Deck 15: Promoting Healthful Living in the Primary Care Setting

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Question
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.
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Question
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
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
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
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
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 US citizens.
D) set of national health mandates.
Question
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.
Question
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
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
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
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
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."
Question
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."
Question
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
Question
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
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
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
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
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
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
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Deck 15: Promoting Healthful Living in the Primary Care Setting
1
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.
C
Lack of information is a major source of anxiety for family members and should be addressed first. Family members should be prepared for the patient's appearance and the ICU environment before visiting the patient for the first time. ICU visiting should be individualized to each patient and family, rather than being dictated by rigid visitation policies. Inviting the family to participate in a multidisciplinary conference is appropriate but should not be the initial action by the nurse.
2
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
A
A nurse practitioner is more likely to treat the patient from a holistic perspective and provide teaching to prevent illness or promote wellness. Although health promotion is a portion of the nurse's role, many other organizations and individuals provide primary health care. The FNP is a primary health care provider. Patients seek out FNPs and trust that their counsel will help keep them well. Writing prescriptions and scheduling stress tests are functions of an FNP and are also good health promoting activities but are not the best in terms of motivating lifestyle changes.
3
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.
D
The priority of care for health promotion is to help a patient regain control over his or her health. The priority nursing diagnoses include health-seeking behaviors or knowledge deficit. The potential for obesity, the potential for impaired mobility, and alteration in nutrition do not address the health promotion intervention of teaching.
4
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.
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Unlock Deck
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5
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
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
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6
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 US citizens.
D) set of national health mandates.
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
7
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.
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
8
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.
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
9
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.
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
10
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.
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
11
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.
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
12
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."
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
13
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."
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
14
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
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
15
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?"
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
16
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
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
17
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."
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
18
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.
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
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.
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
20
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
Unlock Deck
Unlock for access to all 20 flashcards in this deck.
Unlock Deck
k this deck
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Unlock Deck
Unlock for access to all 20 flashcards in this deck.