Question 1

Dunn believes that an individual's state of health should be evaluated in the context of the person's environment.This approach illustrates that:

Accepted Answer

The home environment,community,family,friends,and support system all influence health status.The balance among these variables has a net positive or negative effect on a client's health status.The effect of poor living conditions may be offset by the presence of loving family and friends.Poverty does not always have a negative effect on health.Similarly,the presence of food,shelter,and clothing does not always convey protective health,as loneliness and hopelessness may counteract these positive influences.When examining the client's environment,extended boundaries must be considered,especially when providing community-based care.

Question 2

Many health providers define illness as pathology; however,people experience,rather than define,illness.How do most people experience illness?

Accepted Answer

People typically describe their illness in terms of how it makes them feel or the effect it has on day-to-day life."Feeling lousy" is inappropriate,as many people do not feel "lousy" when they are ill.For example,hypertension is an illness that may have no symptoms.Similarly,patients may have chronic disease that is well managed and therefore does not make them feel ill."Something to be dreaded and avoided ..." is also not accurate.If a person has an external locus of control,he may view illness as a consequence of actions taken.From this viewpoint,he may have little control over whether he can avoid illness.Finally,although some people do grow and learn in the face of illness,most people do not hold such a positive view about illness-and the question asks how people experience illness.

Question 3

To establish a trusting relationship with a client,the nurse will focus on:

Accepted Answer

Take time to get to know your patient by setting a tone of caring,respect,and understanding.Establishing trust in your first contact with patients can go a long way toward relieving anxiety and preserving the energy needed for healing.Information gathered about the patient will include present illness and past history.Merely performing procedures,administering medications,or providing solutions to the patient does not allow you to support the patient transition from health to illness.

Question 4

A client with a history of schizophrenia is diagnosed with a urinary tract infection.What is probably the most significant barrier this patient faces?

Accepted Answer

Mental illness is associated with a stigma that is usually a barrier,and even considered a debilitating handicap.Chronic urinary incontinence is not commonly associated with urinary tract infection,and nothing in the scenario suggests that the patient is incontinent.The patient is at risk for recurring urinary tract infections,but this is not considered a debilitating handicap.Auditory hallucinations are associated with schizophrenia but have not been described as the most debilitating handicap.

Question 5

A client has been hospitalized for 6 weeks.All of the following interventions are good ones,but which intervention is specifically focused on helping the patient cope with the emotional responses to prolonged hospitalization?

Accepted Answer

The patient's environment can help nourish wellness.Helping the patient designate a corner of the room to display personal mementos can be healing and help the patient to cope with the prolonged hospitalization.The other interventions might be helpful to the patient but are not as helpful in specifically dealing with "hospitalization" as is designating a portion of the room that is uniquely hers.

Question 6

When preparing a room to receive a newly admitted patient,which of the following should the nursing assistive personnel (NAP)do?

Accepted Answer

The NAP should create an "open" bed.The housekeeping department is almost always responsible for cleaning the room between patients.The nurse is responsible for hooking up and checking special equipment such as suction.The nurse would need to tell the NAP whether the patient is to be admitted ambulatory,by wheelchair,or by stretcher in order to know whether to position the bed high or low.

Question 7

Which of the following is particularly valuable in helping a patient with a terminal illness maintain a sense of self?

Accepted Answer

When patients are faced with a terminal illness,spirituality can help the patient maintain his sense of self.Family relationships can provide a loving,supportive source of comfort and reassurance,but sometimes cause the patient pain and a feeling of loneliness when faced with a terminal illness.Nutrition,sleep,and rest are healing but usually not as helpful to a patient with terminal illness as is spirituality.

Question 8

Living in a healthy family is an important dimension of wellness.Which of the following most accurately describes a characteristic of healthy families?

Accepted Answer

The most accurately stated characteristic of healthy families is one that focuses on health-promoting lifestyles for its members.Additionally,healthy families do not necessarily respond to health issues only in times of serious illness.A healthy family is also very open about expressing feelings and disagreements rather than squelching feelings to avoid conflict.Finally,healthy families view the family as capable and successful in meeting and responding to illness as opposed to feeling powerless over illness.

Question 9

A 36-year-old mother of three small children has had nausea,vomiting,and extreme fatigue for the past 2 days.She calls her mother and tells her she is ill and asks whether her mother can care for the children.Which stage of illness behavior is she experiencing? Choose all that apply.

Accepted Answer

The 36-year-old mother is assuming sick-role behavior because she is identifying herself as ill.She is also in the stage of experiencing symptoms; she is experiencing symptoms and realizes that illness is starting,even though she has not yet entered the stages of dependence and seeking professional care.By telling her mother of the illness,she is relieved of her normal duties,caring for her children.Dependence on others occurs when the client accepts a diagnosis and treatment from the healthcare provider.Seeking professional care occurs after the sick-role behavior stage.During this stage,the client makes the decision that she is ill and that professional healthcare is needed.

Question 10

The client is a 76-year-old man who is experiencing chronic illness.He has a genetic-linked anemia.He says he does not eat a balanced diet,as he prefers sweets to meat and vegetables.Which of the following dimensions of health can the nurse most likely influence by teaching and counseling him?

Accepted Answer

The nurse is most likely to influence the patient's eating habits because those are the dimensions over which he has the most control and,therefore,has the most potential for changing.Although people consider biological factors when they describe themselves as well or ill,they are not entirely within our control.Biological factors include age and developmental stage,genetic makeup,and gender.

Question 11

Which of the following helps the body release growth hormone (growth hormone assists in tissue regeneration,synthesis of bone,and formation of red blood cells)?

