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Chapter 3: Health, Illness, and
Disparities
The nurse is preparing a care plan for an African American man age 68 years who was recently diagnosed with hypertension. Age, race, gender, and genetic inheritance are examples of what human dimension? A) Physical B) Emotional C) Environmental
D) Sociocultural - Correct answer Ans: A
Feedback: The physical dimension includes genetic inheritance, age, developmental level, race, and gender. These components strongly influence a person's health status and health practices. The emotional dimension focuses on how the mind affects body function and responds to body conditions. The environmental dimension includes influences such as housing, sanitation, climate, and pollution of food, air, and water. Sociocultural dimensions are health practices and beliefs strongly influenced by economic status, lifestyle, family, and culture. The mother of a toddler with asthma seeks support from the parents of other children with asthma. The nurse recognizes that seeking and utilizing support systems is an example of which human dimension? A) Sociocultural dimension B) Physical dimension C) Environmental dimension
D) Intellectual and spiritual dimension - Correct answer Ans: A
Feedback: Communicating with others and the use of support systems relate to the sociocultural dimension. An individual's relationship with others, being connected to a community, and feeling accepted and loved by others are also related to the sociocultural dimension. A nurse educator uses models of health and illness when teaching. Which model of health and illness places high-level health and death on opposite ends of a graduated scale? A) Health-Illness Continuum B) Agent-Host-Environment Model C) Health Belief Model
D) Health Promotion Model - Correct answer Ans: A
Feedback:
The Health-Illness Continuum views health as a constantly changing state, with high- level wellness and death being on opposite ends of a graduated scale. The Agent-Host-Environment Model is useful in examining the causes of disease in an individual. The Health Belief Model describes health behaviors. The Health Promotion Model incorporates individual characteristics and experiences, as well as behavior-specific knowledge and beliefs, to motivate healthy behavior. A homeless client has been brought to the emergency department (ED) by ambulance after being found unresponsive outside a mall. The client is known to the ED staff as having bipolar disorder, and assessment reveals likely cellulitis on his left ankle. He is febrile with a productive cough, and the care team suspects pneumonia. A sputum culture for tuberculosis has been obtained and sent to the laboratory. Which of the following aspects of the client's medical condition would be considered a chronic condition? A) Bipolar disorder B) Pneumonia C) Cellulitis
D) Tuberculosis - Correct answer Ans: A
Feedback: Bipolar disorder is a long-standing diagnosis that requires the lifelong education and treatment associated with chronic conditions. Pneumonia, tuberculosis, and cellulitis are all acute, infectious diseases that may be treated with antibiotic regimens of varying length. Which of the following activities related to respiratory health is an example of tertiary health promotion and illness prevention? A) Administering a nebulized bronchodilator to a client who is short of breath B) Assisting with lung function testing of a client to help determine a diagnosis C) Teaching a client that "light" cigarettes do not prevent lung disease D) Advocating politically for more explicit warning labels on cigarette packages -
Correct answer Ans: A
Feedback: The use of medications is characteristic of tertiary health promotion and illness prevention. Testing and screening are examples of secondary health promotion and illness prevention, while client education and political advocacy are associated with primary prevention. An elderly resident of a long-term care facility has developed diarrhea and dehydration as a result of exposure
Health is experienced differently by each person; it is not the opposite of illness, and does not indicate the absence of disease. Which of the following most accurately defines "illness"? A) The inability to carry out normal activities of living B) A pathologic change in mind or body structure or function C) The response of a person to a disease
D) Achieving maximum potential and quality of life - Correct answer Ans: C
Feedback: Illness is the response of a person to a disease, an abnormal process in which one's level of function is changed when compared with the previous level. A disease (a medical term) means there is a pathologic change in the structure or function of the body or mind. Wellness is a term used to describe a person achieving maximum potential and quality of life despite disease or illness. Which of the following statements accurately describes the concepts of disease and illness? A) A disease is traditionally diagnosed and treated by a nurse. B) The focus of nurses is the person with an illness. C) A person with an illness cannot be considered healthy.
