FNP - 590 Midterm And Finals Questions With Verified Answers And Explanations Graded A+, Exams of Nursing

Download FNP - 590 Midterm And Finals Questions With Verified Answers And Explanations Graded A+ and more Exams Nursing in PDF only on Docsity! FNP - 590 Midterm And Finals Questions With Verified Answers And Explanations Graded A+ Midterm Ch 1-8 Finals Ch 1-14, 25 CHAPTER 1 Which model of health is most likely used by a person who does not believe in preventive health care? Question options: Clinical model Role performance model Adaptive model Eudaimonistic model The clinical model of health views the absence of signs and symptoms of disease as indicative of health. People who use this model wait until they are very sick to seek care. A person with chronic back pain is cared for by her primary care provider as well as receives acupuncture. Which model of health does this person likely favor? Question options: Clinical model Role performance model Adaptive model Eudaimonistic model The eudaimonistic model embodies the interaction and interrelationships among physical, social, psychological, and spiritual aspects of life and the environment in goal attainment and creating meaning in life. Practitioners who practice the clinical model may not be enough for someone who believes in the eudaimonistic model. Those who believe in the eudaimonistic model often look for alternative providers of care. A state of physical, mental, spiritual, and social functioning that realizes a person‟s potential and is experienced within a developmental context is known as: Question options: growth and development. health. functioning. high-level wellness. Health is defined as a state of physical, mental, spiritual, and social functioning that realizes a person’s potential and is experienced within a developmental context. Which US report is considered a landmark document in creating a global approach to health? Question options: The 1990 Health Objectives for the Nation: A Midcourse Review Healthy People 2020 Healthy People 2000 The U.S. Surgeon General Report Healthy People 2000 and its Midcourse Review and 1995 Revisions were landmark documents in which a consortium of people representing national organizations worked with US Public Health Service officials to create a more global approach to health. care manager. consultant. educator. Health education is a primary prevention technique available to avoid major causes of disease. Teaching can range from a chance remark to a planned lesson. A nurse is asked to provide an expert opinion about the development of an education program for newly diagnosed diabetics. In this scenario, the nurse is acting as a(n): Question options: advocate. care manager. consultant. educator. Nurses with a specialized area of expertise provide education about health promotion and disease prevention to individuals and groups as consultants. A nurse is planning to deliver an educational program to individuals with diabetes. Which of the following should be the initial action taken by the nurse to ensure the success of the program? Question options: Assess the motivation level of the individuals Assess the knowledge level of the individuals Establish teacher-learner goals with the individuals Establish multiple teaching sessions with the individuals Selection of the methods most likely to succeed involves the establishment of teacher-learner goals. Thus, the first step by the nurse should be establishment of goals. A nurse who uses findings from a randomized, controlled trial on the care of Foley catheters to change practice at an institution is practicing: Question options: evidence-based medicine. qualitative research. quantitative research. clinical judgment. The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research. Which of the following is most influenced by the social and economic environment of a community? Question options: Social health policies Quality of care Evidence-based practice Practice guidelines Social policies concerning health are influenced by the social and economic environment of a population. Analysis of population trends and projections is necessary to help health professionals determine changing needs. A major cause of death in the early twentieth century was: Question options: cancer. cerebrovascular disease. heart disease. infections. Infections and acute disease were the major causes of death in the early part of the twentieth century. Which of the following demonstrates a nurse taking action to promote health and prevent disease? Question options: Making a home visit to a person who is recovering from a heart attack Administering medications to a cardiac client in the hospital Providing cardiopulmonary resuscitation during a heart attack Educating a person about the advantages of a heart-healthy diet during a home visit give the individual a weight loss goal. Nurses must work with individuals to determine what they are willing to do to lose weight. To do this successfully, nurses must know what options are available to the individuals for weight loss. Once nurses learn about the methods of weight loss, they can then develop goals for weight loss with the individual. Assuming that an individual‟s own perspective is correct and shared by others is known as: Question options: ethnocentrism. racism. cultural competency. empathy. Assuming that an individual’s own perspective is correct and shared by others is known as ethnocentrism. CHAPTER 2 A person states, “My grandmother is the decision maker in our family.” Which of the following is being described by the person? Question options: Culture Race Ethnicity Values Culture, as an element of ethnicity, refers to integrated patterns of human behavior that include the language, thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethnic, religious, or social groups. The term “ethnicity” encompasses more than a cultural practice, which is what is being described by the person; it focuses on differences in meanings, values, and ways of living. Race is associated with power and indexes the history or ongoing imposition of one’s group’s authority above another. Values are beliefs about the worth of something and serve as standards that influence behavior and thinking. The nurse recommended to a 50-year-old woman that she schedule a routine mammogram. Which of the following would be the most important factor in this woman‟s decision to schedule this exam? Question options: Race Ethnicity Cultural values Value orientation Cultural values guide actions and decision-making that facilitates self-worth and self-esteem. They shape human behaviors and determine what individuals will do to maintain their health status, how they will care for themselves, and others who become ill, and where and from whom they will seek health care. Race is associated with power and indexes the history or ongoing imposition of one’s group’s authority above another. Ethnicity focuses on differences in meanings, values, and ways of living. Value orientations reflect the personality type of a particular society. Which of the following actions demonstrates a health care professional providing culturally competent care? Question options: Encouraging the person to take medications as prescribed Asking the person to describe his folk healing methods Demonstrating the proper way to administer an insulin injection Assisting the person with discussing his health problems with the family It is very important for health care providers to be aware of how people interpret their health issues or illnesses to be capable to provide culturally competent care. A culturally competent health care professional should be able to consistently and thoroughly recognize and understand the differences in his or her culture and that of the patient or client, to respect the person’s values and beliefs, and adjust the approach of delivering care to meet each person’s needs and expectations. Asking the person to describe his folk healing methods is the only action that demonstrates the health care professional seeking input from the person into the care that is received. A person reports that she has been seeking care from an acupuncturist to help relieve the chronic pain that she has been experiencing. Which of the following statements would be the most appropriate response from the nurse? Question options: “You should have told me that the current treatments were helping your pain.” “Tell me more about your treatments from the acupuncturist.” “Tell me why you decided to not to continue with your treatment plan.” “You should not be seeing an acupuncturist while receiving professional care.” Through a culturally sensitive assessment process, nurses can determine what specific remedies individuals are using and whether their continued use would interfere with the