week 2 -- book ch 6 & 25

Question 1

health

Answer 1

state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity

Question 2

Health Belief Model

Answer 2

*addresses beliefs & behaviors

1.individual’s perception of SUSCEPTIBILITY to an illness

2.individual’s perception of the SERIOUSNESS

3. LIKELIHOOD of preventative action

Question 3

Health Promotion Model

Answer 3

*describes multidimensional nature of people

1. individual’s characteristics & experiences
2. behavior specific knowledge & affect
3. behavioral outcomes

Question 4

Maslow’s Hierarchy of Needs

Answer 4

1. physiological
2. safety & security
3. love & belonging
4. self-esteem
5. self-actualization

Question 5

Internal variables

Answer 5

*developmental stage
*intellectual background
*perception of functioning
*emotional/spiritual factors

Question 6

External Variables

Answer 6

*family practices
*cultural background
*psychosocial & socioeconomic factors

Question 7

5 Social Determinants of Health

Answer 7

1. economic stability
2. education
3. health & health care
4. social & community context
5. neighborhood & built environment

Question 8

passive strategy

Answer 8

individual gains from the activity of others w/o acting themselves
***Vitamin D in milk

Question 9

active strategy examples

Answer 9

smoking cessation
weight reduction

Question 10

primary prevention

Answer 10

aims to reduce incidence of disease
*health education
*physical fitness

Question 11

secondary prevention

Answer 11

focuses on preventing spread of illness/disease once it occurs
**screenings

Question 12

tertiary prevention

Answer 12

defect or disability is permanent or irreversible
**rehab/therapy

Question 13

acute vs chronic

Answer 13

acute = short duration & reversible

chronic = 6+ months, irreversible, & affects functioning in 1 or more systems

Question 14

A patient discharged a week ago following a stroke is currently participating in rehabilitation sessions provided by nurses, physical therapists, and registered dietitians in an outpatient setting. In what level of prevention is the patient participating?

1. Primary prevention
2. Secondary prevention
3. Tertiary prevention
4. Transtheoretical prevention

Answer 14

3. Tertiary prevention

Question 15

Based on the Transtheoretical Model of Change, what is the most appropriate response to a patient who states: “Me, stop smoking? I’ve been smoking since I was 16!”

1. “That’s fine. Some people who smoke live a long life.”
2. “OK. I want you to decrease the number of cigarettes you smoke by one each day, and I’ll see you in 1 month.”
3. “What do you think is the greatest reason why stopping smoking would be challenging for you?”
4. “I’d like you to attend a smoking-cessation class this week and use nicotine replacement patches as directed.”

Answer 15

3. “What do you think is the greatest reason why stopping smoking would be challenging for you?”

Question 16

A nurse working on a medical patient care unit states, “I am having trouble sleeping, and I eat nonstop when I get home. All I can think of when I get to work is how I can’t wait for my shift to be over. I wish I felt happy again.” What are the best responses from the nurse manager? (Select all that apply.)

1. “I’m sure this is just a phase you are going through. Hang in there. You’ll feel better soon.”
2. “I know several nurses who feel this way every now and then. Tell me about the patients you have cared for recently. Did you find it difficult to care for them?”
3. “You can take diphenhydramine over the counter to help you sleep at night.”
4. “Describe for me what you do with your time when you are not working.”
5. “The hospital just started a group where nurses get together to talk about their feelings. Would you like for me to e-mail the schedule to you?”

Answer 16

2. “I know several nurses who feel this way every now and then. Tell me about the patients you have cared for recently. Did you find it difficult to care for them?”
3. “Describe for me what you do with your time when you are not working.”
4. “The hospital just started a group where nurses get together to talk about their feelings. Would you like for me to e-mail the schedule to you?”

Question 17

A patient has been laid off from his construction job and has many unpaid bills. He is going through a divorce from his marriage of 15 years and has been praying daily to help him through this difficult time. He does not have a primary health care provider because he has never really been sick, and his parents never took him to a physician when he was a child. Which external variables influence the patient’s health practices? (Select all that apply.)

1. Difficulty paying his bills
2. Praying daily
3. Age of patient (46 years)
4. Stress from the divorce and the loss of a job
5. Family practice of not routinely seeing a health care provider

Answer 17

1. Difficulty paying his bills
2. Family practice of not routinely seeing a health care provider

Question 18

A nurse is conducting a home visit with a new mom and her three children. While in the home the nurse weighs each family member and reviews their 3-day food diary. She checks the mom’s blood pressure and encourages the mom to take the children for a 15- to 30-minute walk every day. The nurse is addressing which level of need, according to Maslow?

