Fundamentals Nursing Active Learning 1st Edition Yoost Crawford Test Bank

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Fundamentals Nursing Active Learning 1st Edition Yoost Crawford Test Bank

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WITH ANSWERS
Fundamentals Nursing Active Learning 1st Edition Yoost Crawford Test Bank

Chapter 02: Values, Beliefs, and Caring

 

MULTIPLE CHOICE

 

  1. Enduring ideas about what a person considers is desirable or has worth in life is known as a:
a. value.
b. first-order belief
c. higher order belief
d. stereotype

 

 

ANS:  A

Values are enduring ideas about what a person considers is the good, the best, and the right thing to do and their oppositesthe bad, worst, and wrong things to doand about what is desirable or has worth in life. First-order beliefs serve as the foundation or the basis of an individuals belief system. Higher-order beliefs are ideas derived from a persons first-order beliefs, inductive, or syllogistic reasoning.  A stereotype is a belief about a person, a group, or an event that is thought to be typical of all others in that category.

 

DIF:    Remembering                                 REF:   pp. 22-23       OBJ:   2.1

TOP:   Assessment

MSC:  NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

NOT:  Concepts: Professionalism

 

  1. A group of students are discussing the history of nursing. A student states, Yea, nurses used to be called the doctors handmaiden. This type of comment is known as a:
a. prejudice.
b. generalization.
c. stereotype.
d. belief.

 

 

ANS:  C

A stereotype is a belief about a person, a group, or an event that is thought to be typical of all others in that category. A prejudice is a preformed opinion, usually an unfavorable one, about an entire group of people that is based on insufficient knowledge, irrational feelings, or inaccurate stereotypes. In the process of learning, people form generalizations (general statements or ideas about people or things) to relate new information to what is already known and to categorize the new information, making it easier to remember or understand. A belief is a mental representation of reality or a persons perceptions about what is right (correct), true, or real, or what the person expects to happen in a given situation.

 

DIF:    Understanding                                           REF:               pp. 22-23       OBJ:    2.2

TOP:   Evaluation

MSC:  NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

NOT:  Concepts: Professionalism

 

  1. A values system is a set of somewhat consistent values and measures that are organized hierarchically into a belief system on a continuum of relative importance. A value system is also:
a. culturally based.
b. unique to each individual.
c. a poor basis for making decisions.
d. rigid and uniform within a culture.

 

 

ANS:  A

Anthropologists and social scientists have noted that in every culture, a particular value system prevails and consists of culturally defined moral and ethical principles and rules that are learned in childhood. Each individual possesses a relatively small number of values and may share the same values with others, but to different degrees. A value system helps the person choose between alternatives, resolve values conflicts, and make decisions. Within every culture, however, values vary widely among subcultural groups and even between individuals on the basis of the persons gender, personal experiences, personality, education, and many other variables.

 

DIF:    Remembering                                 REF:   pp. 23-24       OBJ:   2.1

TOP:   Assessment    MSC:  NCLEX Client Needs Category: Psychosocial Integrity

NOT:  Concepts: Professionalism

 

  1. The nurse is caring for a patient who is under arrest for murder. She is attempting to perform her duties while, at the same time, feeling a sense of repugnance toward the patient.  The nurse is undergoing:
a. value clarification
b. value conflict
c. first-order beliefs
d. higher-order beliefs

 

 

ANS:  B

A values conflict occurs when a persons values are inconsistent with his or her behaviors or when the persons values are not consistent with the choices that are available.  Providing care for a convicted murderer may elicit troubling feelings for a nurse, resulting in a values conflict between the nurses commitment to care for all people and a personal repugnance for the act of murder. First-order beliefs serve as the foundation or the basis of an individuals belief system.  Higher-order beliefs are ideas derived from a persons first-order beliefs, inductive, or syllogistic reasoning.

 

DIF:    Understanding                                           REF:               pp. 22-24       OBJ:    2.2

TOP:   Diagnosis       MSC:  NCLEX Client Needs Category: Psychosocial Integrity

NOT:  Concepts: Professionalism

 

  1. While helping patients with values clarification and care decisions, nurses should:
a. convince the patient to do what the nurse believes is best.
b. give advice about what the nurse would do.
c. tell the patient what the right thing to do is.
d. provide information so that the patient can make informed decisions.