prescribed method. The nurse asking the person to describe the treatments from the acupuncturist allows the nurse to learn this information. The other responses demonstrate an ethnocentric perspective by the nurse, viewing the treatments from the acupuncturist as inferior to professional care. When providing an educational session about the Arab American population, which of the low numbers of minority health care providers use of emergency rooms for care increased infant mortality rates in African American populations A decrease in resources for preventive care leads to the use of emergency rooms and other more expensive health care services that are often used as resources when severe illness occurs. A health care provider is working with an African American woman who has recently suffered a stroke and is homebound. She insists that she must get out of the house and attend Sunday worship services. What is the most likely explanation for her insisting that she participate in this cultural practice? Question options: The church is the only place where prayer can be performed. The church serves as a social support for its members. The church is the place where the family meets on a weekly basis. The church serves as a site for folk healing practices. The church is significant support system many African Americans. It serves many purposes beyond worship and formation, including serving as a place to meet where members could pass news, take care of business, and find strength of purpose; providing direct social welfare services; acting as a stabilizing force in the community; facilitating citizenship training and community social action; serving as a transmitter of cultural history; and providing the means for coping and surviving in a hostile world. African Americans often find comfort in the support their religious leader can give them, but it does not have to happen within the church. African Americans believe in the healing power of prayer, but that can happen outside of the church as well. Family is the strongest source of support for African Americans, and most meet more often than weekly at church. Which of the following ethnic groups has a disproportionately high death rate from unintentional injuries and suicide? Question options: American Indian/Alaska Native Americans Asian Americans Latino/Hispanic Americans Black/African Americans American Indian/Alaska Native Americans have disproportionately high death rates from unintentional injuries and suicide. Difficult life situations and stresses of daily life contribute to an array of problems, including feelings of hopelessness, desperation, family dissolution, and substance abuse. A health care professional is offering an educational session about providing culturally congruent care. Which of the following information would be included the presentation? Question options: Hispanic Americans value keeping balance and harmony with the earth. The oldest male is the decision maker in African American families. Native Americans are present oriented, taking one day at a time. The hot and cold concept of disease is part of the Asian American culture. Native Americans are generally present oriented, emphasizing events that are occurring now rather than events that will happen later. They take one day at a time and in times of illness they cope by hoping for improvements the next day. Native Americans value keeping balance and harmony with the earth. The oldest male is the decision maker and spokesperson in Asian American families. The hot and cold concept of disease is part of the Hispanic culture. A family has recently become homeless. Which of the following factors most likely contributed to this situation? Question options: Being from an ethnic minority background Declining rates of poverty Question options: Using previous knowledge about ethnic minority cultures to plan care Adapting nursing care to meet the need of a person from an ethnic minority Requesting an interpreter when caring for a person from an ethnic minority Attending a presentation about cultural diversity Transcultural nursing is defined as an area of nursing study and practice that focuses on discovering and explaining cultural factors that influence the health, well-being, illness, or death of individuals or groups and seeks to provide culturally based appropriate care to people of diverse cultures. Adapting nursing care to meet the needs of a person from an ethnic minority best meets this definition of transcultural nursing. A nurse may initially use previous knowledge about minority cultures to plan care, but then must individualize the care based on individual differences within the culture. Having an interpreter present will not be necessary when working with all persons from ethnic minorities. Attending a presentation about cultural diversity would assist the nurse in becoming more culturally competent, but it is not the best example of practicing transcultural nursing because no nursing care is being provided when attending a presentation. A nurse would like to improve his cultural competence. Which of the following is the best strategy to use? Question options: Explore complementary and alternative medicine practices used by other cultures. Discuss cultural differences with coworkers. Provide care to diverse populations. Participate in continuing education programs about cultural diversity. Salman et al. (2007) assessed cultural awareness and cultural competence levels among staff nurses who participated in a continuing education program aimed at increasing knowledge of culturally competent care of geriatric populations. Staff nurses who participated in this training program had higher cultural competence levels as compared with those who did not join this training program. Exploring complementary and alternative medicine practices used by other cultures will assist if a nurse is using these practices; however, depending on whom the nurse is caring for, this information may have limited usefulness. Discussing cultural differences with coworkers may help the nurse learn about other cultures, but it may not provide the best source of information. Providing care to diverse populations may not help the nurse to become more culturally competent without having some baseline knowledge about cultural diversity. A nurse is told by a colleague that an Asian American individual on home care is using complementary and alternative medicine (CAM). Which of the following conclusions can accurately be drawn from this statement? Question options: The client will have adverse complications from using this form of medicine. The client may be using meditation, acupuncture, or another therapy. The client will soon be returning to his or her native country for further treatment. The client does not agree with the current professional care medication regimen. Examples of complementary and alternative medicine (CAM) include acupuncture, feedback, relaxation, music therapy, massage, art, music, and dance therapy. Persons who do not experience relief from chronic conditions often resort to complementary alternative medicine. It is important the nurse learn more about the CAM that the person is using so that any potential interactions between the use of CAM and professional care can be addressed. Complementary and alternative medicine can be used in conjunction with the use of professional care. A woman reports that she has strong spiritual practices. Which of the following is she most likely to experience? Question options: Improved coping skills and social support Increased understanding of religious differences Decreased pain and improved healing Decreased use of Western medicine Spiritual practices are likely to improve coping skills and social support, promote feelings of optimism and home, encourage healthy behavior, decrease feelings of depression and anxiety, and support a sense of relaxation. CHAPTER 3 Which addition to a community best demonstrates the concept of the Healthy People 2020 report? Question options: New cardiothoracic intensive care unit at a major hospital New rehabilitation center New recreational health center New children‟s hospital The Healthy People 2020 report promotes health care, not illness care. A hospital, ICU, and rehabilitation center emphasize episodic care after an illness. The recreation health center serves to preserve health in the community and helps meet the goals of the Healthy People 2020 report. Which nurse is at risk of making a medical error? Question options: Working overtime Works in a hospital that advocates multidisciplinary care Caring for four clients during the shift Clinical nurse specialist Pediatric nurse practitioner Acute care nurse practitioner A primary care provider serves as a gatekeeper, coordinating care of individuals by determining