Question 1

An older adult patient has recently experienced some difficulty sustaining an erection as a result of medication he has been prescribed.The nurse best assesses the patient's perception of his own sexuality by asking:

Accepted Answer

Asking about the impact of the dysfunction directly assesses the patient's satisfaction or dissatisfaction with current circumstances related to sexual function and intimacy,thus providing the best evaluation of his self-perception of the issue.

Question 2

Using social cognitive theory,which action by the nurse will have the most impact on older adults' participation in health promotion behaviors?

Accepted Answer

According to this theory,self-efficacy and outcome expectations are influenced by successful performance of the behavior,verbal encouragement,seeing similar people do the behavior,decreasing unpleasant aspects of the behavior,caring approaches to facilitate the behavior,and education about benefits.A local walking club with other seniors fulfills many of these criteria.Private nutritional counseling does not allow the participant to see others engaged in this activity.Meals may or may not be healthy or palatable.Educational materials on their own may not have great benefit.

Question 3

To engage the older adults who frequently attend a senior citizens' center in primary disease prevention,the nurse:

Accepted Answer

Primary prevention refers to specific action taken to optimize the health of the older individual by helping him or her to become more resistant to disease or to ensure that the environment will be less harmful.Providing immunizations would be included in this level of prevention.Colorectal cancer screening is secondary prevention.Cooking for diabetic patients is tertiary prevention.Surveying patients does not fall into any level of prevention.

Question 4

The nurse is discussing an older adult's past marital history during the admission assessment.The nurse can best determine that the patient has a healthy ability to cope with emotional stressors when the patient states:

Accepted Answer

This pattern encompasses the patient's reserve and capacity to resist challenges to self-integrity and his or her ability to manage difficult situations.The ability to view herself as a success in fulfilling her responsibilities as a mother is evidence of healthy stress coping skills.

Question 5

When assessing the older adult for bowel health,the nurse is most effective in obtaining subjective data when asking:

Accepted Answer

Subjective data can be obtained through the health history.Asking the patient to identify how often the bowels move would establish the fundamental baseline of the patient's elimination patterns."Normal" is a vague term that should not be used.Asking if there are problems with constipation or if bowel habits have changed are yes/no questions,which are generally avoided.

Question 6

A nurse is working with a woman who has been reluctant to start a walking program for her osteoporosis.What assessment by the nurse is most important?

Accepted Answer

Fear of falling is a common fear in older adults and has special significance to those with osteoporosis.The nurse should first assess for this factor.All other factors can be possible contributors,but people usually attend to safety first.

Question 7

Financial considerations are a major barrier to the older adult's participation in health promotion because:

Accepted Answer

Older adults must incur the cost of many preventive services because Medicare does not cover them all.This can be hard on the fixed,limited income of many older adults.It is not true that older adults accept poor health as inevitable.Health promotion activities can occur in the presence of chronic illnesses.Some older adults do place high value on saving money,but not all older adults are influenced by this desire.

Question 8

A male patient complains about the digital rectal prostate exam and blood work for prostate-specific antigen (PSA)and asks,"How long am I expected to do this?" What response by the nurse is best?

Accepted Answer

According to the U.S.Preventative Task Force,there is no evidence that continuing routine PSA screening past the age of 75 has any benefit,so the patient can forgo the blood test after he turns 75.

Question 9

A nurse is assessing a patient's ability to manage existing health problems.What question by the nurse is most helpful?

Accepted Answer

The results of a laboratory test used to monitor glucose control will show how well the patient has been managing the various aspects of his or her treatment plan.This information is collected in the health perception/health management functional health pattern.The other questions do not demonstrate the patient's knowledge level.

Question 10

The nurse has the greatest impact on a patient's health promotion when:

Accepted Answer

Health promotion includes interventions that help prevent disease and disability in a patient.Education regarding health promotion issues has the greatest impact on the health of a patient.The other patients already have established diseases.