1. Physiological
2. Safety and security
3. Love and belonging
4. Self-actualization

Answer 18

1. Physiological

Question 19

When taking care of patients, a nurse routinely asks whether they take any vitamins or herbal medications, encourages family members to bring in music that the patient likes to help the patient relax, and frequently prays with her patients if that is important to them. The nurse is practicing which model?

1. Holistic
2. Health belief
3. Transtheoretical
4. Health promotion

Answer 19

1. Holistic

Question 20

Using the Transtheoretical Model of Change, order the steps that a patient goes through to make a lifestyle change related to physical activity.

1. The individual recognizes that he is out of shape when his daughter asks him to walk with her after school.
2. Eight months after beginning walking, the individual participates with his wife in a local 5K race.
3. The individual becomes angry when the physician tells him that he needs to increase his activity to lose 30 lb.
4. The individual walks 2 to 3 miles, 5 nights a week, with his wife.
5. The individual visits the local running store to purchase walking shoes and obtain advice on a walking plan.

Answer 20

3. The individual becomes angry when the physician tells him that he needs to increase his activity to lose 30 lb.
4. The individual recognizes that he is out of shape when his daughter asks him to walk with her after school.
5. The individual visits the local running store to purchase walking shoes and obtain advice on a walking plan.
6. The individual walks 2 to 3 miles, 5 nights a week, with his wife.
7. Eight months after beginning walking, the individual participates with his wife in a local 5K race.

Question 21

Which of the following are symptoms of secondary traumatic stress and burnout that commonly affect nurses? (Select all that apply.)

1. Regular participation in a book club
2. Lack of interest in exercise
3. Difficulty falling asleep
4. Lack of desire to go to work
5. Anxiety while working

Answer 21

2. Lack of interest in exercise
3. Difficulty falling asleep
4. Lack of desire to go to work
5. Anxiety while working

Question 22

As part of a faith community nursing program in her church, a nurse is developing a health promotion program on breast self-examination for the women’s group. Which statement made by one of the participants is related to the individual’s accurate perception of susceptibility to an illness?

1. “I have a door hanging tag in my bathroom to remind me to do my breast self-examination monthly.”
2. “Since my mother had breast cancer, I know that I am at increased risk for developing breast cancer.”
3. “Since I am only 25 years of age, the risk of breast cancer for me is very low.”
4. “I participate every year in our local walk/run to raise money for breast cancer research.”

Answer 22

2. “Since my mother had breast cancer, I know that I am at increased risk for developing breast cancer.”

Question 23

The nurse assesses the risk factors for coronary artery disease (CAD) in a female patient. Which of these factors are classified as genetic and physiological? (Select all that apply.)

1. Sedentary lifestyle
2. Mother died from CAD at age 48
3. History of hypertension
4. Eats diet high in sodium
5. Elevated cholesterol level

Answer 23

2. Mother died from CAD at age 48
3. History of hypertension
4. Elevated cholesterol level

Question 24

6 components of cognitive learning

Answer 24

1.Remember
2. Understand
3. Apply
4. Analyze
5. Evaluate
6. Create

Question 25

5 components of Affective Learning

Answer 25

1. Receiving 2. Responding 3. Valuing 4. Organizing 5. Characterizing

Question 26

7 components of Psychomotor Learning

Answer 26

1. Fundamental (walking) 2. Perception (body movements) 3. Guided Response 4. Mechanism (confidence & proficiency) 5. Complex overt 6. Adaptation 7. Origination

Question 27

Cognitive Dissonance Theory

Answer 27

individuals desire consistency & will make necessary changes & adaptations to gain it

Question 28

Transtheoretical Model of Change

Answer 28

*change & behavior 1. Pre-contemplation 2. Contemplation 3. Preparation 4. Action 5. Maintenance

Question 29

Nursing Process

Answer 29

1. Assessment 2. Analysis 3. Planning 4. Implementation 5. Evaluation

Question 30

E.D.U.C.A.T.E. Model

Answer 30

E--enhance comprehension & retention D--deliver patient-centered education U--understand the learner C--communicate clearly A--address heath literacy & cultural competence T--teaching E--education goals

Question 31

A patient asks a nurse to provide instruction on how to perform a breast self-exam. Which domains are required to learn this skill? (Select all that apply.) 1. Affective domain 2. Sensory domain 3. Cognitive domain 4. Attentional domain 5. Psychomotor domain