the need for referrals and procedures. A primary care provider can be a physician, physician’s assistant, or advanced practice nurse in a primary care setting. The primary care provider provides basic and routine care usually in an office or a clinic. A pediatric nurse practitioner is an example of a primary care provider. Which form of managed care restricts providers to caring for individuals who are members of their organization? Question options: Fee-for-service plan Health maintenance organization (HMO) Preferred provider organization (PPO) Independent practice association (IPA) The traditional HMO was a group or staff model in which a group of physicians and some specialty services provided care to its members. Providers generally spent all their time serving members of the HMO. Fee-for-service, IPAs, and PPOs are not restricted to serving clients for any one organization. A Medicare client reports to the home care nurse that he is receiving care through an accountable care organization (ACO). Which of the following considerations should be made when delivering care to this individual? Question options: The individual must see a primary care provider before being referred to a specialist. The focus of care is prevention and management of individuals with chronic disease. The individual has paid a membership fee to be part of this organization. The focus of care is to conserve money in a health savings account. The focus of care of accountable care organizations (ACOs) is to focus on prevention and management of individuals with chronic disease out of the hospital. In an ACO, physicians accept the responsibility for the quality of care provided and overall costs of delivering care to a defined population of patients. Accountable care organizations are composed of physicians, specialists, and hospitals, so a specialist will be able to be seen within the ACO. Individuals who are part of concierge care pay a membership fee in return for enhanced health care services or amenities. Health savings accounts are used in conjunction with high deductible health insurance plans and are not related to the use of ACOs. Which of the following is a health plan consisting of hospitals and physician providers providing health care services to plan members (usually at discounted rates) in return for expedited claims payment? Question options: Health maintenance organization (HMO) Health savings account (HSA) Preferred provider organization (PPO) Independent practice association (IPA) A health plan consisting of hospitals and physician providers providing health care services to plan members (usually at discounted rates) in return for expedited claims payment is known as a preferred provider organization (PPO). A nurse complies with the Patient Self-Determination Act when asking: Question options: a person upon admission to the hospital if he or she has an advanced directive the family in the recovery room if the client has an advanced directive a person before discharge from the hospital if he or she has an advance directive the family about an advanced directive after the person has been intubated The Patient Self-Determination Act is designed to increase individual involvement in decisions about life- sustaining treatments. The nurse must ensure that advanced directives are available to physicians at the time the medical decision is being made. Therefore, the nurse complies with the act when she asks a person upon admission to the hospital if he or she has an advanced directive. Which is a violation of the Health Insurance Portability and Accountability Act of 1996? Question options: Nurse reporting a case of TB to the health department Nurse reporting a case of child abuse to the Department of Human Services Nurse discussing the person‟s case with his or her physician Nurse discussing the person‟s case with his or her school nurse 27-year-old who attends college and works part time in a small pizza parlor Young adults (27 years of age or older) are not eligible to be covered under their parents’ insurance. Medicare is available for those over the age of 65 and for people who require dialysis. Medicaid and SCHIP are available for children whose families meet the financial requirements. This child would likely meet criteria for either Medicaid or SCHIP because the parents are considered working poor. Because health care insurance is so expensive, it would be difficult for a 27-year-old to afford his or her own plan. Young adults often go without insurance because of the high costs. Adoption of a Canadian-style health care system in the United States has the potential to: Question options: decrease waiting times for tests and procedures. create further health disparities. increase the number of HMOs. increase the amount of funding available for health care. Canadians with private health insurance and higher incomes have access to greater health care services and more expedient health care. This translates to a two-tier system of health care, which can contribute to health disparities in health care access and quality. A system used to evaluate the necessity, appropriateness, and efficiency of the use of the health care system, the purpose of which is to lower costs by discouraging unnecessary treatments, is known as: Question options: managed care gate keeping utilization review capitation A system used to evaluate the necessity, appropriateness, and efficiency of the use of the health care system, the purpose of which is to lower costs by discouraging unnecessary treatments, is known as utilization review. The country with the lowest infant mortality rate in 2011 was: Question options: Canada Mexico Sweden the United States Sweden had the lowest infant mortality in 2011 with a mortality rate of 2.74 per 1000 live births. The country with the highest life expectancy for women in 2011 was: Question options: France Germany Sweden the United States France was the country with the highest life expectancy for women (85 years of age) in 2011. CHAPTER 4 Which of the following statements about values is true? Question options: It is impossible for someone to understand his or her values. Values evolve over time; they are not static. Values assimilated in childhood are those held for a lifetime. Values clarification tells a person how to act. Values take time to develop, and they may change with education, experience, exposure, or a combination of these. A nurse is providing education about improving self-awareness to a small group of women who have been victims of domestic violence. Which of the following should the nurse recommend the clients do first to improve their self-awareness? Question options: Use self-disclosure to share aspects of self. Listen to and learn from others. Listen to oneself and pay attention to emotions, thoughts, and reactions. Which of the following statements about nonverbal communication is true? Question options: Nonverbal behavior is not usually contextual. Nonverbal behavior is culturally and situationally bound. Nonverbal communication is the most important type of communication. Nonverbal communication is easy to interpret. Cultural exposure and situational impact are essential components of interpreting nonverbal communication and must be taken into consideration in attempts to interpret nonverbal communication. Which of the following scenarios best describes a nurse using metacommunication? Question options: Using both touch and silence when counseling an individual Practicing reflection when interaction with an individual Discussing with an individual how to solve a problem Understanding that an individual needs a break before proceeding Metacommunication refers to a message about the message. It is the relationship aspect of communication. In a sense, it involves reading between the lines or going past the surface content of the message to glean nuances of meaning. Which of the following statements can be identified as a method for clarifying a message? “I get very upset when you talk to me in that tone.” “You make me very angry when you drink alcohol.” “I can make you happy. I know I can.” “What I want from you is to be left alone!” Use of “I” statements is one technique that can be used for clarifying and qualifying messages. A nurse and a man are involved in a conversation. When the person folds his arms across his chest, the nurse almost simultaneously folds her arms across her chest. This behavior is recognized as: Question options: empathy. reciprocity. flexibility. spacing. The patterning of similar activities within the same interval by two people can facilitate communication. This patterning is known as reciprocity. A nurse and her client are engaged in meaningful conversation when suddenly there is silence between the two. To facilitate effective client-centered