Chapter 17 My Nursing Test Banks

Kozier & Erbs Fundamentals of Nursing, 10/E
Chapter 17

Question 1

Type: MCSA

A client is attending classes on building positive relationships with significant others as well as learning skills to be open-minded and respectful to those whose opinions are different. The nurse realizes that this client is focusing on which component of wellness?

1. Physical

2. Social

3. Emotional

4. Environment

Correct Answer: 2

Rationale 1: The physical component of wellness is the ability to carry out daily tasks, achieve fitness of all body systems, and practice positive lifestyle habits.

Rationale 2: The social component of wellness focuses on the ability to interact successfully with people and within the environment of which each person is a part, to develop and maintain intimacy with significant others, and to develop respect and tolerance for those with different opinions and beliefs.

Rationale 3: The emotional component deals with the ability to manage stress and express emotions appropriately.

Rationale 4: The environmental component focuses on the health measures that improve the standard of living and quality of life in the community.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 1. Assess protective and predictive factors, including genetics, which influence the health of individuals, families, groups, communities and populations

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2. Describe five components of wellness.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 263

Question 2

Type: MCSA

The nurse is assisting a client and his family after the client had a stroke and is no longer able to return to his previous employment. The nurse has made a referral to vocational rehabilitation for assistance in retraining the client in a different occupation. With which component of wellness is the nurse assisting this client?

1. Intellectual

2. Environmental

3. Occupational

4. Emotional

Correct Answer: 3

Rationale 1: The intellectual component focuses on learning and using information effectively for personal, family, and career development. It also involves striving for continued growth and learning to deal with new challenges effectively.

Rationale 2: Environmental components focus on standards of living and quality of life in the community and include basic human needs such as water, air, and food.

Rationale 3: Occupational components deal with a balance between work and leisure time. A persons beliefs about education, employment, and home influence personal satisfaction and relationships with others. Assisting a client in retraining to find gainful employment and to attain satisfaction in his work is part of the occupational component of wellness. Because the client requires retraining, he must learn anew those aspects of a job that allow for growth, which would better fit under the occupational component of wellness.

Rationale 4: Emotional components of wellness involve the ability to manage stress and express emotions appropriately.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2. Describe five components of wellness.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 264

Question 3

Type: MCSA

A nurse educator is explaining the concept of health and parallels this with interruption of body systems and symptoms of disease or injury. This educator is interpreting health according to which model?

1. Healthillness continua

2. Eudemonistic

3. Adaptive

4. Clinical

Correct Answer: 4

Rationale 1: The healthillness continua is often used to measure a persons perceived level of wellness in which health and illness are at opposite ends of a health continuum.

Rationale 2: The eudemonistic model incorporates a comprehensive view of health, where health is seen as a condition of actualization or realization of a persons potential.

Rationale 3: In the adaptive model, health is seen as a creative process and disease is seen as a failure in adaptation or maladaptation.

Rationale 4: The narrowest interpretation of health occurs in the clinical model, where people are viewed as physiologic systems with related functions and health is defined by the absence of signs and symptoms of disease or injury.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Compare the various models of health outlined in this chapter.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 264

Question 4

Type: MCSA

A nurse is working in a rehabilitation center with a client who had a serious injury. Part of the clients care plan includes working on coping with her current limitations since the injury. This nurse is working within which model of health?

1. Role performance

2. Adaptive

3. Eudemonistic

4. Clinical

Correct Answer: 2

Rationale 1: The role performance model defines health in terms of the individuals ability to fulfill societal roles or to perform work. According to this model, people who fulfill their roles are healthy, even though they may have an illness.

Rationale 2: In the adaptive model, health is a creative process; disease is a failure in adaptation or maladaptation. The aim of treatment is to restore the ability of the person to adapt and cope, as in a rehabilitation setting.

Rationale 3: The eudemonistic model incorporates a comprehensive view of health, which is seen as a condition of actualization or

realization of a persons potential.

Rationale 4: The clinical model is a narrow interpretation of health, which is defined by the absence of disease.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Compare the various models of health outlined in this chapter.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 264

Question 5

Type: MCSA

A nurse is conducting a community assessment to determine which diseases are prevalent and most likely to occur. The nurse is basing the assessment on which model of health?

1. Role performance

2. Eudemonistic

3. Ecological

4. Adaptive

Correct Answer: 3

Rationale 1: The role performance model defines health according to how individuals are able to fulfill their roles or perform their work.

Rationale 2: The eudemonistic model incorporates a comprehensive view of health, which is seen as a condition of actualization or realization of a persons potential.

Rationale 3: The ecological modelalso called the agent-host-environment model of health and illnessis used primarily in predicting illness rather than promoting wellness. Identification of risk factors results from interactions between agent, host, and environment, and is helpful in promoting and maintaining health.