 

 

ANS:  D

While helping patients with values clarification and care decisions, nurses must be aware of the potential influence of their professional nursing role on patient decision making. Nurses should be careful to assist patients to clarify their own values in reaching informed decisions. Providing information to patients so that they can make informed decisions is a critical nursing role. Giving advice or telling patients what to do in difficult circumstances is both unethical and ill-advised.

 

DIF:    Applying        REF:   p. 25              OBJ:   2.2                 TOP:   Implementation

MSC:  NCLEX Client Needs Category: Psychosocial Integrity   NOT:  Concepts: Professionalism

 

  1. A patient with terminal cancer says to the nurse, I just dont know if I should allow CPR in the event I quit breathing. What do you think? Which statement by the nurse would be most beneficial to the patient?
a. If it were me, I would want to live no matter what.
b. Dont worry. You have plenty of time to decide that later on.
c. Its totally up to you. Have you discussed this with your family?
d. Lets talk about what CPR means to you.

 

 

ANS:  D

The use of the value clarification process is helpful when assisting patients in making health care decisions regarding end-of-life care. Giving advice or telling patients what to do is unethical and not recommended. Ignoring a patient concern or changing the subject is inappropriate. Patients should be given factual information in order for them to make their own decisions.

 

DIF:    Applying        REF:   pp. 24-25       OBJ:   2.3                 TOP:   Implementation

MSC:  NCLEX Client Needs Category: Psychosocial Integrity   NOT:  Concepts: Professionalism

 

  1. The nurse is observed sitting at the bedside of a patient discussing the nursing care plan for the shift. Which theory or model most accurately reflects this nursepatient relationship?
a. Swansons Theory of Caring
b. Travelbees Human-to-Human Relationship Model
c. Watsons Theory of Caring
d. Leininger Cultural Care Theory

 

 

ANS:  A

Swansons five caring processes include being with and enabling. Sitting at the bedside and sharing information are activities that exemplify these behaviors. Travelbees model describes steps toward compassionate and empathetic care. Watsons theory of caring impacts both the person and the universe and is built upon 10 carative factors. Leininger describes patient care and its relationship to cultural diversity.

 

DIF:    Understanding                                           REF:               pp. 27-28       OBJ:    2.5

TOP:   Diagnosis       MSC:  NCLEX Client Needs Category: Psychosocial Integrity

NOT:  Concepts: Professionalism

 

  1. The student nurse is planning care for a patient who believes that Western medicine is effective but not always accurate. Nursing theory would best explain the patients health practices?
a. Nursing: Human Science and Human Care
b. Cultural Care Theory
c. Human-to-Human Relationship Model
d. Five Caring Processes

 

 

ANS:  B

Leininger describes patient care and its relationship to cultural diversity. Swansons five caring processes include maintaining belief, knowing, being with, doing for, and enabling. Travelbees Human-to-Human Relationship Model describes steps toward compassionate and empathetic care. Watsons theory of Human Science and Human Care impacts both the person and the universe and is built upon 10 carative factors.

 

DIF:    Understanding                                           REF:               pp. 27-28       OBJ:    2.5

TOP:   Diagnosis       MSC:  NCLEX Client Needs Category: Psychosocial Integrity

NOT:  Concepts: Professionalism

 

  1. Which nursing theorist describes the nursepatient relationship as interpersonal with a focus on compassion and empathy?
a. Kristen Swanson
b. Jean Watson
c. Madeleine Leininger
d. Joyce Travelbee

 

 

ANS:  D

Travelbees Human-to-Human Relationship Model describes steps toward compassionate and empathetic care. Leininger describes patient care and its relationship to cultural diversity. Swansons five caring processes include maintaining belief, knowing, being with, doing for, and enabling. Watsons theory of Human Science and Human Care impacts both the person and the universe and is built upon 10 carative factors.

 

DIF:    Remembering                                 REF:   pp. 27-28       OBJ:   2.5

TOP:   Assessment    MSC:  NCLEX Client Needs Category: Psychosocial Integrity

NOT:  Concepts: Professionalism

 

  1. The nurse on a busy medicalsurgical floor contacts a social worker requesting a home care referral prior to a patients discharge. This action is best illustrated by which of Swansons Five Caring Processes?
a. Enabling
b. Knowing
c. Doing For
d. Being with
e. Maintaining Belief

 

 

ANS:  A

Advocating for a patients post-hospitalization care is an enabling process. Enabling also includes informing, anticipating, and preparing for the future. Swansons Five Caring Processes also include maintaining belief, knowing, being with, and doing for.

