Deck 17: Promoting Healthful Living in the Primary Care Setting

Question 1

A nurse recognizes that a homeless patient must walk great distances to obtain food. What kind of need does this patient demonstrate?

A) Health-deviation need
B) Developmental need
C) Universal need
D) Health continuum need

Answer 1

C
A universal need is an essential requirement for everyone: food, shelter, air, water, and other basic needs. A developmental need, such as trust, love, and belonging, changes as a person moves through each life-cycle period. A health-deviation need is based on an individual's genetic or constitutional deviations from normal. A health continuum need is not a true term.

Question 2

Before discharging a patient with osteoarthritis (OA) of the left hip and lower lumbar vertebrae, the nurse teaches her about management of the condition. Which replies by the patient demonstrate proper understanding of how to manage her condition? (Select all that apply.)

A) "I should try and stay active all the day to keep my joints from becoming stiff."
B) "I can use a cane if I find it helpful in relieving the pressure on my back and hips."
C) "A warm shower in the morning will help relieve the stiffness I have when I get up."
D) "I should take no more than 1 gram of acetaminophen four times a day to control the pain."
E) "Exercising daily on a stationary recumbent bicycle will lessen joint stress."

Answer 2

B, C, D
Protection and avoidance of joint stressors are recommended for patients with OA, so this patient should use a cane to ambulate more comfortably, take warm showers to lessen joint stiffness, and should use nonsteroidal anti-inflammatory medication as directed. Staying active all day or exercising daily will likely exacerbate joint swelling and pain.

Question 3

A home health nurse is going to visit a new patient for admission to the nurse's care. At the first meeting the nurse is able to meet the entire family. The nurse recognizes some unhealthy characteristics. Which statement made by the patient would lead the nurse to this conclusion?

A) "We all have specific chores that we are responsible for on a daily basis."
B) "We allow our 14-year-old to make all of her own decisions."
C) "We like to go camping together as a family in the summertime."
D) "Our children are actively involved in school-sponsored sports."

Answer 3

B
Allowing a 14-year-old child to make her own decisions led to the nurse's conclusion that unhealthy characteristics existed within this family. The nurse should engage in health protective behaviors as well as health promotion behaviors. Health protective behaviors take a person away from a dangerous situation or from a dangerous habit. Health promotion behaviors move an individual to a higher level of health, greater vigor, or energy to do more than he or she is currently capable of doing. All the other statements imply a strong and healthy family unit.

Question 4

A patient has chosen to see a Family Nurse Practitioner (FNP) to assist with health promoting activities. Which of the following services provided by the FNP is the best example of a health promotion activity?

A) Teaching about a low-fat diet for a patient with a blood pressure of 136/82
B) Prescribing a cholesterol-lowering medication
C) Scheduling a cardiac stress test
D) Prescribing an anticoagulant for a patient with atrial fibrillation

Question 5

Negative dietary influences on the health of Asian immigrants to the United States are most likely considered to be which type of environmental factor affecting health promotion?

A) Spiritual
B) Cultural
C) Developmental
D) Economic

Question 6

Which family would the nurse consider healthy?

A) A family in which the parents do not allow their 10-year-old child to make basic decisions.
B) A family that encourages independence while supporting each other.
C) A family that does not require a specific curfew for their 16-year-old son.
D) A family that does not allow their 15-year-old child to be an individual.

Question 7

To help prevent drug-drug interactions in an older adult patient taking many medications, the most appropriate instruction by the nurse is:

A) "Do not take any over-the-counter (OTC) drugs with your prescription drugs."
B) "Bring a list or all of your medications, supplements, and herbs that you use to every health care appointment and/or the hospital."
C) "Be sure to have all your prescriptions filled at the same pharmacy."
D) "Use a medication reminder system so that you won't forget to take your medications as scheduled."

Question 8

A patient admitted with chest pain who is a one pack-a-day smoker tells the nurse, "I am just not ready to quit smoking yet." The most appropriate response by the nurse is:

A) "This would be a really good time to quit."
B) "Are you familiar with the nicotine patch?"
C) "Your smoking is the cause of your chest pain."
D) "What do you think keeps you from quitting?"