Answer 31

3. Cognitive domain 5. Psychomotor domain

Question 32

A patient suddenly experiences a severe headache with numbness and decreased movement in the left arm. The emergency room physician suspects a stroke and is going to have the patient undergo an emergent angiogram to remove the clot. Which teaching approach is most appropriate? 1. Selling approach 2. Telling approach 3. Entrusting approach 4. Participating approach

Answer 32

2. Telling approach

Question 33

A nurse is caring for a young patient who has been told he has multiple sclerosis. The nurse has planned time to conduct a teaching session that will focus on the disease and principles of management. The nurse chooses to use the EDUCATE model to proceed with instruction. Which of the following are components of the model? (Select all that apply.) 1. State goals of the session for the patient. 2. Repeat the most important information. 3. Practice empathetic skills. 4. Be aware of nonverbal messages. 5. Use a standard question list for the chosen topic.

Answer 33

2. Repeat the most important information. 3. Practice empathetic skills. 4. Be aware of nonverbal messages.

Question 34

A nurse is teaching an older adult patient about ways to detect a melanoma. Which of the following are age-appropriate teaching techniques for this patient? (Select all that apply.) 1. Speak in a low tone. 2. Begin and end the session with the most important information regarding melanoma. 3. Provide a pamphlet about melanoma with large font in blues and greens. 4. Provide specific information in frequent, small amounts for older adult patients. 5. Speak quickly so that you do not take up much of the patient’s time.

Answer 34

1. Speak in a low tone. 2. Begin and end the session with the most important information regarding melanoma. 4. Provide specific information in frequent, small amounts for older adult patients.

Question 35

A 55-year-old adult male has been in the hospital over a week following surgical complications. The patient has had limited activity but is now finally ordered to begin a mobility program. The patient just returned from several diagnostic tests and tells the nurse he is feeling quite fatigued. The nurse prepares to instruct the patient on the mobility program protocol. Which of the following learning principles will likely be affected by this patient’s condition? 1. Motivation to learn 2. Developmental stage 3. Stage of grief 4. Readiness to learn

Answer 35

4. Readiness to learn

Question 36

A patient recovering from open heart surgery is taught how to cough and deep breathe using a pillow to support or splint the chest incision. Following the teaching session, which of the following is the best way for the nurse to evaluate whether learning has taken place? 1. Verbalization of steps to use in splinting 2. Selecting from a series of flash cards the images showing the correct technique 3. Return demonstration 4. Cloze test

Answer 36

3. Return demonstration

Question 37

Assessment

Answer 37

Learn about the patient’s health beliefs and practices.

Question 38

Communication

Answer 38

Remain aware of verbal and nonverbal responses.

Question 39

Cultural

Answer 39

Become aware of your patient’s culture and your own cultural biases.

Question 40

Establishment

Answer 40

Show respect by creating a caring rapport.

Question 41

Sensitivity

Answer 41

Be aware of how patients from diverse backgrounds perceive their care needs.

Question 42

Safety

Answer 42

Help patients feel culturally secure and able to maintain their cultural identity.

Question 43

A 63-year-old woman is a family caregiver for her 88-year-old mother who has dementia. The caregiver asked the home health nurse how to manage her mother when she becomes confused and violent. The best instructional method a nurse can use for this situation is: 1. Demonstration 2. Preparatory instruction 3. Role-playing 4. Group instruction with other family caregivers

Answer 43

Role-playing

Question 44

A nurse is preparing to teach a patient who has sleep apnea how to use a CPAP machine at night. Which action is most appropriate for the nurse to perform first? 1. Allow patient to manipulate machine and look at parts. 2. Provide a teach-back session. 3. Set mutual goals for the education session. 4. Discuss the purpose of the machine and how it works.

Answer 44

Set mutual goals for the education session.

Question 45

Which of the following scenarios demonstrate that learning has taken place? (Select all that apply.) 1. A patient listens to a nurse’s review of the warning signs of a stroke. 2. A patient describes how to set up a pill organizer for newly ordered medicines. 3. A patient attends a spinal cord injury support group. 4. A patient demonstrates how to take his blood pressure at home. 5. A patient reviews written information about resources for cancer survivors.

Answer 45

2. A patient describes how to set up a pill organizer for newly ordered medicines. 4. A patient demonstrates how to take his blood pressure at home.