 

DIF:    Remembering                                 REF:   p. 28              OBJ:   2.5

TOP:   Assessment    MSC:  NCLEX Client Needs Category: Psychosocial Integrity

NOT:  Concepts: Professionalism

 

  1. Which action observed by a nurse manager may be indicative of codependency behavior?
a. A staff nurse orders extra desserts for a patient diagnosed with morbid obesity.
b. A medication nurse administers scheduled pain medication to patients as ordered.
c. A respiratory therapist teaches a patients wife how to adjust an oxygen mask.
d. A nursing assistant encourages a patient to assist with the morning bath.

 

 

ANS:  A

Codependency is a dysfunctional relationship in which the person who wants to help acts in a manner that enables harmful behavior by another person. The staff nurse who is providing additional calories and sugar to an extremely overweight patient may be exhibiting codependency behaviors. Many authors, theorists, and professional groups have identified qualities and behaviors that demonstrate caring in nursing practice. Several of the most important concepts include the simple fact of the nurses presence, consistency and predictability, the use of touch, and the importance of listening in the nursepatient relationship. Giving medication to patients as ordered demonstrates the nurse providing consistency and predictability. Teaching how to adjust an oxygen mask and encouraging self-independence demonstrate presence.

 

DIF:    Evaluating      REF:   p. 29              OBJ:   2.7                 TOP:   Evaluation

MSC:  NCLEX Client Needs Category: Physiological Integrity: Basic Care and Comfort

NOT:  Concepts: Caregiving

 

  1. When developing a nursing practice, it is important for the nurse to:
a. be exposed to negative as well as positive role models.
b. avoid negative role models as much as possible.
c. understand that caring and compassion are taught in class.
d. consider another profession if he/she is not naturally compassionate.

 

 

ANS:  A

Lohri-Posey evaluated how nursing students learned to be caring, The surprising finding was that the negative role models inspired the students to not be like those people and motivated the students just as much as the positive role models. In her study, Lohri-Posey concluded that caring and compassion depended on personal qualities within the individual student, or on experiences that shaped the students values, rather than on something that was taught in class.

 

DIF:    Applying        REF:   pp. 28-29       OBJ:   2.6                 TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

NOT:  Concepts: Caregiving

 

  1. The nurse is discussing the use of a values clarification tool with a patient. The patient asks, What is the goal of the values clarification tool? Which is the best response by the nurse?
a. The tool will help change your value system so that you can make the right decision.
b. The tool will dispel your current beliefs and formulate brand new ones.
c. The tool will assist you in prioritizing your value preferences and help you make decisions.
d. The tool allows you to make decisions without the need of self-awareness.

 

 

ANS:  C

Values clarification is a process used to help people reflect on, clarify, and prioritize personal values to increase self-awareness or to make decisions. Nurses can use values clarification to help patients identify the nature of a conflict and reach a decision based on their values.

 

DIF:    Understanding                                           REF:               pp. 24-25       OBJ:    2.3

TOP:   Evaluation

MSC:  NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

NOT:  Concepts: Caregiving

 

  1. The nurse is preparing to perform a health history interview with a non-English speaking patient. An interpreter has been assigned to assist in the translation. Which action by the nurse indicates understanding the guidelines for working with an interpreter?
a. Use short sentences and allow time for translation.
b. Ask the interpreter to use third person.
c. Look at the interpreter during the interview.
d. Suggest the use of paraphrasing whenever possible.

 

 

ANS:  A

The use of short sentences and stopping frequently for the interpretation are effective means of communicating. Additional guidelines for working with an interpreter include speaking to the patient in first person (not the third person), looking at the patient (not the interpreter), translating exactly what the patient says (not paraphrasing), and asking for clarification whenever necessary.

 

DIF:    Understanding                                           REF:               p. 27   OBJ:    2.4

TOP:   Assessment

MSC:  NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

NOT:  Concepts: Caregiving

 

  1. Patients who enter the health care system have two reasonable expectations. The first is not to be harmed, and the second is that the nurses providing care will be both competent and compassionate. Provision of care that is consistent and delivered in a predictable way can make the experience less intimidating for the patient. The nurse provides predictable care by:
a. Explaining what is going to take place beforehand.
b. Never making promises to patients.
c. Assuring the patient that his/her requests will get done eventually.
d. Protect the patient from knowing why things are happening.