D) Illness is a normal process that affects level of functioning. - Correct answer Ans:
B
Feedback: A disease is traditionally diagnosed and treated by a physician (although nurses with advanced educations are increasingly doing so), while nurses focus on the person with an illness. A person may have an illness or injury but still achieves maximum functioning and quality of life, and considers himself or herself to be healthy. Illness is the response of the person to a disease; it is an abnormalprocess in which the person's level of functioning is changed when compared with a previous level. A nurse calls in to his unit to report he has the flu and will not be at work. What stage of illness behavior is he exhibiting? A) Experiencing symptoms B) Assuming the sick role C) Assuming a dependent role
D) Achieving recovery and rehabilitation - Correct answer Ans: B
Feedback: When assuming the sick role, the person defines himself or herself as sick, seeks validation from others, and gives up
normal activities such as going to work. Although the other choices are stages of illness, they are not defined by the behavior presented. A cleint accepts the fact that he needs bypass surgery for a blocked artery and is admitted into the hospital. Which one of the following stages of illness is this client experiencing? A) Stage 1 B) Stage 2 C) Stage 3
D) Stage 4 - Correct answer Ans: C
Feedback: In Stage 3, assuming a dependent role, the patient decides to accept the diagnosis and follow the prescribed treatment plan. The person conforms to the opinions of others, often requires assistance in carrying out activities of daily living, and needs emotional support through acceptance, approval, physical closeness, and protection. A child age 4 years has leukemia but is now in remission. What does it mean to be in remission when one has a chronic illness? A) The chronic disease has been cured. B) Nothing further can be done in terms of treatment. C) Severe symptoms of the chronic illness have reappeared.
D) The disease is present, but symptoms are not experienced. - Correct answer Ans:
D
Feedback: Many chronic illnesses have periods of remission and exacerbation. During remission, the disease is present but the person does not experience symptoms. During exacerbation, the symptoms of the illness reappear. What may happen to the family when one of the family members suffers an illness? A) Alterations in values and religious beliefs B) More public displays of affection C) Changes in roles for the client and family
D) Increased resistance to stress - Correct answer Ans: C
Feedback: When an illness occurs, roles change for both the client and the family. Chronic illnesses often result in increased stress for the family, but responses by all members are individualized. A baby is born with Down syndrome, which influences his health-illness status. This is an example of which of the following human dimensions?
Teaching breast self-examination is an example of a primary preventive care activity. Which of the following models of health promotion and illness prevention was developed to illustrate how people interact with their environment as they pursue health? A) The health promotion model B) The health belief model C) The health-illness continuum
D) The agent-host-environment model - Correct answer Ans: A
Feedback: The health promotion model (Pender, Murdaugh, & Parsons, 2006) was developed to illustrate how people interact with their environment as they pursue health. The model incorporates individual characteristics and experiences and behavior-specific knowledge and beliefs, to motivate healthy behavior. A nurse is caring for a client who is in the remission state of leukemia. The client expresses anxiety about the recurrence of leukemia. The client feels depressed when thinking about the outcome of leukemia. Which aspect of health is the client talking about? A) Physical health B) Emotional health C) Social health
D) Spiritual health - Correct answer Ans: B
Feedback: Anxiety and depression are components of emotional health. The client is not feeling emotionally well because of worry about the disease outcomes. Currently the client is in remission and thus is physically healthy. The client does not mention anything about social interactions and spiritual health. A nurse is educating women on the need for calcium to prevent bone loss. What level of prevention does this represent? A) Primary prevention B) Secondary prevention C) Tertiary prevention
D) Residual prevention - Correct answer Ans: A
Feedback: Primary prevention or primary health care involves the education of clients in the prevention of disease. A client states, "I must be in poor health because I am a senior citizen. That's what my neighbor says and she is older than I am." This statement is based on which of the following factors? A) Age
B) Gender C) Peer influence
D) Illness factors - Correct answer Ans: C
Feedback: Peer influence, personality characteristics, ethnicity, and socioeconomic factors may affect a person's response to illness. An woman 80 years of age has had a cerebrovascular accident. She has flaccidity of her right side with aphasia. For this client, which of the following activities constitutes tertiary prevention? A) Assessment of her blood pressure B) Daily bleeding and clotting times C) Gait training and speech therapy
D) Education on the symptoms of a CVA - Correct answer Ans: C
Feedback: Tertiary prevention occurs when a person already has been diagnosed with a long-term disease or disability. Which of the following statements accurately describes how risk factors may increase a person's chances for illness or injury? Select all that apply. A) Risk factors are unrelated to the person or event. B) All risk factors are modifiable. C) An increase in risk factors increases the possibility of illness. D) A family history of breast cancer is not a modifiable risk factor.
