Question 1

A 50-year-old African American male is being seen by his primary healthcare provider for an annual physical. His last complete physical was 2 years ago and he has no complaints at this time. He asks what health screening tests he should expect now that he is 50 years old, in addition to his annual health examination. Based on the patient's age and ethnicity, which screening tests should the nurse review with the patient?

Accepted Answer

Cholesterol level screening is recommended for adults to monitor and manage the risk of cardiovascular diseases. Colonoscopy and occult blood screening are advised starting at age 50 to screen for colorectal cancer, which has a higher incidence and mortality rate in African American males. Prostate cancer screening is also important for African American males, who are at a higher risk for developing and dying from prostate cancer. Vision screening is recommended as part of regular health maintenance for adults, especially as they age. Osteoporosis screening is typically recommended for women over 65 and men over 70, or for individuals with risk factors that are not specifically highlighted in this scenario.

Question 2

The nurse is preparing discharge instructions for a 63-year-old African American male patient recovering from a same-day surgical procedure. What genetic, racial, ethnic, and cultural factors affecting health and well-being should the nurse consider prior to giving discharge instructions?

Accepted Answer

African American individuals have a higher prevalence of hypertension and diabetes. Sickle cell anemia is more common in African Americans than in other ethnic groups. Lactose intolerance is also more prevalent in African Americans. These conditions can affect recovery and self-care after surgery, thus important for discharge planning. Osteoporosis is less relevant in this context as it is not particularly associated with African American males and does not have the same prevalence or impact on immediate post-surgical care.

Question 3

The nurse is caring for an older patient experiencing confusion and lethargy after taking routine doses of medication. Which age-related changes should the nurse identify that could predispose this patient to toxic drug effects?

Accepted Answer

Age-related changes such as alterations in tissue and organ structure, decreased liver function, polypharmacy (taking several drugs at once), and decreased renal function can predispose older patients to toxic drug effects. These changes can affect the metabolism and excretion of drugs, leading to increased sensitivity and potential toxicity.

Question 4

Which statement by a 52-year-old female patient admitted for evaluation of migraines reflects the changes that occur in middle adulthood?

Accepted Answer

The answer of Which statement by a 52-year-old female patient...

Question 5

A patient with seizures is being monitored to determine if the seizure activity was present at birth or has been slowly developing. For which classifications of diseases is this patient's seizure activity being evaluated?

Accepted Answer

The patient's seizure activity is being evaluated to determine if it is congenital (present at birth) or chronic (slowly developing over time). Therefore, the best choice is A, which contrasts congenital versus chronic. The other options are not relevant to the evaluation of seizure activity in this patient.

Question 6

During a routine physical examination, a 52-year-old Caucasian male declines to have his prostate gland examined and states he does not have a family history and does not feel he is at risk. What initial response by the nurse is most appropriate?

Accepted Answer

The nurse should provide education on the increasing risk of prostate cancer with aging, even if the patient does not have a family history or other risk factors. This information may encourage the patient to reconsider having the exam.

Question 7

A 45-year-old woman is having a routine examination and has no significant personal or family medical history. What information concerning health-promotion behaviors should the nurse provide to this patient?

Accepted Answer

Ensuring an adequate intake of calcium is important for bone health, especially for women over the age of 40. This can be achieved through dietary sources or supplements. Mammograms should be done annually, not every other year. Blood pressure should be measured at least once a year for adults over the age of 40. Exercise should be done for at least 30 minutes a day, five days a week for overall health benefits.

Question 8

A patient is diagnosed with an ear infection and has been prescribed antibiotics. Which level of intervention has the patient received?

Accepted Answer

Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. This is done through measures such as screening to detect diseases in the earliest stages, and in this case, treating an ear infection with antibiotics to prevent it from worsening.

Question 9

The nurse is assisting an 18-year-old female patient to strategize ways to avoid the onset of disease with aging. What should the nurse include in this plan?

Accepted Answer

Maintaining a healthy weight, avoiding smoking, and avoiding substance abuse are all important strategies to prevent disease with aging. Annual mammograms and colonoscopies are screening tests for specific cancers and may not be necessary for every 18-year-old female patient.

Question 10

The nurse is preparing to provide disease management care to a patient with heart failure. On what should the nurse focus when caring for this patient?

Accepted Answer

The nurse should focus on understanding the disease process of heart failure, daily monitoring of the patient's symptoms and vital signs, and managing the patient's medications to prevent exacerbations and complications. Transfer to long-term care and frequency of hospitalization may be necessary at some point, but these are not the primary focus of disease management care.