 

 

ANS:  A

Patients who enter the health care system have two reasonable expectations. The first is not to be harmed, and the second is that the nurses providing care will be both competent and compassionate. Provision of care that is consistent and is delivered in a predictable way can make the experience less intimidating for the patient. The nurse provides predictable care by explaining what is going to take place beforehand or why things are happening, and by following through with the promised care in a timely fashion. Setting up a schedule with the patient and adhering to it can greatly reduce the anxiety the patient experiences and create a supportive environment that provides a sense of security. When nurses are consistent in providing competent care that is delivered on time and matches the patients expectations, the patient is reassured that nursing care will be predictable and delivered as prescribed (Bartzak, 2010).

 

DIF:    Applying        REF:   p. 30              OBJ:   2.6                 TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

NOT:  Concepts: Caregiving

 

  1. The nurse is planning to change a dressing on an anxious patient. The best approach for the nurse is to:
a. ask another staff member to perform the task.
b. tell the patient the dressing change will take 30 minutes.
c. schedule a time in collaboration with the patient.
d. review the physicians order prior to the procedure.

 

 

ANS:  C

Setting up a schedule to perform tasks helps to relieve patient anxiety and promotes a sense of security. Explaining the procedure and reviewing physician orders should be completed after establishing a schedule. Asking another staff member to change the dressing may increase patient anxiety.

 

DIF:    Applying        REF:   p. 30              OBJ:   2.6                 TOP:   Implementation

MSC:  NCLEX Client Needs Category: Psychosocial Integrity   NOT:  Concepts: Caregiving

 

  1. Nurses must collaborate effectively with patients to find treatment methods that are congruent with the patients belief systems and that promote healthy outcomes. This approach requires:
a. focusing on patient values only and disregard family desires in setting goals.
b. relying more and more on their scientific background.
c. listening carefully to how the patients beliefs impact their health beliefs.
d. Understanding that the nurses beliefs are the most important.

 

 

ANS:  C

Nurses must collaborate effectively with patients to find treatment methods that are congruent with the patients belief systems and that promote healthy outcomes. This approach requires excellent assessment skills and a willingness to listen carefully to determine how patients personal beliefs impact their health beliefs. Incorporating patient values and beliefs into a plan of care requires that patients and their families or primary caregivers be actively involved in establishing goals and outcome criteria. As nurses learn about their discipline, their paradigm (or worldview) gradually changes to one based on a body of knowledge that focuses on scientific principles and dismisses as superstition other explanations for the presence of disease or illness. Research shows that the beliefs of nurses and other health care workers are equally important factors in determining how patients are treated.

 

DIF:    Applying        REF:   pp. 25-26       OBJ:   2.3                 TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

NOT:  Concepts: Caregiving

 

  1. The nurse is caring for a patient scheduled for heart surgery. Which statement made by the patient requires further discussion?
a. My friend died on the operating table several months ago.
b. The surgeon has a great reputation in the community.
c. I believe that this surgery is going to make me better.
d. Yesterday I asked my pastor to visit me after the procedure.

 

 

ANS:  A

Personal beliefs are one of the most important factors in determining how a person responds to a health problem and its treatment. The patient has a concern about the possibility of dying during the surgery based on prior experiences. The nurse should further explore the concern and determine the patients true meaning of the statement. Belief in the surgeons reputation, the success of the surgery, and the patients ability to visit after the surgery indicates a positive belief.

 

DIF:    Analyzing      REF:   p. 25              OBJ:   2.3                 TOP:   Analysis

MSC:  NCLEX Client Needs Category: Psychosocial Integrity   NOT:  Concepts: Coping

 

  1. A vital aspect of providing effective and appropriate nursing care is being able to actively listen to a patient. This requires the nurse to:
a. pay attention as if in a social conversation with the patient.
b. practice and develop this skill over many years.
c. focus on what the patient is saying.
d. passively listen with the ears.

 

 

ANS:  B

A vital aspect of providing effective and appropriate nursing care is being able to actively listen to a patient in a way that conveys understanding, sensitivity, and compassion. Caring involves interpersonal relationships and communication skills that require paying more attention to the details of communication than would be necessary in a social conversation. This type of listening is a highly developed skill that usually takes a great deal of time and many years of experience to acquire. It can be learned with practice and enhanced with sensitivity and attention to the feedback that is received during each interaction. In a caring nursepatient relationship, the nurse takes responsibility for establishing trust, making sure that the lines of communication are open and that the nurse accurately understands not only what the patient is saying, but also that the nurse is clearly understood. Active listening means paying careful attention and using all of the senses to listen rather than just passively listening with the ears. It requires energy and concentration and involves hearing the entire messagewhat the patient means as well as what the patient says. This type of listening focuses solely on the patient and conveys respect and interest.