E) School-aged children are at high risk for communicable diseases. - Correct
answer Ans: C, D, E
Feedback: A risk factor is something that increases a person's chances for illness or injury. Like other components of health and illness, risk factors are often interrelated. Risk factors may be further defined as modifiable (able to be changed, such as quitting smoking) or nonmodifiable (unable to be changed, such as a family history of cancer). As the number of risk factors increases, so does the possibility of illness. School-aged children are at high risk for communicable diseases. Multiple sexual relationships increase the risk for sexually transmitted diseases (e.g., gonorrhea or acquired immunodeficiency syndrome AIDS). Which of the following statements explains why models of health promotion and illness prevention are useful when planning health care? Select all that apply. A) They help health care providers understand health-related behaviors. B) They are useful for adapting care to people from diverse backgrounds.
Primary health promotion and illness prevention are directed toward promoting health and preventing the development of disease processes or injury. Nursing activities at the primary level may focus on individuals or groups. Examples are immunization clinics, family planning services, providing poison-control information, counseling about obesity and smoking cessation, and accident-prevention education. Conducting a high blood pressure screening and providing family counseling are secondary level preventive measures. Rehabilitation and career counseling fall under the tertiary level of preventive care. The nursing instructor has given an assignment to a group of nurse practitioner students. They are to break into groups of four and complete a health-promotion teaching project, then present a report back to their fellow students. What project is the best example of health-promotion teaching? A) Demonstrating an injection technique to a client for anticoagulant therapy B) Explaining the side effects of a medication to an adult client C) Discussing the importance of preventing sexually transmitted disease to a group of 12th-grade students
D) Instructing an adolescent client about safe food preparation - Correct answer Ans:
C
Feedback: Health promotion encourages people to live a healthy lifestyle and to achieve a high level of wellness. Discussing the importance of STD prevention to a group of 12th-grade students is the best example of a health-promotion teaching project. This makes the other options incorrect. A nurse is providing an educational event to a local group of disabled citizens. What would be important for the nurse to be aware of when planning this event? A) The health promotion needs of the group the nurse is speaking to B) What the disability of each person is C) Wellness needs of each individual person
D) What the families want you to talk about - Correct answer Ans: A
Feedback: The nurse must be aware of the health promotion needs when teaching specific groups of people. The other options are incorrect because the nurse doesn 't need to aware of them when planning the event. Which of the following is not one of the six general types of risk factors in regard to increasing an individual 's chances for illness and injury? A) Gender
B) Age C) Environment
D) Lifestyle - Correct answer Ans: A
Feedback: The six general types of risk factors are age, genetics, physiologic factors, health habits, lifestyle, and environment. Gender is not a risk factor per se, but certain conditions, such as pregnancy, can contribute to risk. After teaching the students about health and wellness, the nursing instructor identifies a need for further instruction when one of the students makes which of the following statements? A) "Health is more than just the absence of illness." B) "Health is an active process." C) "Health means the same to every person."
D) "Health is dynamic and ever-changing." - Correct answer Ans: C
Feedback: Health is more than just the absence of illness; it is an active process in which a person moves toward his or her maximum potential. It also has different definitions for different people. It is not stagnant, but changes frequently. A client is admitted to the hospital with abrupt symptoms of increasing shortness of breath, fever, and a productive cough with green sputum. Upon further exam the client is diagnosed with chronic obstructive pulmonary disease (COPD) exacerbation. The nurse identifies this as which type of illness? A) Acute B) Chronic C) Terminal
D) Contagious - Correct answer Ans: B
Feedback: Chronic illness encompasses many different physical and mental alterations in health. Chronic illnesses usually have a slow onset and many periods of remission (disease is present, but there are no symptoms) and exacerbation (symptoms of the disease reappear). COPD is not terminal (although there is no cure) and it is not contagious. A nurse is giving a talk to a local community group on the importance of proper diet and regular exercise. This is an example of which type of health promotion? A) Primary health promotion B) Secondary health promotion C) Tertiary health promotion
D) Chronic health promotion - Correct answer Ans: A
regular exercise, and using seat belts are other examples. Secondary health promotion focuses on screening for early detection of diseases with prompt diagnosis. Things included are screenings for blood pressure and cholesterol, recommending gynecologic exams, and recommending mammograms for women at appropriate ages.