communication, the nurse should: Question options: ask the person what he is thinking, so they can understand each other. restate what the person said before silence ensued, to get clarification. change the subject to one that is more pleasant for the person to discuss. wait quietly to give the person time to reflect where he wants to lead the conversation. Silence allows the person to reflect on what is being discussed or experienced and lets him or her know that the nurse is willing to wait until he or she is ready to say more. A person has just been admitted to the hospital. In talking with the person, the nurse is able to elicit from her that the reason for her hospitalization is that her husband beat her up. Which characteristic of the therapeutic relationship is being demonstrated? Question options: Empathy Trust Rapport Purposeful communication The nurse focuses communication for a particular aim: to obtain information to be used in care of the person. An individual reveals to the nurse that he is having an affair with his wife‟s best friend. Which of the following statements will enhance effective therapeutic communication between him and the nurse? Question options: “You know that what you are doing is wrong.” This distance is too far for the nurse to build a therapeutic relationship while obtaining the information. This is the recommended distance between client and nurse for effective therapeutic communication. The nurse should position himself an additional foot away to facilitate the conversation. Personal space of 18 inches to 4 feet is appropriate for close relationships in which touching may be involved and good visualization is desired. A nurse is working on values clarification with a person who has chosen to smoke during her pregnancy. Which of the following statements would be the most appropriate for the nurse to assist in this process? (select all that apply) Question options: “Why do you smoke cigarettes? “What do you value most in life?” “Who has influenced your decision to smoke?” “Is your decision to smoke consistent with your values?” Techniques to clarify values include assisting the person to identify her own values (“What is important to you?”), identify values conflicts or conflicts between values and actions (“Are your actions consistent with your values?”), and using reflection to restate the value and make it explicit. A nurse is in the process of establishing a therapeutic relationship with a person. Which of the following techniques should be used by the nurse? (select all that apply) Question options: Learn about the person‟s interests. Sit close to the person. Show interest in the person‟s concerns. Define the parameters of the relationship with the person. Purposeful communication should be an aim of the therapeutic relationship. Social chitchat, communication without a goal, should not make up the bulk of the therapeutic interaction. The amount of space between communicators varies from culture to culture, so sitting close to the person may not be culturally appropriate. Building rapport by showing the person that his or her concerns interest the nurse is important. Also, trust can be built with the person by clearly defining the relationship parameters and expectations. Which of the following is an essential question that nurses should encourage individuals to ask at every health visit? (select all that apply) Question options: “What is my main problem?” “What health information do I not understand?” “What do I need to do?” “What is the plan for the next visit?” Health literacy is the capacity to read, comprehend, and follow through on health information; it is a critical component of health promotion. To combat low health literacy, nurses can encourage individuals to ask three essential questions at every health visit: “What is my main problem?” “What do I need to do?” “Why is it important for me to do this?” CHAPTER 5 Which of the following statements is true with regard to health promotion? Question options: Health promotion efforts are not concerned with addressing environmental obstacles to health. Advocates of health promotion are not involved in political campaigns against harmful products. The business of eliminating health disparities is a unique function of Healthy People 2010 goals. Health promotion involves collaboration of many professional groups. Health promotion is not the province of a single discipline but involves individuals, health care providers, and institutions working together to create a positive environment for health and to achieve health goals. Which of the following types of ethical theories tells us how people act toward each other and their environments and what they believe are good or moral actions? Question options: Descriptive value theories Normative theories Consequentialism theory Duty-based theories process? Question options: Assists in predicting all of the possible consequences of future actions Facilitates gathering of the most important information to solve the problem Considers the importance of caring when solving the problem Highlights salient aspects of future actions The purpose of ethical inquiry is to gain clarity on actual or potential moral issues arising in the context of health-promotion endeavors and to understand what is expected of the health-promotion agent viewed as a moral agent. Ethical reasoning can facilitate appropriate and in-depth data gathering, permit the uncovering of hidden agendas and interests, and focus on the most salient aspects of a particular problem. A nurse whose religious beliefs prohibit abortion has been asked to participate in a termination of the pregnancy of a 16-year-old victim of date rape. According to the revised American Nurses Association‟s (ANA‟s) Code of Ethics for Nurses, which of the following actions should the nurse take next? Question options: Suspend her religious beliefs and provide comfort and support for the client. Quit her job and find another source of employment. Notify her supervisor about her beliefs and request a change in assignment. Refuse to participate in the abortion. In the immediacy of the situation, the ANA Code of Ethics provides for the right of nurses to refuse to participate in procedures that violate their own values, but the nurse’s ethical behavior must ensure that arrangements for the care of the client are provided. A liver for which two people are tissue-typed has become available after the death of a donor in a car accident. Client A is a 45-year-old substance abuser whose liver is damaged as a result of his use of alcohol. Client B is a 16-year-old adolescent in need of a liver transplant because of a birth abnormality. Which of the following would be useful for a nurse in giving input as to which of the two should receive the liver? Question options: Advocate for Client B because he is the younger of the two and will live longer. Use feminist moral theory to advocate for Client A in spite of his alcohol use. Use a guided set of moral principles in decision-making before advocating for either. Advocate for Client A because he has 15 to 20 years of productive life left. Systematically using a set of moral principles in making ethical decisions assists the nurse in resolving ethical dilemmas such as that described. Which concept is aimed at interrupting potential ethical problems before they develop? Question options: Feminist ethics Preventive ethics Metaethics Normative ethics Preventive ethics is a requirement of health promotion in which practitioners envision potential problems and institute actions that stop their development. When providing preoperative teaching for a client who will be undergoing total knee arthroplasty, the nurse asks the client questions to assess his understanding of the surgery. Which type of ethics is the nurse implementing? Question options: Duty-based ethics Normative ethics Metaethics Preventive ethics Preventive ethics aims to forestall ethical problems before they develop. Preventive ethics is an important requirement of health-promotion endeavors that includes individual action by the nurse, as well as social and political activism with other nurses or professional nursing organizations. Assessing the client’s understanding of what is going to happen during a surgical procedure before the client signs the consent for the procedure makes sure the client understands the information and should help prevent ethical problems. A 24-year-old man with severe cognitive impairment, and no relatives participating in his care, needs to make a decision about removal of a brain tumor that will render him totally dependent for completion of all activities of daily living. The nurse participates in ethical decision making on his behalf, knowing that the client is unable to benefit from which of the