Question 1

A nurse has been working with Mrs. Griffin, a 71-year-old patient whose poorly controlled type 1 diabetes has led to numerous health problems. Over the past several years Mrs. Griffin has had several admissions to the hospital medical unit, and the nurse has often carried out health promotion interventions. Who is ultimately responsible for maintaining and promoting Mrs. Griffins health?

Accepted Answer

American society places a great importance on health and the responsibility that each of us has to maintain and promote our own health. Therefore, the other options are incorrect.

Question 2

An elderly female patient has come to the clinic for a scheduled follow-up appointment. The nurse learns from the patients daughter that the patient is not following the instructions she received upon discharge from the hospital last month. What is the most likely factor causing the patient not to adhere to her therapeutic regimen?

Accepted Answer

Variables that appear to influence the degree of adherence to a prescribed therapeutic regimen include gender, race, education, illness, complexity of the regimen, and the cost of treatments. The ethnic background of the health care provider and the personality of the physician are not considered variables that appear to influence the degree of adherence to a prescribed therapeutic regimen. A learning disability could greatly affect adherence, but cost is a more likely barrier.

Question 3

A gerontologic nurse has observed that patients often fail to adhere to a therapeutic regimen. What strategy should the nurse adopt to best assist an older adult in adhering to a therapeutic regimen involving wound care?

Accepted Answer

The nurse must consider that older adults may have deficits in the ability to draw inferences, apply information, or understand major teaching points. Demonstration and practice are essential in meeting their learning needs. The other options are incorrect because the elderly may have problems reading and/or understanding a written pamphlet or verbal instructions. Having a family member change the dressing when the patient is capable of doing it impedes self-care and independence.

Question 4

A 20-year-old man newly diagnosed with type 1 diabetes needs to learn how to self-administer insulin. When planning the appropriate educational interventions and considering variables that will affect his learning, the nurse should prioritize which of the following factors?

Accepted Answer

One of the major variables that influences a patients readiness to learn is the patients culture, because it affects how a person learns and what information is learned. Other variables include illness states, values, emotional readiness, and physical readiness. Lifespan, occupation, and gender are variables that are usually less salient.

Question 5

The nurse is planning to teach a 75 -year-old patient with coronary artery disease about administering her prescribed antiplatelet medication. How can the nurse best enhance the patients ability to learn?

Accepted Answer

Studies have shown that older adults can learn and remember if the information is paced appropriately, relevant, and followed by appropriate feedback. Family members should be included in health education. The nurse should not assume that the patients color vision is intact or that the patient possesses adequate computer skills.

Question 6

A nurse is planning care for an older adult who lives with a number of chronic health problems. For which of the following nursing diagnoses would education of the patient be the nurses highest priority?

Accepted Answer

For some nursing diagnoses, education is a primary nursing intervention. These diagnoses include risk for ineffective management of therapeutic regimen, risk for impaired home management, health-seeking behaviors, and decisional conflict. The other options do not have patient education as the highest priority, though each necessitates a certain degree of education.

Question 7

Health promotion ranks high on the list of health-related concerns of the American public. Based on current knowledge, what factor should the nurse prioritize in an effort to promote health, longevity, and weight control in patients?

Accepted Answer

It has been suggested that good nutrition is the single most significant factor in determining health status, longevity, and weight control. A balanced diet that uses few artificial ingredients and is low in fat, caffeine, and sodium constitutes a healthy diet. Stress reduction and screening for health risks are correct answers, just not the most significant factors. Vitamin use is not normally necessary when an individual eats a healthy diet, except in specific circumstances.

Question 8

The nursing profession and nurses as individuals have a responsibility to promote activities that foster well-being. What factor has most influenced nurses abilities to play this vital role?

Accepted Answer

Nurses, by virtue of their expertise in health and health care and their long-established credibility with consumers, play a vital role in health promotion. The other options are incorrect because they are not the most influential when it comes to health promotion by nursing and nurses.

Question 9

The nurse is teaching a local community group about the importance of disease prevention. Why is the nurse justified in emphasizing disease prevention as a component of health promotion?

Accepted Answer

Healthy People 2020 defines the current national health-promotion and disease-prevention initiative for the nation. The overall goals are to (1) increase the quality and years of healthy life for people and (2) eliminate health disparities among various segments of the population. Most deaths are not classified as being preventable. HMO priorities do not underlie this emphasis. The external environment affects many disease processes, but the course of illness is primarily determined by factors intrinsic to the patient.

Question 10

The nurse is preparing discharge teaching for a 51-year-old woman diagnosed with urinary retention secondary to multiple sclerosis. The nurse will teach the patient to self-catheterize at home upon discharge. What teaching method is most likely to be effective for this patient?

Accepted Answer

Demonstration and practice are essential ingredients of a teaching program, especially when teaching skills. It is best to demonstrate the skill and then give the learner ample opportunity for practice. When special equipment is involved, such as urinary catheters, it is important to teach with the same equipment that will be used in the home setting. A list of instructions, a video, and an audio recording are effective methods of reinforcing teaching after the discussion and demonstration have taken place.