 

DIF:    Applying        REF:   p. 31              OBJ:   2.6                 TOP:   Implementation

MSC:  NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care

NOT:  Concepts: Caregiving

 

  1. The nurse is caring for a patient with lung disease. The patient tells the nurse that the most important thing to do during the shift is to walk down to the nurses station and back without having shortness of breath. The patients request is an example of which nursing theory?
a. Leiningers Cultural Care Theory
b. Travelbees Human-to-Human Relationship Model
c. Swansons Theory of Caring
d. Watsons Human Science and Human Care Theory

 

 

ANS:  C

Swansons Theory of Caring is composed of five interrelated caring processes: having faith in the ability of others to have meaningful lives; striving to understand the meaning of events in others lives; being emotionally present to the other person; doing for others what they would do if possible, and facilitating or enabling the capacity of others to help themselves and their families. The patients goal to walk without breathing problems is an example of the enabling process. Leiningers Cultural Care Theory centers on cultural practices that influence patient care. Travelbees model describes steps toward compassionate and empathetic nursing care. Watsons theory describes holistic care and focuses on carative factors such as instilling faith and hope, promoting and accepting positive and negative feelings, and developing a helping-trust relationship.

 

DIF:    Remembering                                 REF:   pp. 27-28       OBJ:   2.4

TOP:   Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation

NOT:  Concepts: Caregiving

 

  1. In dealing with beliefs and values, the type that is based in the unconscious are:
a. zero-order beliefs.
b. first-order beliefs.
c. higher-order beliefs.
d. prejudices.

 

 

ANS:  A

Three types of beliefs are recognized: zero-order beliefs, most of which are unconscious, such as object permanence; first-order beliefs, which are conscious, typically based on direct experiences; and higher-order beliefs, which are generalizations or ideas that are derived from first-order beliefs and reasoning. A prejudice is a preformed opinion, usually an unfavorable one, about an entire group of people that is based on insufficient knowledge, irrational feelings, or inaccurate stereotypes.

 

DIF:    Remembering                                 REF:   pp. 22-23       OBJ:   2.1

TOP:   Assessment    MSC:  NCLEX Client Needs Category: Psychosocial Integrity

NOT:  Concepts: Cognition

 

MULTIPLE RESPONSE

 

  1. A nurse working in a dermatology clinic observes that a patient of Mexican-American descent typically arrives 10 to 15 minutes late to every appointment. Based on an understanding of first-order beliefs, the nurse determines that:  (Select all that apply.)
a. first-order beliefs serve as the basis of a persons belief system.
b. first-order beliefs begin to develop in early adolescence.
c. first-order beliefs are completely formed in childhood.
d. people seldom question their first-order beliefs.
e. challenging a patients first-order beliefs may cause cognitive upset.

 

 

ANS:  A, D, E

First-order beliefs serve as the foundation or the basis of an individuals belief system. People begin developing first-order beliefs about what is correct, real, and true in early childhood directly through experiences and indirectly from information shared by authority figures such as parents or teachers. People continue to develop first-order beliefs into adulthood through both direct experiences and the acquisition of knowledge from a vast number of sources with various degrees of expertise and levels of influence. People seldom question their first-order beliefs and rarely replace one, because to do so would require a great deal of rethinking about both that belief and similar or closely associated beliefs. Remember that presenting information to patients that challenges their first-order beliefs may cause a great deal of emotional or cognitive upset.

 

DIF:    Remembering                                 REF:   pp. 22-23       OBJ:   2.2

TOP:   Assessment    MSC:  NCLEX Client Needs Category: Psychosocial Integrity

NOT:  Concepts: Professionalism

 

  1. The most effective approach for dealing with a values conflict in which substance abuse or an addiction is involved is to begin with an assessment interview, during which the nurse should: (Select all that apply.)
a. listen for subtle signs of denial.
b. directly confront the patient about his drug abuse.
c. use a matter-of-fact approach to inform the patient.
d. provide straightforward information.
e. avoid direct confrontation.

