Test bank for health promotion throughout the life span 7th edition by edelman

A client with an alteration in the health-perception–health-management pattern and an alteration in the values-beliefs pattern will likely: a.. Dimensions of assessment in the values-bel

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Chapter 06: Health Promotion and the Individual

Test Bank

MULTIPLE CHOICE

1 A primary prevention method for colon cancer is:

a Hemoccult testing

b High fiber diet

c Colonoscopy

d Laparoscopy

ANS: B

Primary prevention includes generalized health promotion and specific protection from disease Hemoccult and colonoscopy are forms of screening, not prevention Eating a healthy diet high in fiber is a preventive measure

DIF: Cognitive Level: Application REF: 148

2 Over the last week, a client has had finger stick glucose levels of 127, 132, 140,

138, 143, 145, and 140 This information allows the nurse to characterize the client's function pattern by utilizing which area of focus?

a Age-developmental

b Functional

c Individual-environmental

d Pattern

ANS: D

Pattern focus implies that the nurse explores patterns or sequences of behavior over time Pattern recognition occurs during information collection Functional health patterns then provide structure to analyze factors

DIF: Cognitive Level: Application REF: 150-151

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3 A nurse using a functional focus to assess a client would evaluate which of the

following?

a Visual acuity

b Pupil reactivity

c Ability to drive

d For the red reflex

ANS: C

Functional focus refers to the individual's performance level Nurses assess how

particular visual patterns affect lifestyle The ability to drive would affect a person's

lifestyle and might require a change in how the client functions

4 A nurse is meeting a mother, father, grandmother, and 4-year-old child The family

is Hispanic In explaining the plan for the child's asthma management, the nurse

should direct her education to:

a The mother

b The father

c The grandmother

d The parents and the grandmother

ANS: D

Culturally competent care is delivered with knowledge of and sensitivity to cultural

factors influencing health behaviors Nurses provide culturally competent care when

they identify and use cultural norms and values In the Hispanic population, the male

figure is usually the decision maker, and the family elders are highly respected

However, assumptions about cultural norms should not be made As a result, the nurse should direct education to all three adults, as they may all have an impact on the

child's health care needs

DIF: Cognitive Level: Synthesis REF: 151

5 A 27-year-old has not received a Pap test in 3 1/2 years This assessment identifies

an alteration in which functional pattern?

a Health-perception–health-management pattern

b Elimination pattern

c Activity-rest pattern

d Self-perception–self-concept pattern

ANS: A

Assessment objectives for health-perception–health-management consist of obtaining

data about perceptions, management, and preventive health practices Exploring these

values identifies potential health hazards A 27-year-old should receive yearly Pap

tests Failing to do so could place her at risk for health problems, thus this finding

identifies an alteration in the health-perception–health management pattern

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6 A client with an alteration in the health-perception–health-management pattern and

an alteration in the values-beliefs pattern will likely:

a Never see a physician

b Only see a physician if not feeling well

c See a physician for screenings only

d See a physician for follow-up care of a chronic disease

ANS: B

Health beliefs and perceptions directly impact participation in care Dimensions of

assessment in the values-beliefs pattern include the individual's values, beliefs, or

goals that guide choices or decisions that are related to health People who do not

believe in health promotion activities will likely only see a physician when sick Thus, someone with an alteration in the health-perception–health-management and

values-beliefs patterns will likely only see a physician if not feeling well

DIF: Cognitive Level: Application REF: 152 | 164

7 In assessing a client's nutritional-metabolic pattern, which objective finding would

have implications for nursing practices?

a The client's 24-hour diet diary

b The client's dentition

c The client's food preferences

d The client's financial status

ANS: B

Although all of the assessment parameters listed have implications for nursing

diagnosis and planning for this client, the only objective measure is the client's

dentition It is the only one that can be validated with a physical exam

8 In assessing a client's activity-exercise pattern, which subjective finding has

implication for nursing practice?

a A client's decreased muscle tone

b A client's amount of leisure time

c A client's decreased range of motion

d A client's use of a cane

ANS: B

Although all findings are important in assessing the activity-exercise pattern, the only

subjective finding is the amount of leisure time that the client reports having All

others are objective findings and can be validated with a physical exam

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9 During a health history, a client reports getting 5 hours of sleep a night This

information indicates to the nurse that:

a The client is not receiving enough sleep

b The client is receiving adequate sleep

c The client is receiving too much sleep

d She needs to ask additional questions

ANS: D

The single most important factor assessed in the sleep-rest pattern is probably the

perception of adequacy of sleep and relaxation The objective when assessing the

sleep-rest pattern is to describe the effectiveness of the pattern from the client's

perspective Wide variation in sleep time doesn't necessarily affect functional

performance Different individuals require different amounts of sleep Thus, without

further subjective data, the nurse is not able to make a diagnosis in this functional

pattern

10 A nurse assesses the cognitive-perceptual pattern of a Type 1 diabetic individual

Which finding has implications for the individual's nursing plan of care?