Question 9

Healthy People 2020 is a:

A) new global action plan to prevent and treat disease.
B) prevention agenda for the nation.
C) national effort to improve lives of U.S. citizens.
D) set of national health mandates.

Question 10

Several family members of a patient who has just been admitted to the intensive care unit (ICU) with multiple traumatic injuries have just arrived in the ICU waiting room. Which action should the nurse take first?

A) Take the family members to the patient's room.
B) Discuss ICU visitation policies and encourage family visits.
C) With the patient's approval, describe the patient's injuries and the care that is being provided.
D) Invite the family to participate in a multidisciplinary care conference.

Question 11

A patient has had no visitors for the 2 weeks he has been on your unit. The patient seems dejected and insists on having his few belongings in sight at all times. The nurse realizes that he may be experiencing what kind of need?

A) Health-deviation need
B) Developmental need
C) Universal need
D) Health continuum need

Question 12

When developing strategies to decrease health care disparities, the nurse working in a hospital located in a neighborhood with many Vietnamese individuals will include:

A) educating the staff about Vietnamese health beliefs.
B) improving public transportation.
C) obtaining low-cost medications.
D) updating equipment and supplies for the clinic.

Question 13

A nurse is developing a health promotion care plan for an otherwise healthy man who is married with four children and has a career as a public school teacher. Which of the following environmental factors could have a major effect on the patient's health promotion activities?

A) Developmental
B) Spiritual
C) None of the above
D) Both a and b

Question 14

The priority health promotion nursing diagnoses for an overweight, but not yet obese, patient who is learning about weight reduction may include:

A) the potential for obesity.
B) the potential for impaired mobility.
C) alteration in nutrition.
D) health-seeking behaviors or knowledge deficit.

Question 15

A patient is admitted to the hospital with a new diagnosis of diabetes mellitus type 1 and is scheduled for discharge on the second day after admission. In view of the patient's 2-day inpatient stay, the nurse should set realistic goals by planning to:

A) teach the patient how to monitor glucose and self-administer insulin.
B) include detailed information about diet and medication use in patient teaching.
C) use every interaction to teach the patient about the details of glucose control.
D) focus on teaching the family instead of the patient about diabetic management.

Question 16

A program designed to increase exercise, reduce fat in a diet, and teach low-fat cooking methods to improve the health of a large population could be best described as:

A) supportive care.
B) rehabilitation.
C) diagnosis and treatment.
D) health promotion and health protective.

Question 17

A homeless patient with severe anorexia, fatigue, jaundice, and hepatomegaly is diagnosed with viral hepatitis and has just been admitted to the hospital. In planning care of the patient, the nurse assigns the highest priority to the patient outcome of:

A) establishing a stable home environment.
B) maintaining adequate nutrition.
C) increasing activity level.
D) identifying the source of exposure to hepatitis.

Question 18

After the nurse implements diet instruction with a patient with heart disease, the patient can explain the information but fails to make the recommended dietary changes. The nurse's evaluation is that:

A) learning did not occur because the patient's behavior did not change.
B) the nursing responsibility for helping the patient make dietary changes has been fulfilled.
C) choosing not to follow the diet is the behavior that resulted from the learning.
D) the teaching methods were ineffective in helping the patient learn the dietary information.

Question 19

A nurse is caring for a non-English-speaking Asian patient whose cultural practices are not familiar to the nurse. The nurse is curious about practices regarding communication and eye contact. The nurse should:

A) tell the patient that it is cultural practice in the United States to maintain good eye contact when communicating with someone.
B) observe the behaviors and interactions between the patient and other members of the culture.
C) avoid all eye contact unless the patient establishes eye contact.
D) use eye contact and communication techniques that are most comfortable for the nurse.

Question 20

While obtaining a health history of a patient who has a large infected wound on the foot, the nurse learns that the patient has taken goldenseal to boost immune function rather than taking antibiotics for the infection. Which action by the nurse is initially most appropriate?

A) Instruct the patient about the reasons for antibiotic use with infection.
B) Ask the patient, "How do you feel about using both antibiotics and natural remedies?"
C) Tell the patient that the doctor is likely to prescribe antibiotics.
D) Tell the patient that studies of goldenseal show that it is not effective in treating infection.