 

 

ANS:  A, C, D, E

The most effective approach for dealing with a values conflict in which substance abuse or an addiction is involved is to begin with an assessment interview, during which the nurse should: Listen for the subtle signs of denial, avoid direct confrontation, use a matter-of-fact approach to inform the patient of the reality of the consequences of the harmful behavior, and provide straightforward information about the effects of the substance abuse.

 

DIF:    Applying        REF:   p. 25              OBJ:   2.3                 TOP:   Implementation

MSC:  NCLEX Client Needs Category: Psychosocial Integrity   NOT:  Concepts: Professionalism

 

  1. Caring, according to the American Nurses Association (ANA) Code of Ethics (2001), is having concern or regard for that which affects the welfare of another. As a profession, nursing can trace its earliest beginnings to the types of nurturing activities that demonstrate care, such as: (Select all that apply.)
a. active listening.
b. advocating for the vulnerable.
c. valuing all individuals.
d. separating healing from spirit.
e. attempting to relieve pain.

 

 

ANS:  A, B, C, E

Caring, according to the American Nurses Association (ANA) Code of Ethics, is having concern or regard for that which affects the welfare of another. As a profession, nursing can trace its earliest beginnings to the types of nurturing activities that demonstrate care, such as taking time to be with a suffering person, actively listening, advocating for the vulnerable, valuing and respecting all individuals, attempting to relieve pain, and making the healing process an act of the body, mind, and spirit.

 

DIF:    Remembering                                 REF:   p. 26              OBJ:   2.6

TOP:   Assessment

MSC:  NCLEX Client Needs Category: Physiological Integrity: Basic Care and Comfort

NOT:  Concepts: Caregiving

 

  1. Touch is the intentional physical contact between two or more people. It occurs so often in patient care situations that it has been deemed to be an essential and universal component of nursing care. Task-oriented touch occurs when the nurse: (Select all that apply.)
a. holds the patients hand during a painful procedure.
b. gives the patient an injection to treat discomfort.
c. starts an intravenous (IV) line for fluid administration.
d. inserts a nasogastric tube to decompress the patients stomach.
e. shakes the patients hand in order to establish rapport.

 

 

ANS:  B, C, D

Task-oriented touch includes performing nursing interventions such as giving treatments, changing dressings, suctioning an endotracheal tube, giving an injection, starting an IV line, or inserting an NG tube. Task-oriented touch should be done gently, skillfully, and in a way that conveys competence. Patients become alarmed when they detect that their nurse is unfamiliar with a procedure. It is best to seek assistance with any procedure or skill that the nurse cannot safely accomplish alone. Every task-oriented procedure should be explained to a patient, followed by feedback indicating patient understanding, before care is initiated.

Caring touch is considered by most people to be a valuable means of nonverbal communication. In todays highly technical world of nursing, caring touch is an essential aspect of patient-centered care. Caring touch can be used to soothe, comfort, establish rapport, and create a bond between the nurse and the patient. Care may be conveyed by holding the hand of a patient during a painful or frightening procedure or when delivering bad news. This is an important way nurses let patients know that they are not alone and that another human being cares.

 

DIF:    Applying        REF:   pp. 30-31       OBJ:   2.6                 TOP:   Implementation

MSC:  NCLEX Client Needs Category: Psychosocial Integrity   NOT:  Concepts: Caregiving

 

Chapter 16: Health and Wellness

 

MULTIPLE CHOICE

 

  1. The World Health Organization defines health as
a. the absence of disease.
b. the lack of infirmity.
c. complete well-being.
d. being independent of fiscal responsibility.

 

 

ANS:  C

The World Health Organization offers a definition for health: a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. Nurses are responsible for helping patients reach their optimal levels of physiologic and mental health, but they also must provide health care in a system that requires cost containment and fiscal responsibility.

 

DIF:    Remembering                                 REF:   p. 220            OBJ:   16.1

TOP:   Assessment    MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  Concepts: Health Promotion

 

  1. Several models exist that describe the relationship between health and wellness. The model used to understand the interrelationship between elements of basic requirements for survival and the desires that drive personal growth and development and is represented as a pyramid is:
a. Maslows hierarchy of needs.
b. Health Belief Model.
c. Health Promotion Model.
d. Holistic Health Model.