following ethical concepts? Question options: Autonomy Justice Beneficence Advocacy Because the client is cognitively delayed and is unable to understand explanations of treatment that would be given to him, the client is unable to be autonomous in making a decision regarding neurosurgery. information, or providing information that is misleading or incomprehensible, in an attempt to influence someone to agree to a treatment or intervention, conflicts with veracity. Which of the following concepts of ethics is described as the “duty to maximize the benefits of actions while minimizing harm”? Question options: Advocacy Justice Beneficence Autonomy Beneficence governs actions taken to further the overall health or well-being of an individual or society. “Beneficence” means doing good. A nurse reflects on previous experiences with minority populations and considers how these interactions have influenced her present care to these populations. Which part of values clarification and reflection has the nurse used? Question options: Formulate a possible course of action. Examine the influence of beliefs. Reflect on practice. Determine the prevalent values. It is important for the nurse to think about the influence that beliefs and values have on his or her practice. An understanding of how personal beliefs and values are either congruent, or are liable to interfere, with the task at hand is crucial to ethical problem solving. A nurse is working with a community to increase its awareness about the dangers of lead poisoning. Which of the following provides the best explanation as to why the nurse is performing this action? (select all that apply) Question options: It is the right thing to do. It is a moral responsibility. It is an ethical responsibility. It is the role of the nurse. When nurses provide service to society through health promotion interventions, their care for clients can be seen as a moral endeavor. Moral issues are confronted in the process of attempting to enhance the well-being of a society overall, as well as promoting and protecting health for individual members of a society. The ANA Code of Ethics for Nurses Interpretive Statements promises that “nursing encompasses the prevention of illness, the alleviation of suffering, and the protection, promotion, and restoration of health in the care of individuals, families, groups and communities.” The terms ethical and moral are used interchangeably throughout the chapter. A nurse is using feminist ethics when planning a program for women to promote screening and early detection of breast cancer. Which of the following considerations would be made by the nurse? (select all that apply) Question options: Importance of relationships Understanding of the oppression of women Importance of responsibility when caring for others Understanding of the imbalance of power Characteristics of feminist ethics include: understanding that human beings are inseparable from their relationships with others; a focus on care and responsibility aspects of relationships, rather than application of abstract principles; a concern with the development of character and attitudes that result in caring actions reflective of a person who is related to rather than detached from context; and a concern for the rights and equality of all individuals that is not limited to the oppression of women. CHAPTER 6 Who authored the framework which provides the foundation for nursing assessment and diagnosis using the functional health patterns? Question options: Erikson Gordon Newman Nightingale Gordon’s framework provides the foundation for most NANDA nursing diagnoses using the functional health pattern. Nurses use the framework to combine assessment skills with subjective and objective data to construct patterns. When assessing a client‟s activity-exercise pattern, which subjective finding has implications for nursing practice? Question options: A person‟s decreased muscle tone A person‟s amount of leisure time A person‟s decreased range of motion A person‟s use of a cane Although all findings are important in assessing the activity-exercise pattern, the only subjective finding is the amount of leisure time that the person reports having. All others are objective findings and can be validated with a physical exam. During a health history, a person reports getting 5 hours of sleep a night. What does this information indicate to the nurse? Question options: The person is not receiving enough sleep. The person is receiving adequate sleep. The nurse must determine where the person sleeps. The nurse must ask additional questions. The single most important factor assessed in the sleep-rest pattern is probably the perception of adequacy of sleep and relaxation. The objective when assessing the sleep-rest pattern is to describe the effectiveness of the pattern from the person’s perspective. Wide variation in sleep time does not necessarily affect functional performance. Different individuals require different amounts of sleep. Thus, without further subjective data, the nurse is not able to make a diagnosis in this functional pattern. A nurse assesses the cognitive-perceptual pattern of a Type 1 diabetic client. Which finding has implications for the individual‟s nursing plan of care? Question options: Decreased sense of hearing Decreased sense of smell Decreased sense of taste Decreased visual acuity Assessment parameters in the cognitive-perceptual pattern include hearing, vision, smell, and taste. A person with Type 1 diabetes mellitus requires insulin injections. A decrease in visual acuity will make it difficult for the individual to draw up his or her medication and therefore will influence the nurse’s plan of care. Which scenario indicates a potentially dysfunctional pattern? Question options: Adult with frequent urination Woman who lost her job Elderly person with blurred vision Overweight adult with a sweet tooth A pattern is potentially dysfunctional when sufficient evidence exists or enough risk factors are present to indicate that a pattern of dysfunction will likely occur if interventions are not instituted. A dysfunctional pattern is a problem when it represents a deviation from established norms or from the individual’s previous condition or goal. The woman who lost her job indicates a potential dysfunction pattern because the stress of losing her job places her at risk for ineffective coping. The other scenarios are not potentially dysfunctional; by definition, they are dysfunctional. A nurse is counseling a person with a dysfunctional sleep pattern. Which of the following recommendations would the nurse most likely give the person? Question options: Read in bed until he falls asleep. Avoid fluids after 7 PM. Exercise immediately before bedtime. Watch television in the recliner in the evening. Etiological factors of most dysfunctional patterns often lie within another pattern or patterns. Outcomes and plans are based on probable cause. Exercising before bed, watching television, and reading in bed are not considered appropriate sleep hygiene. Frequent urination may be the cause of his dysfunctional sleep pattern and, if so, avoiding fluids before bed would be an appropriate plan. A nurse is caring for a person with a potential dysfunction in the health-perception–health- management pattern. Which of the following nursing interventions would most likely be performed? Question options: A Hispanic mother tells the nurse that she has been using home remedies for her child‟s asthma. Which home remedy might this mother be using? Question options: Acupuncture Cupping Hot tea Massage In the Hispanic population, asthma is viewed as a cold disease (hot-cold imbalance) and thus is treated with warm therapies. Diet is often used to maintain equilibrium. Thus, warm tea added to the child’s diet might be used to restore equilibrium between hot and cold in this child who has asthma. Which classification system fulfills needs that are exclusive to nursing? Question options: The International Classification of Nursing Practice (ICNP) The International Classification of Functioning, Disability, and Health (ICF) The International Nursing Diagnoses Classification (NANDA-I) The Nursing Diagnostic System (NDS) The NANDA-I system includes diagnostic criteria, and related etiologies in addition to the description. The NANDA-I fulfills needs that are exclusive to nursing. A young couple is deciding if they should get married and start a family. Which of Erikson‟s life stages are they experiencing? Question options: Identity vs. role confusion Intimacy vs. isolation Generativity vs. stagnation Ego integrity vs. despair During early adulthood individuals experience Erikson’s life stage of intimacy vs. isolation. Examples of life events in this stage include committing to a mate and family responsibilities