Question 1

Which of the following factors has the largest impact on health disparities among all populations?

Accepted Answer

Poverty is a strong and underlying current factor that affects all special groups.Ethnicity,education level,and lifestyle choices do not have as large of an impact on health disparities than income level related to poverty.

Question 2

A nurse is implementing a tertiary prevention program to promote health among middle-aged women with diabetes.Which of the following best describes the intervention being implemented by the nurse?

Accepted Answer

Tertiary prevention includes activities that are aimed to reduce the complications of the disease process.Only monitoring blood glucose levels is directed toward preventing problems in women who already are diagnosed with diabetes.Developing lifestyle improvement programs for women at risk for diabetes is an example of secondary prevention as this group is at risk for developing the problem.Presenting lifestyle management at women's conferences is an example of primary prevention,preventing the disease before it occurs.Screening glucose levels is an example of secondary prevention,as all screening tests are secondary prevention.

Question 3

Toward whom is the TLC model targeted?

Accepted Answer

The TLC model is focused toward caregivers (primarily families)in an effort to relieve caregiver burden.Components are T = training in care techniques,safe medication use,recognition of abnormalities,available resources; L = leaving the care situation periodically to obtain respite and relaxation and maintain their normal living needs; and C = care for themselves (the caregiver)through adequate sleep,rest,exercise,nutrition,socialization,solitude,support,financial aid,and health management.The TLC model is not focused on community organizations,elderly clients,or nurses,rather it focuses on caregivers and relieving caregiver burden.

Question 4

A nurse is providing nutrition counseling to the parents of a 4-year-old.Which of the following recommendations is the nurse most likely to provide?

Accepted Answer

It is recommended that children of 4 to 8 years old consume 1.5-2.5 cups of vegetables and 1-2 cups of fruits on a daily basis.It is recommended that children 4 to 8 years old consume 4-6 ounces of grains on a daily basis.It is recommended that children 4 to 8 years old consume 2 cups of dairy on a daily basis.It is recommended that children 4 to 8 years old consume 3-5.5 ounces of proteins on a daily basis.

Question 5

A client explains to the nurse that it is just impossible for her and her husband to continue to have his mother in the home alone during the day while they work because the woman becomes confused and has fallen twice.Which of the following community resources should the nurse recommend?

Accepted Answer

Adult day health is for individuals whose mental and/or physical function requires additional health care and supervision.Typically,individuals return home to their caregivers at night.Adult day health serves as more of a medical model than the senior center.Long-term care would take the client out of the home.Home health would leave the patient for periods of unsupervised time in which the patient could have problems and help would not be available.

Question 6

Which of the following characteristics indicates a man is at a higher risk for developing prostate cancer?

Accepted Answer

Having a father or brother who has had prostate cancer places a man at higher risk for developing prostate cancer.African American males have a mortality rate from prostate cancer that is nearly twice as high as any other group.The PSA test is not accurate in terms of sensitivity or specificity.This blood test produces many false-positive results because many factors can elevate the PSA.There is not a relationship between benign prostatic hypertrophy and the development of prostate cancer.

Question 7

After seeing a public education program on the need for screening colonoscopy and the dangers of colorectal cancer,an older friend asks the nurse,"I'm really scared of getting cancer.What can I do to avoid that kind of cancer?" Which of the following recommendations should be made by the nurse?

Accepted Answer

Obesity,physical inactivity,smoking,heavy alcohol consumption,a diet high in red or processed meats,and insufficient intake of fruits and vegetables are risk factors for colorectal cancer.Getting an adequate amount of sleep is not a risk factor for the development of colorectal cancer.

Question 8

A health care provider is working with elderly clients who have ongoing chronic disease.Which of the following strategies can best assist them with healing?

Accepted Answer

With chronic illness,the focus is on healing (a unique process resulting in a shift in the body/mind/spirit system)rather than curing (elimination of the signs and symptoms of disease).Appropriate goals include maximizing self-care capacity,managing chronic diseases effectively,preventing complications,delaying deterioration and decline,and achieving the highest possible quality of life before dying with comfort,peace,and dignity.It is probably impossible to eliminate signs and symptoms of the disease with a client who has a chronic disease.Advocating for increased support for elderly persons is not related to assisting the client with healing from the chronic disease.

Question 9

A nurse is implementing Wagner's Chronic Care Model (CCM).Which of the following actions would the nurse most likely take?

Accepted Answer

Use of electronic health records,provider reminders for key evidence-based care components,interprofessional teams communicating regularly,and community health classes to educate people with chronic diseases are various ways the CCM is being implemented.Creating a budget is not a way to use CCM.Administration of immunizations and conducting depression screenings do not address the management of the most common and costly chronic diseases: heart disease,diabetes,stroke,cancer,and arthritis.