 

 

ANS:  A

Maslows hierarchy of needs describes the relationships between the basic requirements for survival and the desires that drive personal growth and development. The model is most often presented as a pyramid consisting of five levels. The lowest level is related to physiologic needs, and the uppermost level is associated with self-actualization needs, specifically those related to purpose and identity. The Health Belief Model was developed by psychologists Hochbaum, Rosenstock, and Kegels. It explores how patients attitudes and beliefs predict health behavior. The Health Promotion Model, developed by Pender and colleagues, defines health as a positive, dynamic state of well-being rather than the absence of disease in the physiologic state. Holistic health models in nursing care are based on the philosophy that a synergistic relationship exists between the body and the environment. Holistic care is an approach to applying healing therapies. Holistic models focus on the interrelatedness of body and mind.

 

DIF:    Remembering                                 REF:   pp. 221-222   OBJ:   16.2

TOP:   Assessment    MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  Concepts: Health Promotion

 

  1. The nurse is developing a plan of care for a patient with a hip fracture. In order to prioritize the patients care, the nurse should use:
a. the Health Belief Model.
b. Penders Health Promotion Model.
c. Maslows hierarchy of needs.
d. the Holistic Health Model.

 

 

ANS:  C

Maslows hierarchy of needs describes the relationships between the basic requirements for survival and the desires that drive personal growth and development. The model is most often presented as a pyramid consisting of five levels. The lowest level is related to physiologic needs, and the uppermost level is associated with self-actualization needs, specifically those related to purpose and identity. The Health Belief Model was developed by psychologists Hochbaum, Rosenstock, and Kegels. It explores how patients attitudes and beliefs predict health behavior. The Health Promotion Model, developed by Pender and colleagues, defines health as a positive, dynamic state of well-being rather than the absence of disease in the physiologic state. Holistic Health Models in nursing care are based on the philosophy that a synergistic relationship exists between the body and the environment. Holistic care is an approach to applying healing therapies. Holistic models focus on the interrelatedness of body and mind.

 

DIF:    Applying        REF:   pp. 221-222   OBJ:   16.2               TOP:   Implementation

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  Concepts: Health Promotion

 

  1. The nurse is preparing a patient teaching plan and is seeking a way to determine the patients readiness and motivation to act regarding lifestyle changes to best manage diabetes mellitus. Which model would be useful for this nurse?
a. Maslows hierarchy of needs.
b. Holistic Health Model.
c. Health Promotion Model.
d. Health Belief Model.

 

 

ANS:  D

The Health Belief Model was developed by psychologists Hochbaum, Rosenstock, and Kegels. It explores how patients attitudes and beliefs predict health behavior. Maslows hierarchy of needs describes the relationships between the basic requirements for survival and the desires that drive personal growth and development. The model is most often presented as a pyramid consisting of five levels. The lowest level is related to physiologic needs, and the uppermost level is associated with self-actualization needs, specifically those related to purpose and identity. Holistic Health Models in nursing care are based on the philosophy that a synergistic relationship exists between the body and the environment. Holistic care is an approach to applying healing therapies. Holistic models focus on the interrelatedness of body and mind. The Health Promotion Model, developed by Pender and colleagues, defines health as a positive, dynamic state of well-being rather than the absence of disease in the physiologic state.

 

DIF:    Understanding                                           REF:               pp. 221-222   OBJ:    16.2

TOP:   Evaluation      MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  Concepts: Health Promotion

 

  1. According to the Health Belief Model, which of the following patients would be most likely to change health behavior?
a. The person who perceives that he is at risk for colon cancer
b. The person who recognizes that colon cancer is easily cured
c. The person who believes that behavior can change outcomes
d. The patient who faces multiple social barriers

 

 

ANS:  A

In the three primary components of the Health Belief Model, six main constructs influence an individuals decision to take action about disease prevention, screening, and controlling illness. The model suggests that individuals are motivated to take action if they believe that they are susceptible to the condition (i.e., perceived susceptibility), that the condition has serious consequences (i.e., perceived severity), that taking action would reduce the susceptibility or severity of the condition (i.e., perceived benefit), that the costs of taking action (i.e., perceived barriers) are outweighed by the benefits, that those who are exposed to factors (e.g., media campaigns, postcard reminders, and advice from others) will be prompted to action, (i.e., cues to action), and that those who have confidence in their ability to perform an action will do so (i.e., perceived self-efficacy).

 

DIF:    Analyzing      REF:   p. 221            OBJ:   16.2               TOP:   Evaluation

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  Concepts: Health Promotion

 

  1. Intentional behaviors to circumvent illness, detect it early, and maintain the best possible level of mental and physiologic function within the boundaries of illness describe:
a. health promotion.
b. self-actualization.
c. health protection.
d. self-transcendence.