and selecting a career. Identity vs. role confusion occurs during adolescence. Intimacy vs. isolation occurs during middle adulthood. Ego integrity vs. despair occurs during maturity. Which cultural group defines illness as a price that is being paid for the past or the future? Question options: African Native American Arabian Asian American Indians define illness as a price that is being paid for the past or the future. A man is telling a nurse that he feels that his health is a gift from God. This statement most closely coincides with beliefs of which cultural group? Question options: African Alaska Native Asian Hispanic Hispanics define health as a gift from God. Which of the following is the leading cause of death among women? Question options: Accidents Cancer Coronary artery disease Stroke The leading cause of death in women is coronary artery disease. Risk-factor Structural-functional Open systems Developmental Duvall and Miller identified stages of the family life cycle and critical family developmental tasks, through a developmental perspective. This conceptual model helps to anticipate family events and discusses how families complete basic family tasks as they transition through these events. Which of the following would be described as a family structural component? Question options: Income earner of the house Socialization for the family Immunization of infants Launching of children Structural components of the family refer to family roles and relationships. A nurse is collecting data for a family assessment using Gordon‟s functional health patterns. The nurse learns that the family has no books in the home to read to the preschool-age children. To which of the following functional health patterns does this information pertain? Question options: Roles-relationship Cognitive-perceptual Health-perception–health-management Self-perception–self-concept The cognitive-perceptual pattern identified characteristics of language, cognitive skills, and perception that influence desired or required family activities. The availability of books in the home for preschool age children impacts this functional health pattern. A nurse who is using Gordon‟s functional health patterns is planning to assess its roles- relationships pattern. Which of the following questions would be most appropriate for the nurse to ask? Question options: What is the family‟s philosophy of health? What does the family do to have fun? How are problems in the family resolved? Who decides when and how children go to sleep? How problems in the family are resolved relates to assessment of the roles-relationships pattern. The family’s philosophy of health relates to the health perception-health management pattern. What the family does to have fun relates to the activity-exercise pattern. The decision concerning when and how children go to sleep relates to the sleep-rest pattern. A nurse is using a genogram to represent a family. Which of the following statements is accurate? Question options: A genogram identifies the genetic disorders of the family. A genogram includes information about the past two generations. A genogram can be used to make connections about family health patterns. A genogram begins with a circle in the center of the page. A genogram shows a variety of family structures and highlights family health patterns, which can be used for anticipatory health guidance. Significant diseases and disorders of the family members are highlighted on the genogram. Data on at least three generations are reported on a genogram. The genogram uses a variety of symbols to demonstrate connections but does not begin with a circle in the center of the page. The ecomap of a client‟s family has slashed lines drawn from the son to the family church. Based on this information, what conclusion can the nurse make? Question options: The son is deceased. The son is actively involved with the family church. The son has a stressful relationship with the church. The son has no relationship with the church. Slashed lines on an ecomap signify stressful relationships. A client reports that her family will be moving because her husband is taking a new job in another state. She is very unhappy about the decision and doesn‟t want to move. What action should the nurse take next? Question options: Genetic diseases in the family Driving practices in the family Toilet training for the child A typical 9-month-old is beginning to crawl. Houses built before 1974 may contain lead-based paint, to which a crawling baby might have access. Lead causes neurological damage and anemia. A nurse is caring for a family with an adolescent child. Which of the following problems would the nurse anticipate that the family would report? Question options: Concerns about career decisions Concerns about exposure to environmental hazards Difficulty with parents finding fulfillment with raising the child Difficulty with open communication with the child Open communication with parents is often difficult during the adolescent stage, partly because of the differing developmental tasks of adolescents and adults. Concerns about exposure to environmental hazards and parents finding fulfillment with raising the child typically are concerns with families with younger children. Concerns about career decisions are typically problematic for families with older children/young adults. A nurse has developed a family nursing diagnosis. Which of the following best describes the purpose of this action? Question options: Describes the strengths of the family Allows for creation of goals for the family Promotes behavioral change among family members Validates health problems with the family Writing a family nursing diagnosis helps families promote health throughout the life cycle and prevents disease through decreasing risk-taking behaviors. Nurses derive diagnoses from assessed validated data. The nursing diagnosis describes and validates potential or actual health problems with families. The diagnosis provides direction for outcomes and interventions first identifying what the problem is. A home care nurse is planning an intervention with a family focusing on decreasing susceptibility. Which of the following nursing interventions would be most appropriate to implement? Question options: Education about building on current strengths of the family Education about hand hygiene Education about health care resources in the community Education about child safety seats Four types of nursing interventions appear in health-promotion and disease-prevention planning: increasing knowledge and skills; increasing strengths; decreasing exposure; and decreasing susceptibility. Decreasing susceptibility means educating families about prevention principles. Examples include education about hand hygiene and how diseases are spread from person to person and by other factors in the environment. A nurse is making a final home visit with a family to evaluate the nursing care plan. Which of the following actions would the nurse most likely complete during this visit? Question options: Obtain vital signs from all members of the family. Ask the family members to state the goals that were previously developed. Collect data similar to that which was collected at the initial visit for comparison. Educate about the importance of using role relationships to create a healthy family. The purpose of evaluation is to determine how the family has responded to the planned interventions and whether these interventions were successful. The family’s baseline data are used as comparative criteria in evaluation; thus, it would be worthwhile to collect data similar to that collected at the initial visit to see if any changes have occurred. The nurse reassesses the situation and compares the new information with that on the original assessment to determine whether change has occurred. A nurse is planning a home visit for a family. Which of the following actions would be most appropriate for the nurse to take? Question options: Study information regarding the family from agency records and other sources. Make a contract with the family that states specific goals and objectives. Identify how the home visit will be financed. Understand the situation from the family‟s perspective. Part of planning the home visit is studying information regarding the family from agency records, referral forms, and other sources. Making a contract, identifying how the visit will be financed, and understanding the situation from the family’s perspective are all part of the process of making the visit. Find literature about smoking cessation. Hand out free nicotine-replacement systems. Nurses interact with communities to promote health. They supply educational information to at-risk groups to develop health-oriented skills as well as encourage