Chapter 41. Promoting Health My Nursing Test Banks

Chapter 41. Promoting Health

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. A client informs the nurse that he has quit smoking because his father died from lung cancer 3 months ago. Based on his motivation, smoking cessation should be recognized as an example of which of the following?

1)

Healthy living

2)

Health promotion

3)

Wellness behaviors

4)

Health protection

____ 2. A patient with morbid obesity was enrolled in a weight loss program last month and has attended four weekly meetings. But now he believes he no longer needs to attend meetings because he has learned what to do. He informs the nurse facilitator about his decision to quit the program. What should the nurse tell him?

1)

By now you have successfully completed the steps of the change process. You should be able to successfully lose the rest of the weight on your own.

2)

Although you have learned some healthy habits, you will need at least another 6 weeks before you can quit the program and have success.

3)

You have done well in this program. However, it is important to continue in the program to learn how to maintain weight loss. Otherwise, you are likely to return to your previous lifestyle.

4)

You have entered the determination stage and are ready to make positive changes that you can keep for the rest of your life. If you need additional help, you can come back at a later time.

____ 3. The school nurse at a local elementary school is performing physical fitness assessments on the third-grade children. When assessing students cardiorespiratory fitness, the most appropriate test is to have the students:

1)

Step up and down on a 12-inch bench.

2)

Perform the sit-and-reach test.

3)

Run a mile without stopping, if they can.

4)

Perform range-of-motion exercises.

____ 4. In the Leavell and Clark model of health protection, the chief distinction between the levels of prevention is:

1)

The point in the disease process at which they occur.

2)

Placement on the Wheels of Wellness.

3)

The level of activity required to achieve them.

4)

Placement in the Model of Change.

____ 5. The muscle strength of a woman weighing 132 pounds who is able to lift 72 pounds would be recorded as which of the following?

1)

1.83

2)

Moderate

3)

0.55

4)

18.3%

____ 6. Which is one of the greatest concerns with heavy and chronic use of alcohol in teens and young adults?

1)

Liver damage

2)

Unintentional death

3)

Tobacco use

4)

Obesity

____ 7. A 55-year-old man suffered a myocardial infarction (heart attack) three months ago. During his hospitalization, he had stents inserted in two locations in the coronary arteries. He was also placed on a cholesterol-lowering agent and two antihypertensives. What type of care is he receiving?

1)

Primary prevention

2)

Secondary prevention

3)

Tertiary prevention

4)

Health promotion

____ 8. Health screening activities are designed to:

1)

Detect disease at an early stage.

2)

Determine treatment options.

3)

Assess lifestyle habits.

4)

Identify healthcare beliefs.

____ 9. Which individuals should receive annual lipid screening?

1)

All overweight children

2)

All adults 20 years and older

3)

Persons with total cholesterol greater than 150 mg/dL

4)

Persons with HDL less than 40 mg/dL

____ 10. A mother of three young children is newly diagnosed with breast cancer. She is intensely committed to fighting the cancer. She believes she can control her cancer to some degree with a positive attitude and feelings of inner strength. Which of the following traits is she demonstrating that is linked to health and healing?

1)

Invincibility

2)

Hardiness

3)

Baseline strength

4)

Vulnerability

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

____ 1. The World Health Organizations definition of health includes which of the following? Choose all that apply.

1)

Absence of disease

2)

Physical well-being

3)

Mental well-being

4)

Social well-being

____ 2. According to Penders health promotion model, which variables must be considered when planning a health promotion program for a client? Choose all that apply.

1)

Individual characteristics and experiences

2)

Levels of prevention

3)

Behavioral outcomes

4)

Behavior-specific cognitions and affect

____ 3. Goals for Healthy People 2020 include which of the following? Choose all that apply.

1)

Eliminate health disparities among various groups.

2)

Decrease the cost of healthcare related to tobacco use.

3)

Increase the quality and years of healthy life.

4)

Decrease the number of inpatient days annually.

____ 4. The nurse is implementing a wellness program based on data gathered from a group of low-income seniors living in a housing project. He is using the Wheels of Wellness as a model for his planned interventions. Which of the following interventions would be appropriate based on this model? Choose all that apply.

1)

Creating a weekly discussion group focused on contemporary news

2)

Facilitating a relationship between local pastors and residents of subsidized housing

3)

Coordinating a senior tutorial program for local children at the housing center

4)

Establishing an on-site healthcare clinic operating one day per week

____ 5. The nurse working in an ambulatory care program asks questions about the clients locus of control as a part of his assessment because of which of the following? Choose all that apply.

1)

People who feel in charge of their own health are the easiest to motivate toward change.

2)

People who feel powerless about preventing illness are least likely to engage in health promotion activities.

3)

People who respond to direction from respected authorities often prefer a health promotion program that is supervised by a health provider.