 

 

ANS:  C

Health protection includes intentional behaviors aimed at circumventing illness, detecting it early, and maintaining the best possible level of mental and physiologic function within the boundaries of illness. Health promotion is behavior motivated by the desire to increase well-being and optimize health status. Maslow considered self-actualization the highest level of optimal functioning and involves the integration of cognition, consciousness, and physiologic utility in a single entity. In later years, Maslow described a level above self-actualization called self-transcendence. He refers to self-transcendence as a peak experience, in which analysis of reality or thought changes a persons view of the world and his or her position in the greater structure of life.

 

DIF:    Remembering                                 REF:   pp. 221-222   OBJ:   16.2

TOP:   Assessment    MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  Concepts: Health Promotion

 

  1. The nurse caring for a patient with chronic pain uses guided imagery, therapeutic touch, and relaxation techniques as interventions for pain. The nurse is using what type of approach?
a. Holistic
b. Eastern holistic
c. Risk factor reduction
d. Health protection

 

 

ANS:  A

Nurses participate in holistic care through the use of natural healing remedies and complementary interventions. These include the use of art and guided imagery, therapeutic touch, music therapy, relaxation techniques, and reminiscence. Eastern holistic therapists have been using techniques such as acupuncture, yoga, and tai chi for thousands of years as methods of healing and, more recently, in conjunction with modern allopathic medical therapies. Risk factor reduction is step-by-step improvement of individual health factors. These combined improvements lower the likelihood of developing a disease. Health protection includes intentional behaviors aimed at circumventing illness, detecting it early, and maintaining the best possible level of mental and physiologic function within the boundaries of illness.

 

DIF:    Remembering                                 REF:   p. 222 | p. 224

OBJ:   16.2               TOP:   Assessment

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  Concepts: Health Promotion

 

  1. An overweight, sedentary middle-aged smoker with a family history of cardiac disease has noticed a steady rise in resting blood pressure over a 3- to 4-year period. The patient is concerned about his slightly elevated blood pressure and begins walking 20 to 30 minutes in the evenings with his wife and reduces his pack-a-day cigarette habit to ten cigarettes a day. This person has taken the first steps in:
a. risk factor reduction.
b. self-actualization.
c. self-transcendence.
d. health promotion.

 

 

ANS:  A

Risk factor reduction is step-by-step improvement of individual health factors. These combined improvements lower the likelihood of developing a disease. Maslow considered self-actualization the highest level of optimal functioning and involves the integration of cognition, consciousness, and physiologic utility in a single entity. In later years, Maslow described a level above self-actualization called self-transcendence. He refers to self-transcendence as a peak experience, in which analysis of reality or thought changes a persons view of the world and his/her position in the greater structure of life. Health promotion is behavior motivated by the desire to increase well-being (as opposed to preventing illness) and optimize health status.

 

DIF:    Remembering                                 REF:   p. 221 | p. 224

OBJ:   16.3               TOP:   Assessment

MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  Concepts: Health Promotion

 

  1. The nursing goal for all individuals and their families seeking preventive care is to have individuals and families:
a. take responsibility for their health and wellness.
b. abandon the use of electronic educational media.
c. make lifestyle changes after diseases occur.
d. use temporary changes until the danger has passed.

 

 

ANS:  A

Nursing goals for all individuals and their families seeking preventive care are improvement of quality of life through positive lifestyle choices and taking responsibility for health and wellness. Nurses can refer patients to a variety of personal health quizzes, located in the online version of Healthy People 2020, for risk assessments of their health status and lifestyle. The quizzes allow people to track their health and wellness status over a period of years and identify trends in disease risk factors that can be modified through lifestyle interventions or preventive measures before the disease occurs. The Healthy People 2020 initiative helps nurses provide educational materials for individuals, families, and communities, enabling them to lead healthier lifestyles and to make permanent changes in wellness habits.

 

DIF:    Understanding                                           REF:               p. 224 OBJ:    16.3

TOP:   Assessment    MSC:  NCLEX Client Needs Category: Health Promotion and Maintenance

NOT:  Concepts: Health Promotion

 

  1. The use of seatbelts and airbags in automobiles is an example of:
a. secondary prevention.
b. tertiary prevention.
c. holistic care model.
d. primary prevention.

 

 

ANS:  D

Primary prevention is instituted before disease becomes established by removing the causes or increasing resistance. Examples include the use of

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