behavior change. As such, nurses act as advocates collaborating with other disciplines and agencies. The success of health promotion programs depends on support from prominent community members. Therefore, arranging for a health fair and inviting local experts to participate is the best way for the nurse to address the smoking issue at her parish. Partnering with school-based clinics and local pediatric dentists so that children can have access to preventive dental care is an example of a(n): Question options: codependent function. independent function. interdependent function. dependent function. Collaboration with community members and interdisciplinary teamwork functions crucial to effective community health are considered interdependent functions. Partnering with school-based clinics and local dentists is a collaborative effort to improve the community’s health. Which of the following health concerns should the nurse have as a priority when planning care for a community? Question options: The limited recreational areas identified through a windshield survey The high crime rate reported in the town records The absence of health clinics on the local bus route The lack of grocery stores within walking distance identified by the community As a community liaison, the nurse establishes priorities for programming and matches resources with needs determined by a community-needs assessment. The goal is to maintain the community’s vision. Nurses’ concerns should be based on the community’s concerns. Therefore, the lack of grocery stores identified by the community should take first priority. A nurse is interviewing members of a substance abuse unit at a local Veterans Administration (VA) hospital. Which of the following parts of a community is the nurse assessing? Question options: Structure of a community Subsystem of a community Supra system of a community Interaction of a community Structural parts of a community form subsystems within a larger supra system. A substance abuse unit of a local VA hospital is a subsystem of a larger system (the VA hospital and family of hospitals). The structure of a community system or subsystem forms a formal or informal arrangement of parts. As a result, because interviewing is a form of assessment, the nurse in this example is assessing the subsystem (substance abuse unit of a local VA hospital) of a community (the VA hospital and family of hospitals). The study of a population is referred to as (a): Question options: community pattern. windshield survey. demography. community diagnosis. Demography is defined as the study of a population. The process of dynamic change with adaptation in the system‟s parts, and how community systems and subsystems interact is known as: Question options: structure of a community. community health promotion. community diagnosis. function of a community. The function of a community is defined as the process of dynamic change with adaptation in the system’s parts and how community systems and subsystems interact. A nurse is assessing a community from both a developmental and risk perspective. Which of the following characteristics would be of most interest to the nurse? Question options: Gender Age Cognitive-perceptual pattern Self-perception–self-concept pattern Coping-stress tolerance pattern Health-perception–health-management pattern The cognitive-perceptual pattern provides information about problem-solving and decision making within communities. Within a community there is an elevated high-school dropout rate and its high school students are experiencing a decreased sense of self-worth. Based on this data, the community is at highest risk to experience an alteration in which of the following functional health patterns? Question options: Self-perception–self-concept pattern Role-relationships pattern Cognitive-perceptual pattern Sexuality-reproduction pattern The elevated high-school dropout rate is a risk factor in the values-beliefs pattern, and the decreased sense of self-worth is a risk factor in the self-perception–self-concept pattern. Risk factors from several pattern areas may form clusters of risks for certain groups. Elevated high-school dropout rates and a decreased sense of self-worth may lead to crimes that the community cannot adequately control or cope with. A nurse is working with a community that is experiencing an alteration in its values-beliefs pattern. Which of the following is most likely to result because of a disturbance in this functional health pattern? Respiratory disorders Hearing loss Coronary artery disease Stress The values-beliefs pattern identifies the community values and beliefs. Values underlie decisions regarding prevention programs. A lack of primary prevention methods (e.g., exercise and a healthy diet) can lead to coronary artery disease. A nurse is using the technique of mapping while implementing the nursing process in the community setting. The nurse is engaging in which aspect of the nursing process? Question options: Collection Planning Analysis Implementation Analysis refers to data categorization and pattern determination. The organization of data is used to determine patterns. Mapping is an organizational technique used in data analysis. A nurse is collecting data regarding the number of crosswalks within a community. Which perspective is being used to gather this data? Question options: Developmental perspective Functional perspective Risk-factor perspective Systems perspective One way to assess a community is from a risk-factor perspective. Risk factors associated with community diseases, illness, and death rates play a role in predicting the likelihood of adverse health conditions. Risk factors include a combination of demographic, psychological, physiological, or environmental characteristics. Select groups may be at risk based on shared risks. Knowing which risk factors are present assists community nurses in developing action plans for health promotion and disease prevention. A community nurse develops a plan to address the problem of teenage pregnancies. Which of the following actions should the nurse take next? Question options: Determine the rate of teenage pregnancies. Evaluate the success of her plan. Provide educational programs at local schools regarding pregnancy prevention. Determine which factors related to teenage pregnancy require intervention. Plans guide nursing actions. Implementation of the nursing process begins based on the health promotion/health protection plan. Providing education is an action item in a plan and thus should be the next step. Determining the rate occurs before diagnosis. Determining which factors require intervention occurs during the planning phase. CHAPTER 9 Which is an example of asymptomatic pathogenesis? Question options: Blood pressure of 170/98 experiencing headaches Positive finding on colonoscopy and blood in his or her stool Elevated prostate-specific antigen (PSA) Elevated TSH who is always tired The primary objective of screening is the detection of a disease in its early stages, to treat it and deter its progression. The screening process is based on the principle that disease is preceded by a period of asymptomatic pathogenesis when risk factors predisposing a person to the pathological condition are building momentum toward manifestation of the disease. Therefore, someone with an elevated PSA without any symptoms is an example of asymptomatic pathogenesis. The other three examples demonstrate manifestation of disease (headaches, blood in stool, and tiredness). Influenza occurs among Americans at a rate of 36 per 100 people annually. Which type of rate is this statement describing? Question options: Prevalence rate Incidence rate Morbidity rate Mortality rate Incidence rate is the rate of a new population problem and estimates the risk of an individual developing the specific disease or condition during a specific period or over a lifetime. Prevalence is the proportion of a given population with the disease or condition at any one point in time. Usually acute conditions are assessed by their incidence (rate of occurrence), whereas chronic conditions are measured by their prevalence (generally existing). A nurse is examining the incidence, prevalence, and mortality rates of colon cancer in the community. Which of the following measures of life is being investigated? Question options: Quality adjusted life year (QALY) Quantity of life Disability adjusted life year (DALY) Satisfaction of life Measures of quantity of life affected by a disease are more readily attainable than quality of life measures. Quantity of life can be measured by using incidence and prevalence rates as well as disease- specific mortality rates. Which represents a disadvantage of screening? Question options: Utilization of group screening methods Utilization