Question 11

You are the nurse planning to teach tracheostomy care to a patient who will be discharged home following a spinal cord injury. When preparing your teaching, which of the following is the most important component of your teaching plan?

Accepted Answer

Assessment in the teachinglearning process is directed toward the systematic collection of data about the person and familys learning needs and readiness to learn. Patient readiness is critical to accepting and integrating new information. Unless the patient is ready to accept new information, patient teaching will be ineffective. Citing the evidence base will not likely enhance learning. Patient guilt cannot be alleviated until the patient understands the intricacies of the condition and his physiologic response to the disease. Inclusion of colleagues can be beneficial, but this does not determine the success or failure of teaching.

Question 12

A public health nurse is preparing to hold a series of health-promotion classes for middle-aged adults that will address a variety of topics. Which site would best meet the learning needs of this population?

Accepted Answer

The workplace has become a center for health-promotion activity. Health-promotion programs can
generally be offered almost anywhere in the community, but the workplace is often more convenient for the adult, working population. This makes this option preferable to a hospital, doctors office, or ambulatory clinic.

Question 13

A nurse has been studying research that examines the association between stress levels and negative health outcomes. Which relationship should underlie the educational interventions that the nurse chooses to teach?

Accepted Answer

Studies have shown the negative effects of stress on health and a cause-and-effect relationship between stress and infectious diseases, traumatic injuries (e.g., motor vehicle crashes), and some chronic illnesses. It is well known that stress decreases the immune response, thereby making individuals more susceptible to infectious diseases. The other options can also be correct in certain individuals, but they are not those that best support stress-reduction initiatives.

Question 14

A public health nurse understands that health promotion should continue across the lifespan. When planning health promotion initiatives, when in the lifespan should health promotion begin?

Accepted Answer

Health promotion should begin prior to birth because the health practices of a mother prior to the birth of her child can be influenced positively or negatively. This makes the other options incorrect.

Question 15

A nurse is working with a teenage boy who was recently diagnosed with asthma. During the current session, the nurse has taught the boy how to administer his bronchodilator by metered-dose inhaler. How should the nurse evaluate the teachinglearning process?

Accepted Answer

Demonstration and practice are essential ingredients of a teaching program, especially when teaching skills. It is best to demonstrate the skill and then give the learner ample opportunity for practice. By observing the patient using the inhaler, the nurse may identify what learning needs to be enhanced or reinforced. Asking questions is not as an accurate gauge of learning. Respiratory assessment is a relevant, but indirect, indicator of learning. Delaying the appraisal of the patients technique until a later clinic visit is inappropriate because health problems could occur in the interval.

Question 16

A team of public health nurses are doing strategic planning and are discussing health promotion activities for the next year. Which of the following initiatives best exemplifies the principles of health promotion?

Accepted Answer

Health promotion may be defined as those activities that assist people in developing resources that maintain or enhance well-being and improve their quality of life. A family planning clinic meets these criteria most closely. Workplace health and safety would be considered a protection service. A blood pressure clinic and immunization clinic would fall under the category of preventive services.

Question 17

You are the oncoming nurse and you have just taken end-of-shift report on your patients. One of your patients newly diagnosed with diabetes was admitted with diabetic ketoacidosis. Which behavior best demonstrates this patients willingness to learn?

Accepted Answer

Emotional readiness also affects the motivation to learn. A person who has not accepted an existing illness or the threat of illness is not motivated to learn. The patients wiliness to learn is expressed through the action of seeking information on his or her own accord. Seeking information shows an emotional readiness to learn. The other options do not as clearly demonstrate a willingness to learn.

Question 18

A nurse is planning an educational event for a local group of citizens who live with a variety of physical and cognitive disabilities. What variable should the nurse prioritize when planning this event?

Accepted Answer

The nurse must be aware of the participants specific health-promotion needs when teaching specific groups of people with physical and mental disabilities. This is a priority over the relationships between participants and caregivers, each persons wellness state, or caregivers learning needs.

Question 19

A public health nurse is planning educational interventions that are based on Beckers Health Belief Model. When identifying the variables that affect local residents health promotion behaviors, what question should the nurse seek to answer?

Accepted Answer

Barriers, Beckers second variable, are defined as factors leading to unavailability or difficulty in gaining access to a specific health promotion alternative. The other listed questions do not directly relate to the four variables that Becker specified.

Question 20

A nursing student is collaborating with a public health nurse on a local health promotion initiative and they recognize the need for a common understanding of health. How should the student and the nurse best define health?

Accepted Answer

Health is viewed as a dynamic, ever-changing condition that enables people to function at an optimal potential at any given time. Health does not necessarily denote the absence of disease, an effort to maximize wellness, or mitigate the effects of disease.

Quiz 4: Health Education and Promotion