Question 11

A nurse wishes to volunteer in a tertiary health care activity.What activity would the nurse choose?

Accepted Answer

Tertiary prevention aims to care for established disease.Helping women having radiation therapy for cancer would fall into this realm.Teaching is primary prevention.The emergency pregnancy clinic is secondary prevention.Home safety is primary prevention.

Question 12

The nurse admitting an 89-year-old patient to an assisted living facility notes that the patient is currently taking numerous prescribed and over-the-counter medications.The nurse's initial intervention is to:

Accepted Answer

The first nursing action is to determine if the patient's health is at risk from possible drug interactions.The other actions might be warranted,but patient safety comes first.

Question 13

The nurse is seeing a 68-year old woman for a physical exam in the family practice clinic.The woman complains about having another pelvic exam.What response by the nurse is best?

Accepted Answer

According to the U.S.Preventative Task Force,pelvic exams and pap smears can be discontinued after age 65 if prior testing was normal and the patient is not at high risk for cervical cancer.The other statements are incorrect.

Question 14

During a home visit,a nurse is assessing the nutritional awareness of an older adult patient who lives alone.The nurse is most effective in obtaining objective information when:

Accepted Answer

Objective information is best obtained when observing general appearance and various body system indicators of nutritional status.Note height,weight,and fit of clothes.If possible,observe the older adult eating a meal.Food available in the home does not indicate the patient's knowledge,as someone else may have bought the food.Asking the patient for information is requesting subjective data.Reviewing a healthy diet does not allow the patient to demonstrate knowledge.

Question 15

A patient who is homeless has not followed through with getting an influenza vaccination.What response by the nurse to a student is most appropriate?

Accepted Answer

Competing priorities often cause patients to seem uninterested or "noncompliant" with health recommendations.According to Maslow,basic needs such as food,water,shelter,and safety take priority over other matters.Perhaps it is a good idea to take shots into the community,but that is not the best response by the nurse,as it does not help the student understand the situation.The other two statements are biased and show disregard for the patient's circumstances.

Question 16

The primary focus of the health belief model of health promotion is addressed when the nurse:

Accepted Answer

The health belief model,which was developed to determine the likelihood of an individual's participation in health promotion,health protection,and disease prevention services,includes assessing an individual's perception of his or her susceptibility to developing an illness.Asking the patient about beliefs related to tobacco use and health is an activity that falls within this model.The other activities do not.

Question 17

The nurse wishes to participate in a community secondary prevention activity.Which activity does the nurse choose?

Accepted Answer

Secondary prevention is screening and early diagnosis.It aims to find people with clinical conditions that have not yet become apparent to them.Blood pressure screening would fit this description.Flu vaccinations and teaching about sun exposure are examples of primary prevention.Fitting older adults with glasses is a tertiary prevention.

Question 18

When the home health nurse assists the older adult patient with rearranging furniture within the home to prevent the patient from falling,the nurse is demonstrating:

Accepted Answer

The overarching goals are to attain high-quality,long lives free of preventable disease,disability,and injury;to eliminate disparities;create social and physical environments that promote health;and optimize quality of life across the life span.Health protection targets five areas including unintentional injury.Rearranging furniture to prevent falls is a health protection activity.

Question 19

An 80-year-old woman has found a lump in her breast and is in the clinic.What question by the nurse is most appropriate?

Accepted Answer

All questions are appropriate;however,for a woman this age,further testing is not recommended unless the patient is willing to go through with treatment for cancer.Tumors in older women tend to be slow growing and quality of life is a bigger priority.

Question 20

A nurse routinely assesses patients for alcohol use.What principle guides this assessment?

Accepted Answer

There are both benefits and risks to drinking alcohol.The nurse must help the older patient determine which predominates when assessing and possibly counseling patients on their alcohol use.

Quiz 8: Health Promotion and Illnessdisability Prevention