a Decreased sense of hearing

b Decreased sense of smell

c Altered sense of taste

d Decreased visual acuity

ANS: D

Assessment parameters in the cognitive-perceptual pattern include hearing, vision,

smell, and taste A person with Type 1 Diabetes Mellitus requires insulin injections A decrease in visual acuity will make it difficult for the individual to draw up his or her

medication, and therefore will influence the nurse's plan of care

DIF: Cognitive Level: Synthesis REF: 157-159

11 Which scenario indicates a potentially dysfunctional pattern?

a An adult with frequent urination

b A woman who lost her job

c An elderly person with blurred vision

d An overweight adult with a sweet tooth

ANS: B

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A pattern is potentially dysfunctional when sufficient evidence exists or enough risk

factors are present to indicate that a pattern dysfunction will likely occur if

interventions are not instituted A dysfunctional pattern is a problem when it

represents a deviation from established norms or from the individual's previous

condition or goal The woman who lost her job indicates a potential dysfunction

pattern because the stress of losing her job places her at risk for ineffective coping

The other scenarios are not potentially dysfunctional; by definition, they are

dysfunctional

12 Which scenario represents a dysfunctional pattern?

a A sexually active teenager who does not use condoms

b A salesman who sleeps only 5 hours a night

c A single mother of three children

d A woman with a small extended family

ANS: A

A pattern is potentially dysfunctional when sufficient evidence exists or enough risk

factors are present to indicate that a pattern dysfunction will likely occur if

interventions are not instituted A dysfunctional pattern is a problem when it

represents a deviation from established norms or from the individual's previous

condition or goal Dysfunctional patterns may be present in the absence of disease, and nursing care may be necessary for health promotion and maintenance The teenager,

although free of disease, is in need of health promotion and disease prevention

strategies because her sexual behavior indicates a dysfunction in her

sexuality-reproductive pattern that places her at risk for a sexually transmitted disease and

pregnancy

13 An appropriate action plan for someone with a dysfunctional sleep pattern might

include:

a Reading in bed until he falls asleep

b Avoiding fluids after 7 PM

c Exercising immediately before bedtime

d Watching TV while in bed until he falls asleep

ANS: B

Etiological factors of most dysfunctional patterns often lie within another pattern or

patterns Outcomes and plans are based on probable cause Exercising before bed,

watching TV in bed, and reading in bed are not considered appropriate sleep hygiene

Frequent urination may be the cause of his dysfunctional sleep pattern and if so,

avoiding fluids before bed would be an appropriate plan

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14 An appropriate intervention for a person with a potential dysfunction in the

health-perception–health-management pattern might be:

a Arranging for home delivery of medication from the pharmacy

b Providing education regarding the dangers of smoking

c Instituting visiting nurse services for blood pressure checks

d Providing direct observed therapy for tuberculosis medications

ANS: B

Potential problems are risk states Nursing interventions are directed toward risk

reduction through education Health promotion requires the individual to participate in his own care, and he cannot do this if he does not recognize his susceptibility to an

impending health problem Providing education addresses the risk and provides the

client with information needed to change beliefs The other options make the client a

passive participant rather than an active one

15 Once the nurse determines the client has a dysfunction in the nutritional-metabolic pattern she must:

a Weigh the client

b Set a goal weight with the client

c Ask the client what her favorite foods are

d Develop a plan for weight loss

ANS: B

The individual's goals and the determined diagnosis provide the basis for planning

Prior to developing a plan, a goal must be set Clarity of the goals and diagnosis is

critical to the development of an effective plan In this case, the diagnosis has already

been established and thus assessment of this pattern has occurred (weight, favorite

foods) The next step before developing a plan is to set a goal weight with the client

16 Weighing a client who has been diagnosed with a dysfunction in the

nutritional-metabolic pattern is a function of which aspect of the nursing process?

a Assessment

b Implementation

c Planning

d Evaluation

ANS: D

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The nursing process consists of assessment, diagnosis, planning, implementation, and

evaluation A client who has been diagnosed with a dysfunction has already been

assessed The process of analyzing changes experienced by a client after a plan has

been implemented occurs in the evaluation phase In this question, a weight will

determine whether or not the client is moving toward her goals of weight loss

DIF: Cognitive Level: Synthesis REF: 148 | 166-167

17 A nurse administers the T-ACE test to her pregnant female client The client's

responses result in a score of 3 This score indicates that:

a The client requires interventions for problem drinking

b The client lacks evidence of problem drinking

c The client requires interventions for sexually transmitted disease risks

d The client lacks evidence of sexually transmitted disease risks

ANS: A

The T-ACE provides a sensitive measure of alcohol-intake pattern in pregnant women

A score of 2 or more indicates evidence of problem drinking This client had a score

of 3, which would require an intervention for problem drinking

DIF: Cognitive Level: Application REF: 148 (Think About It box)