Question 10

Which of the following is the best way to ensure good nutrition in infants?

Accepted Answer

Breastfeeding is the preferred method of infant feeding.Breast milk provides appropriate nutrients and antibodies for the infant.Breastfed infants have fewer illnesses and allergies.Breastfeeding is associated with a lower risk in developing childhood obesity.Feeding brand-name foods,homemade cereals,and supplementing with formula are not the best ways to ensure good nutrition in infants.Breastfeeding is the best option to ensure good nutrition.

Question 11

A nurse is conducting a screening for type 2 diabetes for children attending a local school.In addition to an elevated BMI,which of the following risk factors should the nurse consider?

Accepted Answer

Screening for type 2 diabetes mellitus is recommended for children with a BMI from the 85?? to 95?? percentile with two or more for the following risk factors: family history of type 2 diabetes in a first or second degree relative; Native American,African American,latino,Asian American or Pacific Islander descent; signs of insulin resistance or conditions associated with insulin resistance; or maternal history of diabetes or GDM during the child's gestation.Native American,African American,latino,Asian American or Pasific Islander descent is a risk factor,not Caucasian descent.Elevated birthweight and poverty have not been identified by the American Diabetes Association as significant risk factors that indicate the need for additional screening.

Question 12

Which of the following interventions would the nurse most likely implement when addressing the problem of asthma among school-aged children?

Accepted Answer

Population-focused strategies for asthma management include education programs for families of children and adolescents who have asthma,development of home and environmental assessment guides to identify triggers,education and outreach efforts in high-risk populations to aid in case finding (e.g.,in areas with low income,high unemployment,and substandard housing,where there is exposure to secondhand smoke),development of community clean air policies (e.g.,no burning of leaves,use of smoke-free zones),improved access to care for asthmatic patients (e.g.,developing clinic services with consistent health care providers to decrease emergency department use),and assessment of schools and day-care centers for lack of asthma triggers.Sharing nutritional information is not related to the care of asthma patients.It is not necessary that all school personnel know how to use rescue inhalers,rather those who are in direct contact with the child with asthma.

Question 13

A nurse wants to promote improved health for obese children in the community.Which of the following best describes a tertiary prevention measure that the nurse would implement?

Accepted Answer

Tertiary prevention includes activities aimed to reduce the complications of the disease process.Only lifestyle improvement programs are directed toward preventing problems in children who are already obese.Evaluating food intake and evaluating BMI are types of screening programs (secondary prevention).Providing education programs to overweight expectant parents does not involve children.

Question 14

An elderly person is in the last stages of dying.Which type of care would be the best for him?

Accepted Answer

Hospice would be the best form of care for a person in the last stages of dying.The other options are not specifically designed for persons in the last stages of dying.Home health provides care in the home,but is not specific to meet the needs of the dying patient and his/her family.Assisted living relates to a living situation where the client receives different amentities depending on the level of care needed.This type of living arrangment is not specific to care for the dying patient.Nursing homes provide long-term care and are not specific to care needed for a dying patient.

Question 15

A nurse advises a client who has HIV not to donate blood,plasma,or organs.Which of the following levels of prevention is being used?

Accepted Answer

Tertiary prevention includes those interventions aimed at disability limitations and rehabilitation from disease,injury,or disability.Primary prevention and health promotion both address the use of interventions before the disease occurs and to reduce the risk of developing the disease.Secondary prevention is aimed at detecting the disease early through screening programs and early intervention for at risk individuals.

Question 16

A nurse's mother leans forward and says,"My best friend fell the other day and now she's in the hospital.I'm really worried about getting osteoporosis.What do you think I should do?" What should the nurse recommend?

Accepted Answer

It is estimated that one of every two American women older than 50 years will experience an osteoporosis-related fracture in her lifetime.Primary prevention activities include a diet rich in calcium and vitamin D; exposure to sunlight for 20 minutes a day; exercise,especially weight-bearing activities such as walking,running,stair climbing,and weight lifting,to improve bone density; limiting alcohol consumption; and avoiding smoking.Use of hormone replacement therapy and consumption of green leafy vegetables are not related to decreasing the risk of developing osteoporosis.

Question 17

Which of the following adolescent(s)would receive care from the advanced practice nurse without parental consent?

Accepted Answer

Most states have enacted laws allowing health care providers to treat adolescents in certain situations without parental consent.These situations include emergency care,substance abuse,pregnancy,and birth control.All 50 states recognize the "mature minors doctrine." This allows youths 15 years of age and older to give informed medical consent if it is apparent that they are capable of understanding the risks and benefits and if the procedure is medically indicated.If an adolescent has a diagnosis that has a serious prognosis,parental consent will be neededed as this is not a situation that involves emergency care,substance abuse,pregnancy,and birth control.

Quiz 20: Health Risks Across the Life Span