Rationale 4: The adaptive model defines health as a creative process and disease as a maladaptation. The aim of treatment is restoration of the persons ability to cope.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Compare the various models of health outlined in this chapter.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 264

Question 6

Type: MCSA

A nurse is assessing a client who practices yoga for relaxation, is following a nutritionally sound diet, and has supportive, sound relationships with her spouse and children. According to Dunns high-level wellness grid, this client would exemplify which health characteristic?

1. Emergent high-level wellness in a favorable environment

2. Emergent high-level wellness in an unfavorable environment

3. Protected health in a favorable environment

4. High-level wellness in a favorable environment

Correct Answer: 4

Rationale 1: Dunn describes a health grid in which a health axis and an environmental axis intersect. The intersection of the two axes forms four quadrants of health and wellness. Emergent high-level wellness in a favorable environment is not part of Dunns four quadrants of health and wellness.

Rationale 2: Dunn describes a health grid in which a health axis and an environmental axis intersect. The intersection of the two axes forms four quadrants of health and wellness. Emergent high-level wellness in an unfavorable environment would be exemplified by a client who has the knowledge to implement healthy lifestyles, but does not implement them because of family responsibilities, job demands, or other factors.

Rationale 3: Dunn describes a health grid in which a health axis and an environmental axis intersect. The intersection of the two axes forms four quadrants of health and wellness. Protected health in a favorable environment is not part of Dunns four quadrants of health and wellness.

Rationale 4: Dunn describes a health grid in which a health axis and an environmental axis intersect. The intersection of the two axes forms four quadrants of health and wellness. High-level wellness in a favorable environment involves biopsychosocial, spiritual, and economic resources that support healthy lifestyles.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 4. Identify variables affecting health status, beliefs, and practices.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 265

Question 7

Type: MCSA

A nurse has volunteered to go on a health mission to rural Haiti, where the majority of the people do not have access to health care and live in poverty. According to Dunns high-level wellness grid, the nurse will be working with clients in which quadrant?

1. Emergent high-level wellness in an unfavorable environment

2. Protected poor health in a favorable environment

3. Poor health in an unfavorable environment

4. Protected poor health in an unfavorable environment

Correct Answer: 3

Rationale 1: According to Dunns grid, the health axis extends from peak wellness to death, and the environmental axis extends from very favorable to very unfavorable. Emergent high-level wellness in an unfavorable environment would include clients who have the knowledge to implement healthy lifestyle practices, but cannot implement them because of other factors or demands.

Rationale 2: According to Dunns grid, the health axis extends from peak wellness to death, and the environmental axis extends from very favorable to very unfavorable. Protected poor health in a favorable environment is where clients have an illness but their needs are met by the health care system. These clients have adequate access to appropriate medications, diet, and health care instruction.

Rationale 3: According to Dunns grid, the health axis extends from peak wellness to death, and the environmental axis extends from very favorable to very unfavorable. A health mission to an environment such as rural Haiti would involve clients who are not being treated for problems because of poor access and who also live in poor environmental conditions such as poverty and belowstandard sanitation.

Rationale 4: According to Dunns grid, the health axis extends from peak wellness to death, and the environmental axis extends from very favorable to very unfavorable. Protected poor health in an unfavorable environment is not one of Dunns quadrants.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4. Identify variables affecting health status, beliefs, and practices.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 265

Question 8

Type: MCSA

The nurse educator is reviewing internal variables that affect peoples health status. On which variables is this nurse focusing?

Standard Text: Select all that aply.

1. Genetic makeup

2. Age

3. Developmental level

4. Environment

5. Spiritual and religious beliefs

Correct Answer: 1, 2, 3, 5

Rationale 1: Internal variables that affect peoples health include biologic, psychologic, and cognitive dimensions. Biologic dimensions include genetic makeup.

Rationale 2: Internal variables that affect peoples health include biologic, psychologic, and cognitive dimensions. Biologic dimensions include age.

Rationale 3: Internal variables that affect peoples health include biologic, psychologic, and cognitive dimensions. Biologic dimensions include developmental level.

Rationale 4: Internal variables that affect peoples health include biologic, psychologic, and cognitive dimensions. Environment is an example of an external variable that affects a persons health.

Rationale 5: Internal variables that affect peoples health include biologic, psychologic, and cognitive dimensions. Cognitive dimensions include spiritual and religious beliefs.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 4. Identify variables affecting health status, beliefs, and practices.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 267

Question 9

Type: MCSA

An occupational health nurse is surveying employees. Which employee should the nurse identify as being predisposed to an illness?

1. An employee who is in a middle-management position and takes stress from administration as well as the employees

2. An employee who works in the janitorial department

3. An employee who works 12-hour days, 3 days a week

4. An employee who works 4 days on and 3 days off

Correct Answer: 1

Rationale 1: People who hold management positions are in stressful occupational roles that predispose them to stress-related diseases.