of multiple test screening Utilization of a test with high specificity Utilization of a test with low sensitivity Group screening and multiple test screening are advantages of screening programs. A disadvantage of screening occurs when the test is unable to distinguish those who probably have the disease from those who do not. Tests with low sensitivity produce a large number of false-negative tests and leave those screened with a false sense of a healthful state, resulting in them losing the opportunity to receive early treatments that could prevent irreversible damage. The nurse is examining the ability of a phenylketonuria (PKU) screening test to distinguish correctly between newborns who have and who do not have the disease. Which of the following measures of accuracy of the instrument is being evaluated? Question options: Sensitivity Specificity Validity Efficacy Validity is defined as a test’s ability to distinguish correctly between diseased and nondiseased individuals. The proportion of people with a condition who correctly test positive when screened is known as: Question options: sensitivity. specificity. validity. efficacy. for another community. A community assessment conducted as a partnership with key stakeholders provides information about the high-risk population, available health care resources, and the high-risk population’s health needs. By conducting the assessment, the nurse can identify the necessary community resources and mobilize them to achieve maximal benefits and positive outcomes. A nurse is planning to offer a depression screening at a local community center. Which of the following should be considered prior to implementation of the program? Question options: Limited referral sources in the community Limited support groups in the community Insufficient evidence that depression screening tools are cost effective Insufficient evidence mental health screening is appropriate Constraints affecting the operation of a screening program include financial concerns, political issues, cultural constraints, follow-up and referral services, and accessible treatment facilities. An efficient referral system should link the follow-up resources to the screening program, providing continuity of care. A method must be devised to encourage the participant to take positive action on the referral. Depression screening for adults is a covered preventive service for adults. A nurse is implementing a test that screens for hypercholesterolemia. Which of the following parameters should this test have? Question options: No cutoff point Low cutoff point Intermediate cutoff point High cutoff point The goal of a screening program, identifying an individual as high risk or not, depends on the numerical value of the screening instrument. When the parameter for this distinction is not clear, a cutoff point is set. Above this point, the person is considered disease positive; below this point, the individual is considered disease negative. Thus, if the disease were potentially life-threatening or if a disease is relatively benign in terms of stigmatization, anxiety, and problems with treatment, the lower cutoff would be preferred. High cholesterol, if left untreated, could contribute to life-threatening cardiac disease. Additionally, it is benign in terms of stigmatization. Therefore, a lower cutoff point should be set. A nurse is educating a group of community members about how hypertension screening is effective in reducing the rate of cardiovascular disease, thus reducing the expenses that are spent on management of this disease. Which of the following ratios is being described? Question options: Cost-disease analysis Cost-efficiency analysis Cost-benefit ratio analysis Cost-effectiveness analysis Cost-benefit ratio analysis allows the comparison of various outcomes in monetary terms. The cost of the screening versus the cost of chronic care management is considered. Which of the following is an example of a screenable population for hypertension? Question options: High school students Professional hockey players High-level business executives attending an annual conference Cardiac rehabilitation clients The objective of identifying a screenable population is to identify a high-risk group that, when tested, will yield a significant number of diseased individuals. The main criterion used to define an appropriate population is the definitive presence of risk factors related to the disorder. Most high-level business executives are middle-aged men with stressful jobs, placing them at high risk for heart disease. Thus, this would be the best example of a screenable population for hypertension. A nurse is assessing a low-income population in a community. Which of the following would be most appropriate for this population? Question options: HIV screening Blood pressure screening Colorectal cancer screening Breast cancer mammography screening According to a 2010 Gallup poll, ‘Low-income Americans are more likely than their high-income counterparts to say they have been diagnosed with each of the chronic conditions.......the differences are largest for depression, high blood pressure, and diabetes......the high level of obesity among low- income Americans is likely a contributing factor in these differences.’ A nurse is working at a women‟s health clinic and is asked by a client when she should return for her next Pap smear. Which of the following resources would the nurse use to find the most current recommendations? Question options: National Health Information Center Healthy People 2020 A 25-year-old woman with one child whom she gave birth to when she was a teenager A 17-year-old woman with one child who started menstruating at the age of 13 In the United States, the incidence of breast cancer increases with age. Breast cancer mammography screenings are recommended every 1 to 2 years for women over 40. A nurse is speaking to a women‟s group in the community about the importance of completing mammography to screen for breast cancer. At which age should the nurse recommend that mammography begin? Question options: 18 21 35 40 It is recommended that all women age 40 and older have a mammography performed every 1 to 2 years to screen for breast cancer. A nurse is reviewing the chart of a 15-year-old girl who has been sexually active since the age of 12. Which of the following findings would be of most concern? Question options: She does not perform self-breast exams. She has never had a Pap test. She had one HIV test performed at the age of 13. She does not use birth control pills. Although self-breast exams are encouraged and considered an important aspect of breast health education, data regarding its efficacy is weak. Although she does not use birth control pills, there is no indication that she does not use other forms of birth control such as condoms that would also prevent against STDs. There is also no indication that she has had more than one sex partner and is at high risk for HIV infection. A cervical dysplasia screening is recommended for sexual active females. Therefore, the fact that she never had a Pap test to screen for cervical cancer and has been sexually active for the last 3 years is concerning. CHAPTER 10 A nurse would like to assist Americans in improving their health. Which strategy would be most beneficial to improve the health of the American public? Question options: Encourage Americans to stop smoking. Lobby for state-of-the-art magnetic resonance imaging machines in all hospitals. Provide free medications for Americans. Offer free condoms to teenagers. The greatest opportunity to improve the health of the American people lies in addressing unhealthy, personal, behavioral risk factors. Intensive lifestyle changes can be effective not only in preventing chronic diseases, but also in reversing their progression and significantly reducing health care costs. Improvement of the public’s health is more likely to come from behavior change than technology. Therefore, people deciding they are going to change their behavior and stop smoking are likely to lead to improvements in the health of the public. A nurse is using a health education component when teaching about smoking cessation. Which of the following actions is the nurse implementing? Question options: Setting a quit date for people in a smoking cessation class Providing education regarding the benefits of smoking cessation Allowing smokers to participate in a smoking cessation program only if they use the patch nicotine replacement system Encouraging attendees of a smoking cessation program to participate in a research study Essential components of health education involve using teaching strategies, having learners maintain voluntary control over the decision to make changes in their actions, and focusing on behavior changes