4)

People who feel in charge of their own health are less motivated by health promotion activities.

____ 6. Health promotion programs assist a person to advance toward optimal health. Which of the following activities might such programs include? Choose all that apply.

1)

Disseminating information

2)

Changing lifestyle and behavior

3)

Prescribing medications to treat underlying disorders

4)

Environmental control programs

____ 7. Which of the following actions demonstrate how nurses promote health?

1)

Role modeling

2)

Educating patients and families

3)

Counseling

4)

Providing support

Completion

Complete each statement.

1. A middle-aged woman performs breast self-examination monthly. This intervention is considered to be ____________________ prevention.

2. ____________________ refers to nursing actions performed to help clients to achieve an optimal state of health.

3. What is the name of the nursing theorist who defines health as having three elements: a high level of overall physical, mental, and social functioning; a general adaptive-maintenance level of daily functioning; and the absence of illness (or the presence of efforts that lead to its absence)? ____________________

Chapter 41. Promoting Health

Answer Section

MULTIPLE CHOICE

1. ANS: 4

Although health promotion and health protection may involve the same activities, their difference lies in the motivation for action. Health protection is motivated by a desire to avoid illness. Health promotion is motivated by the desire to increase wellness. Smoking cessation may also be a wellness behavior and may be considered a step toward healthy living; however, neither of these addresses motivation for action.

PTS: 1 DIF: Moderate REF: V1, p. 1040

KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Comprehension

2. ANS: 3

Prochaska and Diclemente identified four stages of change: the contemplation stage, the determination stage, the action stage, and the maintenance stage. This patient demonstrates behaviors typical of the action stage. If a participant exits a program before the end of the maintenance stage, relapse is likely to occur as the individual resumes his previous life style.

PTS: 1 DIF: Moderate REF: V1, p. 1042

KEY: Nursing process: Interventions | Client need: PSI | Cognitive level: Application

3. ANS: 3

Field tests for running are good for children and can be utilized when assessing cardiorespiratory fitness. The step test is appropriate for adults. The 12-inch bench height is too high for young children. The sit-and-reach test as well as range-of-motion exercises would be appropriate when assessing flexibility.

PTS: 1 DIF: Moderate REF: V2, p. 1015

KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

4. ANS: 1

Leavell and Clark identified three levels of activities for health protection: primary, secondary, and tertiary. Interventions are classified according to the point in the disease process in which they occur.

PTS: 1 DIF: Difficult REF: V1, p. 1040

KEY: Client need: HPM | Cognitive level: Recall

5. ANS: 3

Muscle strength measures the amount of weight a muscle (or group of muscles) can move at one time. This is recorded as a ratio of weight pushed (or lifted) divided by body weight. A woman weighing 132 pounds who is able to lift 72 pounds has a ratio of 72 divided by 132, or 0.55.

PTS: 1 DIF: Moderate REF: V2, p. 1015

KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

6. ANS: 2

Heavy and chronic use of alcohol and use of illicit drugs increase the risk of disease and injuries and intentional death (suicide and homicide). Although alcohol as a depressant slows metabolism, chronic alcohol use is more likely associated with poor nutrition, which may or may not lead to obesity. Chronic alcohol use causes damage to liver cells over time in the later years. Alcohol intake is often associated with tobacco and recreational drug use; however, the risk of unintentional injury, such as car accident, suicide, or violence, is more concerning than smoking.

PTS: 1 DIF: Easy REF: V1, p. 1041

KEY: Nursing process: Planning | Client need: HPM | Cognitive level: Recall

7. ANS: 3

Primary prevention activities are designed to prevent or slow the onset of disease. Activities such as eating healthy foods, exercising, wearing sunscreen, obeying seat-belt laws, and getting immunizations are examples of primary level interventions. Secondary prevention activities detect illness so it can be treated in the early stages. Tertiary prevention focuses on stopping the disease from progressing and returning the individual to the pre-illness phase. The patient has an established disease and is receiving care to stop the disease from progressing.

PTS: 1 DIF: Difficult REF: V1, p. 1040

KEY: Client need: Physiological Integrity | Cognitive level: Application

8. ANS: 1

Health screening activities are designed to detect disease at an early stage so that treatment can begin before there is an opportunity for disease to spread or become debilitating.

PTS: 1 DIF: Moderate REF: V1, p. 1048 | V2, p. 1024

KEY: Nursing process: Interventions | Client need: HPM | Cognitive level: Comprehension

9. ANS: 1

The American Academy of Pediatrics take a targeted approach, recommending that overweight children receive cholesterol screening, regardless of family history or other risk factors for cardiovascular disease. The American Heart Association recommends that all adults age 20 years or older have a fasting lipid panel at least once every 5 years. If total cholesterol is 200 mg/dL or greateror HDL is less than 40 mg/dLfrequent monitoring is required.