Rationale 2: Working as a custodian would not pose the same type of stress as the management position.

Rationale 3: Working longer shifts would not pose the same type of stress as the management position.

Rationale 4: Working longer shifts would not pose the same type of stress as the management position.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 4. Identify variables affecting health status, beliefs, and practices.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 267

Question 10

Type: MCSA

A community health nurse is testing the theory of locus of control (LOC). Which client demonstrates the internal control concept of this theory?

1. A client who takes an active role in all health decisions

2. A client who allows the primary care provider to make all the decisions

3. A client who does not make any decisions without his or her spouses input

4. A client who relies on information from the local hospital for his or her health needs

Correct Answer: 1

Rationale 1: Locus of control (LOC) is a concept from social learning theory. People who exercise internal control are more likely than others to take the initiative on their own health care and to be more knowledgeable about their health. They are also more likely to adhere to prescribed health care regimens such as taking medication, making and keeping appointments with physicians, maintaining diets, and giving up smoking.

Rationale 2: People who believe their health is largely controlled by outside forces (chance or others) are referred to as externals.

Rationale 3: People who believe their health is largely controlled by outside forces (chance or others) are referred to as externals.

Rationale 4: People who believe their health is largely controlled by outside forces (chance or others) are referred to as externals.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 4. Identify variables affecting health status, beliefs, and practices.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 269

Question 11

Type: MCSA

The nurse case manager is concerned about a particular client being discharged from the hospital. Which factors should alert the nurse to possible problems with this clients adherence to treatment?

1. The prescribed therapy is costly and of unknown duration.

2. The therapy will require no lifestyle changes of the client.

3. The client has not had difficulty understanding the regimen.

4. The clients culture is supportive of Western medicine.

Correct Answer: 1

Rationale 1: Adherence to a particular therapy can be compromised if the therapy is expensive or if the duration of the proposed therapy is long.

Rationale 2: Adherence is the extent to which an individuals behavior coincides with medical or health advice. If no lifestyle changes are expected, then adherence should not be an issue.

Rationale 3: Adherence is the extent to which an individuals behavior coincides with medical or health advice. If the client understands the regimen, adherence is not an issue.

Rationale 4: Adherence is the extent to which an individuals behavior coincides with medical or health advice. Following Western medicine is not an adherence issue.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5. Describe factors affecting health care adherence.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 270

New Questions:

Question 12

Type: MCMA

During a home visit with a new community member, the nurse suspects that a client has a chronic illness. What did the nurse assess to make this clinical decision?

Standard Text: Select all that apply.

1. Experienced symptoms for 8 months

2. Has periods where the symptoms disappear

3. Altered activities of daily living because of the illness

4. Problem disappeared with over-the-counter medication

5. Symptoms appeared abruptly and disappeared after treatment

Correct Answer: 1, 2, 3

Rationale 1: A chronic illness is one that lasts for an extended period, usually 6 months or longer, and often for the persons life.

Rationale 2: Chronic illnesses usually have a slow onset and often have periods of remission, when the symptoms disappear.

Rationale 3: With chronic illnesses clients often need to modify activities of daily living.

Rationale 4: An acute illness may subside with the help of over-the-counter medication.

Rationale 5: Symptoms of an acute illness appear abruptly and subside quickly after intervention.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 6. Differentiate illness from disease and acute illness from chronic illness.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 271

Question 13

Type: MCMA

The nurse determines that an older client is in the medical care contact stage of an illness. What did the client demonstrate to cause the nurse to make this decision?

Standard Text: Select all that apply.

1. The client asked if the illness can be treated or recovery is possible.

2. The client asked if the symptoms experienced are a part of an illness.

3. The client asked if the symptoms can be explained in plain language.

4. The client stated that the illness is not acceptable and wants a second opinion.

5. The client stated that treatment is accepted and will be completed as identified.

Correct Answer: 1, 2, 3, 4

Rationale 1: In the medical care contact stage the client seeks reassurance that the illness can be treated and the outcome predicted.

Rationale 2: In the medical care contact stage the client wants validation of a real illness.

Rationale 3: In the medical care contact stage the client wants the symptoms explained in understandable terms.

Rationale 4: In the medical care contact stage the client may deny the diagnosis and seek the other of other health care professionals.

Rationale 5: In the dependent client role the client becomes dependent on the professional for help.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience

AACN Essentials Competencies: VII. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan

NLN Competencies: Context and Environment; Practice; apply health promotion/disease prevention strategies; apply health policy

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 8. Explain Suchmans stages of illness.

MNL Learning Outcome: 1.3.1. Use appropriate strategies to promote health.

Page Number: 272

 

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