meeting. Which topics would be appropriate to include? (Select all that apply.)

a.

Use sympathetic responses to patients.

b.

Seek daily evaluation from other health care team members.

c.

Practice time management.

d.

Use humor to reduce tension.

e.

Keep nursing skills current.

f.

Maintain perspective about work.

ANS: C, D, E, F

Time management, humor, keeping current, and maintaining perspective are all good strategies for preventing burnout. Sympathetic responses to patients leave the nurse vulnerable to burnout. Seeking daily evaluation from other health care team members puts the nurse at the mercy of others who may not give a balanced evaluation. It is also excessive to think that other team members can provide a peer with daily evaluative feedback. Nurses should use objective self-evaluation.

DIF: Cognitive Level: Analysis REF: pp. 63-64 OBJ: 7

TOP: Burnout prevention KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

3. Telltale signs of chemical dependency in nurses include which of the following behaviors? (Select all that apply.)

a.

Complaints by staff, students, and patients

b.

A greater number of injuries caused while moving patients

c.

Arriving early or staying late to assist in the narcotic count

d.

Frequent absenteeism after days off and for personal emergencies

e.

Increased visits to the employee health department or emergency room

f.

Work performance that consistently exceeds the expectations of the supervisor

ANS: A, B, C, D, E

Telltale signs of chemical dependency in nurses include behaviors such as complaints by staff, students, and patients; accidents, errors in documentation, a greater number of injuries caused while moving patients or equipment, errors in practice, and poor judgment; increased visits to the employee health department or emergency room, increased volunteering to take calls for others (especially true for evening and night shifts if there are fewer staff members, because this makes stealing patients drugs easier); arriving early or staying late to assist in the narcotic count; frequent absenteeism after days off and for personal emergencies, especially on a Monday; irritability and mood swings; performing only the minimum amount of work required; inability to perform psychomotor skills, owing to intoxication or tremors.

DIF: Cognitive Level: Comprehension REF: p. 65, Box 6-2

OBJ: 9 TOP: Chemical dependency KEY: Nursing Process Step: N/A

MSC: NCLEX: N/A

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