18 A Hispanic mother tells the nurse that she has been using home remedies for her

child's asthma Which home remedy might this mother be using?

a Acupuncture

b Cupping

c Hot tea

d Massage

ANS: C

In the Hispanic population, asthma is viewed as a cold disease (hot-cold imbalance)

and thus is treated with warm therapies Diet is often used to maintain equilibrium

Thus, warm tea added to the child's diet might be used to restore equilibrium between

hot and cold in this child who has asthma

DIF: Cognitive Level: Application REF: 153 (Multicultural Awareness

box)

19 Which nursing diagnosis classification system is the best researched and most

widely implemented classification internationally?

a The International Classification of Nursing Practice

b The International Classification of Functioning, Disability, and Health

c The International Nursing Diagnoses Classification

d The Nursing Diagnostic System of The Center For Nursing Development and

Research

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ANS: C

There is evidence to support that The International Nursing Diagnoses Classification is the best researched and most widely implemented classification system internationally DIF: Cognitive Level: Knowledge REF: 165 (Research Highlights box)

20 Whose framework provides the foundation for nursing assessment and diagnosis

using the 11 functional health patterns?

a Erikson

b Gordon

c Newman

d Nightingale

ANS: B

Gordon's framework provides the foundation for most NANDA nursing diagnoses

using the functional health pattern Nurses use the framework to combine assessment

skills with subjective and objective data to construct patterns

DIF: Cognitive Level: Knowledge REF: 149-150

21 Healthy People 2010 objectives provide a framework for:

a Assessment

b Diagnosis

c Prevention

d Treatment

ANS: C

The health promotion initiative named Healthy People 2010 provides a framework for

prevention

DIF: Cognitive Level: Knowledge REF: 148

22 Erikson's task of autonomy vs shame and doubt occurs during which stage of

development?

a Infancy

b Early childhood

c Late childhood

d Early adolescence

ANS: B

Erikson's task of autonomy vs shame and doubt occurs during early childhood

DIF: Cognitive Level: Knowledge REF: 159 (Table 6-3)

23 Erikson's task of intimacy vs isolation occurs during which stage of development?

a Adolescence

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b Early adulthood

c Middle adulthood

d Maturity

ANS: B

Erikson's task of intimacy vs isolation occurs during early adulthood

DIF: Cognitive Level: Knowledge REF: 160 (Table 6-3)

24 Which cultural group defines illness as a price that is being paid for the past or the future?

a African

b Native American

c Arabian

d Asian

ANS: B

American Indians define illness as a price that is being paid for the past or the future

DIF: Cognitive Level: Knowledge REF: 152 (Multicultural Awareness

box)

25 Which cultural group defines health as a gift from God?

a African

b Alaska Native

c Asian

d Hispanic

ANS: D

Hispanics define health as a gift from God

DIF: Cognitive Level: Knowledge REF: 153 (Multicultural Awareness

box)

26 The leading cause of death in women is:

a Accidents

b Cancer

c Heart disease

d Stroke

ANS: C

The leading cause of death in women is heart disease

DIF: Cognitive Level: Knowledge REF: 166 (Hot Topics box)

MULTIPLE RESPONSE

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1 A client who fails to take his insulin on a regular basis may have a conflict in which

of the following functional health patterns? Select all that apply

a Health-perception–health-management

b Cognitive-perceptual

c Elimination

d Values-beliefs

ANS: A, B, D

A problem in one area serves as a clue to dysfunction in other areas Cognitive

patterns include the ability of the individual to understand and follow directions, retain information, make decisions, solve problems, and use language appropriately As a

result, this client may not understand how to give himself the insulin properly The

values-beliefs pattern describes values including the individual's spiritual values,

beliefs, and goals This person may not believe in the use of medications unless he is

symptomatic The health-perception–health-management pattern involves the

individual's health status and health practices used to reach the current level of health

or wellness, with a focus on perceived health status and meaning of health to the

individual This person may not believe in health promotion and prevention Thus, a

person who fails to take his insulin on a regular basis may have a conflict in the

health-perception–health-management, cognitive-perceptual, and values-beliefs

patterns

DIF: Cognitive Level: Application REF: 152 | 154 | 157 | 164

2 Which individual is at risk for a dysfunction in elimination pattern? Select all that

apply

a A 46-year-old mother of two

b A 32-year-old African American male

c A 15-year-old female

d A 72-year-old white female

ANS: A, B, C, D

When evaluating elimination patterns, nurses must consider age, developmental level, and cultural considerations A 46-year-old mother of two is at risk for urinary stress

incontinence because of the two vaginal births; an older adult is at risk for urinary

control problems; African Americans often have a diet low in fiber, which can lead to

constipation; and teenagers, especially girls, may have problems with body image,

leading to abuse of laxatives Thus, all persons listed are at risk for a dysfunction in

elimination patterns

DIF: Cognitive Level: Synthesis REF: 155

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