Accepted Answer

During sleep,our bodies release the majority of our growth hormone,which assists in tissue regeneration,synthesis of bone,and formation of red blood cells.Consuming healthy foods helps prevent disease.Physical activity reduces the risk of chronic disease and promotes longevity.Keeping the body at a comfortable temperature helps maintain health but not release of growth hormone.

Question 12

The nursing student is caring for a group of patients on the medical-surgical unit who need to be ambulated during the day.She tells the primary nurse,"Some of my patients feel so sick but want to get out of bed.Others say they feel well but don't want to get out of bed.What should I do?" What is the most appropriate response by the nurse?

Accepted Answer

Nurses understand health and illness as individual experiences,emerging from each patient's unique responses.In short,nurses honor the patient's understanding and feelings of his or her state of health and illness.It is appropriate to ambulate patients who want to get out of bed and allow others to ambulate later.This promotes and facilitates patient-centered care and allows the patient some control and decision making in his environment.All patients may indeed have prescriptions to get out of bed,but telling the nursing student to do the best she can or push the patients,does not assist the student to understand that all patients do respond to illness and wellness differently; nor does it consider the patient-centered approach to care.

Question 13

Using the concept of the wellness-illness continuum,a nursing care plan for a chronically ill patient would outline steps to:

Accepted Answer

The health-illness continuum defines health and illness as a graduated spectrum that cannot be divided into parts.A person's position on the continuum is constantly changing according to physiological changes,lifestyle choices,and the results of various choices.Encouraging positive health characteristics within the limits of the specific illness will promote maintenance of a personal state of health for the individual patient.

Question 14

When transferring a patient from a hospital to a long-term care facility,which of the following is most helpful in facilitating the patient's planning and emotional adjustment?

Accepted Answer

Notifying the patient and family well in advance of the transfer allows them time to adjust emotionally and to make any necessary plans.A copy of the records is usually sent,and the nurse does coordinate the transfer with the receiving facility; however,that does very little to assist with the patient's emotional status or planning.Someone from the hospital may accompany the patient to the car,or if the transfer is by ambulance,perhaps not.Either way,that will not help the patient and family to do the necessary planning for the transfer.

Question 15

An 80-year-old man arrives in the emergency department after suffering a severe heart attack.His condition is deteriorating and the physician informs the wife,also an older adult,that they do not expect him to live.The wife begins to cry uncontrollably and tells the nurse,"We have been married for 60 years.What am I going to do?" What is the most appropriate response by the nurse?

Accepted Answer

The death of a spouse is no less traumatic for an older adult than it would be for a young spouse.Losing someone with whom one has spent most of one's life is an incredible loss,whether it is expected or unexpected.The best response is to validate this with the spouse.At this most painful time,it is not appropriate nor can it be expected that a spouse will understand that death is part of life.An attempt to comfort a spouse by responding that "he did live to 80 years old" demonstrates ageism and will not comfort a spouse at this time.It is appropriate to contact a social worker for home assistance; however,this can be done after recognizing and acknowledging the spouse's loss.

Question 16

A 76-year-old patient is admitted with an acute myocardial infarction (heart attack).The doctor tells the patient that an angioplasty is necessary.The patient agrees and signs the informed consent.This patient is experiencing which stage of illness behavior?

Accepted Answer

This patient is experiencing the dependence on others stage of illness behavior; he has accepted the diagnosis and treatment of the healthcare provider.The patient entered the experiencing symptoms stage when he began having chest pain at home.He entered the sick-role behavior phase when he admitted to family that he was experiencing chest pain.When he decided to go to the emergency department for healthcare intervention,he entered the seeking professional care stage of illness.

Question 17

Some people readily become ill when under stress.Others are able to deal with tremendous stress and remain physically and mentally healthy.This disparity is affected by a person's level of hardiness.How can you apply this knowledge to your nursing care?

Accepted Answer

Hardiness is a personality trait that helps many to cope with stress and illness.As it is a personality trait,it is unlikely that you can teach or otherwise encourage this trait.Awareness of your own level of hardiness will help you understand your response to stress,but hardiness does not necessarily make you a better nurse.

Question 18

A client's risk of breast cancer is dramatically increased because both her sister and her mother have had breast cancer.Which of the multidimensional aspects of health does this scenario illustrate?

Accepted Answer

Nurses respond to the physical,emotional,mental,and spiritual dimensions of health.Biological factors include genetic makeup,gender,age,and developmental stage.The risk of breast cancer increases dramatically in women who have a family history of a mother,sister,or daughter with breast cancer.Recently,a genetic marker for this type of breast cancer was discovered.This is an example of biological factors.Personal relationships are more psychosocial in nature; for example,family relationships can facilitate coping.Lifestyle choices involve such health behaviors as choosing not to use tobacco and other substances.Environmental factors involve,for example,environmental pollutants,or the psychosocial environment (a quiet versus a noisy hospital room).

Question 19

What type of loss is most common among patients who are hospitalized for complex health conditions?

Accepted Answer

Hospitalized patients commonly experience the loss of dignity.Wearing a hospital gown,having their body exposed,invasive procedures,loss of control over body functions-all of these contribute to loss of dignity,and all are very common among hospitalized patients.Healthcare providers have a duty to protect privacy and confidentiality of patients,even though it is certainly threatened by some situations during hospitalization.Some patients lose functioning and identity during hospitalization,but they are not common occurrences.

Question 20

A 62-year-old patient is admitted to the hospital with hypertension.Which question by the nurse is most important when performing the initial assessment interview?

Accepted Answer

It is most important for the nurse to ask the patient about his greatest concern.His concern can then be incorporated into the plan of care,making sure that his needs are met.Asking about medications,allergies,and an advance directive is also important but does not take priority over asking about the patient's greatest concern.

Quiz 11: Experiencing Health Illness