PTS: 1 DIF: Moderate REF: V1, p. 1049; Box 41-2

KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Comprehension

10. ANS: 2

Research has also demonstrated that in the face of difficult life events, some people develop hardiness rather than vulnerability. Hardiness is a quality in which an individual experiences high levels of stress yet does not fall ill. There are three general characteristics of the hardy person: control (belief in the ability to control the experience), commitment (feeling deeply involved in the activity producing stress), and challenge (the ability to view the change as a challenge to grow). These traits are associated with a strong resistance to negative feelings that occur under adverse circumstances.

PTS: 1 DIF: Moderate REF: V1, pp. 1047-1048

KEY: Nursing process: Planning | Client need: HPM | Cognitive level: Application

MULTIPLE RESPONSE

1. ANS: 2, 3, 4

The World Health Organization defines health as a state of complete physical, mental, and social well-being, not merely the absence of disease of infirmity.

PTS: 1 DIF: Easy REF: V1, p. 1040

KEY: Client need: HPM | Cognitive level: Recall

2. ANS: 1, 3, 4

Pender identified three variables that affect health promotion: individual characteristics and experiences, behavior-specific cognitions and affect, and behavioral outcomes. Levels of prevention were identified by Leavell and Clark; three levels relate to health protection. The levels differ based on their timing in the illness cycle.

PTS: 1 DIF: Difficult REF: V1, pp. 10411042 | V2, p. 1024

KEY: Nursing process: Planning | Client need: HPM | Cognitive level: Comprehension

3. ANS: 1, 3

The four overarching goals of Healthy People 2020 are to 1) increase the quality and years of healthy life, free of disease, injury, and premature death, 2) eliminate health disparities and improve health for all groups of people, 3) create physical and social environments for people to live a healthy life, and 4) promote healthy development for people in all stages of life.

PTS: 1 DIF: Easy REF: V1, p. 1050 | V2, p. 1024

KEY: Nursing process: Planning | Client need: HPM | Cognitive level: Recall

4. ANS: 1, 2, 3, 4

The Wheels of Wellness model identifies the following dimensions of health: emotional, intellectual, physical, spiritual, social/family, and occupational. A weekly discussion group stimulates intellectual health. A relationship between local pastors and those living in subsidized housing creates a climate for spiritual health. A tutorial program offered by seniors to local children will facilitate occupational health. An on-site healthcare clinic addresses physical health.

PTS: 1 DIF: Difficult REF: V1, p. 1042

KEY: Nursing process: Interventions | Client need: HPM | Cognitive level: Analysis

5. ANS: 1, 2, 3

Identifying a persons locus of control helps the nurse determine how to approach a client about health promotion. People who feel powerless about preventing illness are least likely to engage in health promotion activities. People who respond to direction from respected authorities often prefer a health promotion program that is supervised by a health provider. Clients who feel in charge of their own health are the easiest to motivate toward positive change.

PTS: 1 DIF: Difficult REF: V1, p. 1047

KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Recall

6. ANS: 1, 2, 4

Health promotion programs may be categorized into four types: disseminating information; programs for changing lifestyle and behavior; environmental control programs; and wellness appraisal and health risk assessment programs. Prescribing medications to treat underlying disorders is an activity that fosters health focused at an individual level rather than at a group program level.

PTS: 1 DIF: Moderate REF: V1, pp. 1042-1043

KEY: Nursing process: Interventions | Client need: HPM | Cognitive level: Recall

7. ANS: 1, 2, 3, 4

Nurses promote health by acting as role models, counseling, providing health education, and providing and facilitating support.

PTS: 1 DIF: Easy REF: V2, p. 1024

KEY: Nursing process: Interventions | Client need: HPM | Cognitive level: Comprehension

COMPLETION

1. ANS:

secondary

Secondary prevention activities detect illness so that it can be treated in the early stages. Health activities such as mammograms, testicular examinations, regular physical examinations, blood pressure and diabetes screenings, and tuberculosis skin tests are examples of secondary interventions. Primary prevention activities are designed to prevent or slow the onset of disease and promote health. Activities such as eating healthy foods, exercising, wearing sunscreen, obeying seat-belt laws, and getting immunizations are examples of primary level interventions. Tertiary prevention focuses on stopping the disease from progressing and returning the individual to the pre-illness phase.

PTS: 1 DIF: Moderate REF: V1, p. 1040

KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Comprehension

2. ANS:

Health promotion

Not applicable

PTS: 1 DIF: Moderate REF: V1, p. 1040 | V1, p. 1042

KEY: Nursing process: Interventions | Client need: HPM | Cognitive level: Recall

3. ANS:

Jean Watson

Not applicable

PTS: 1 DIF: Moderate REF: V1, p. 1040

KEY: Client need: Safe Care Environment | Cognitive level: Recall

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