Question 11

The overall mission of Healthy People 2020 is to improve the nation's health. What topics are addressed to achieve this goal?

Accepted Answer

The topics addressed in Healthy People 2020 to improve the nation's health include access to health services, nutrition and weight status, reproductive health, and injury and violence. Outpatient surgery is not specifically addressed as a topic in Healthy People 2020.

Question 12

A 20-year-old female nursing student has never been exposed to measles, mumps, or rubella, or received a vaccine; her last tetanus immunization was 4 years ago; and she received the tetanus, diphtheria, and pertussis vaccines as a child. She has never been vaccinated or exposed to varicella, human papillomavirus (HPV), or hepatitis. According to the recommended immunizations for adults, which immunizations should the nurse recommend the student receive at this time?

Accepted Answer

The answer of A 20-year-old female nursing student has never...

Question 13

The nurse is planning interventions to meet a patient's tertiary care needs. Which would be applicable for the patient?

Accepted Answer

The answer of The nurse is planning interventions to meet...

Question 14

A 75-year-old patient tells the nurse about experiencing extreme drowsiness after taking an over-the-counter cold medication. The nurse notes the patient ingested the prescribed amount of the medication. What should this information suggest to the nurse?

Accepted Answer

Older adults are more susceptible to adverse effects of medications due to changes in their metabolic and excretory systems. The extreme drowsiness experienced by the patient may be a result of the slow metabolism of the medication. It is important for healthcare providers to take into consideration the age-related changes in pharmacokinetics and pharmacodynamics when prescribing medication to older adults.

Question 15

A 45-year-old patient voices concerns about gaining 12 pounds over the past 2 years. The patient reports no change in dietary habits. Which response by the nurse is most appropriate?

Accepted Answer

This response acknowledges the patient's concerns and provides accurate information about age-related weight gain. It also does not make assumptions about the patient's behavior or imply blame. Option B only addresses exercise, which may not be the sole reason for the weight gain. Option C implies fault and may not be accurate. Option D is dismissive and does not address the patient's concerns.

Question 16

The nurse is planning an education session to discuss primary levels of disease prevention. Which topics should the nurse include in this presentation?

Accepted Answer

The elimination of smoking and alcohol use is an important primary level of disease prevention as it can significantly reduce the risk of various diseases and conditions such as cancer, lung disease, and liver disease.

Answer: B
 Knowing available locations for diabetes screening is an important primary level of disease prevention as it can help identify individuals who are at risk of developing diabetes early and allow for lifestyle modifications and early treatment.

Answer: C
 Although colonoscopies are an important tool for colon cancer screening, they are not considered a primary level of disease prevention. Primary prevention focuses on preventing disease before it even develops, rather than detecting it early.

Answer: D
 The use of community rehabilitation facilities may be an important component of secondary or tertiary prevention, which focuses on preventing disease progression or reducing complications in individuals who already have a disease. It is not considered a primary level of prevention.

Question 17

A nurse is conducting an educational session on self-care initiatives for chronic heart failure patients and their support persons prior to discharge from the hospital. Which topics should be included in the discussion?

Accepted Answer

Adapting activities of daily living to accommodate for physical limitations, maintaining a sense of hope, feeling in control, and managing symptoms to live as normally as possible are all important aspects of self-care for chronic heart failure patients and their support persons. Seeking multiple opinions is not necessarily a key component of self-care for this population.

Question 18

A patient with a family history of breast cancer is participating in activities to prevent illness. Which primary prevention action is the patient performing?

Accepted Answer

The answer of A patient with a family history of...

Question 19

A patient is diagnosed with an acute onset of pulmonary embolism. Rank the illness behaviors that this patient may demonstrate in the commonly recognized sequence. 
A) experiencing symptoms 
B) assuming a dependent role 
C) seeking medical care 
D) assuming the sick role 
E) recovery and rehabilitation
F) non of the above.

Accepted Answer

The answer of A patient is diagnosed with an acute...

Question 20

In a healthcare provider's office the nurse case manager approaches a patient with type 2 diabetes mellitus to review the patient-centered medical home (PCMH) approach to care. What benefits of this approach should the case manager include in this discussion?

Accepted Answer

The Patient-Centered Medical Home (PCMH) approach focuses on providing comprehensive and coordinated care that is accessible and focused on quality and safety. It emphasizes preventive services to avoid acute crises and manage chronic conditions effectively, like type 2 diabetes mellitus. It also aims to address all levels of illness prevention, from primary to tertiary. However, it does not eliminate health insurance billing; instead, it may streamline processes to ensure care is covered and coordinated with insurance providers.

Quiz 3: Health and Illness Care of Adults