Deck 3 Module 7 Health Wellness and Illness Flashcards
A nurse identifies the seven components of wellness as a useful tool in assessing health. Which are some of the components of wellness?
Select all that apply.
A) Physical B) Environmental C) Emotional D) Financial E) Spiritual
A) Physical
B) Environmental
C) Emotional
E) Spiritual
Rationale: The physical component is the ability to carry out daily tasks, achieve fitness, and generally practice positive lifestyle habits. The environmental component includes influences such as food, water, and air. The emotional component is the ability to manage stress and to express emotions appropriately. Finances are not one of the seven components of health. The spiritual component is the belief in some force (nature, science, religion, or a higher power) that serves to unite human beings and provide meaning and purpose to life.
In preparing a workshop on Healthy People 2020, which are some of the disease processes the nurse should address as part of the 42 topic areas covered in the report?
Select all that apply.
A) Cancer B) HIV C) Diabetes D) Multiple Sclerosis E) Heart Disease and Stroke
A) Cancer
B) HIV
C) Diabetes
E) Heart Disease and Stroke
Rationale: Healthy People 2020 is organized into 42 topic areas with nearly 600 objectives to improve health. These topic areas include: Cancer, Diabetes, Heart Disease and Stroke, and HIV. Multiple Sclerosis is not one of the topic areas.
A nurse is assessing a client to determine level of wellness. The client practices yoga for relaxation several times a week, follows a nutritionally sound diet, and has a supportive, sound relationship with a spouse and several children. Based on this data, which does this client exemplify?
A) An emergent high level of wellness in an unfavorable environment.
B) A high level of wellness in a favorable environment.
C) Protected poor health in a favorable environment.
D) An emergent high level of wellness in a favorable environment.
B) A high level of wellness in a favorable environment.
Rationale: A high level of wellness in a favorable environment involves biopsychosocial, spiritual, and economic resources that support healthy lifestyles. This client meets those criteria. The client is not emerging into high-level wellness; she has already achieved it. An emergent high-level of wellness in an unfavorable environment would be exemplified by a client who has the knowledge to implement healthy lifestyles but does not implement them because of family responsibilities, job demands, or other factors. The client does not have any health problems and therefore does not fit the description of protected poor health.
While teaching a class on health status, the nurse educator reviews internal variables that affect health status. Which internal variables are appropriate for the nurse to include in the class? Select all that apply.
A) Gender B) Spiritual and religious beliefs C) Environment D) Developmental level E) Age
A) Gender
B) Spiritual and religious beliefs
D) Developmental level
E) Age
Rationale: Internal variables that affect people’s health include biologic, psychologic, and cognitive dimensions. Biologic dimensions include genetic makeup, gender, age, and developmental level. Psychologic dimensions include the mind-body interactions. Cognitive dimensions include lifestyle choices and spiritual and religious beliefs. Environment is an example of an external variable that affects a person’s health.
A nurse is teaching a group of couples a class on building positive relationships at a local community center. The nurse is focusing this session on learning skills to be open-minded and respectful to those with opposing opinions. Based on this data, on which component of wellness is the nurse focusing this session?
A) Physical
B) Social
C) Environment
D) Emotional
B) Social
Rationale: The social component of wellness focuses on the ability to interact successfully with people and within the environment of which each person is a part, to develop and maintain intimacy with significant others, and to develop respect and tolerance for those with differing opinions and beliefs. The physical component of wellness is the ability to carry out daily tasks, achieve fitness of all body systems, and practice positive lifestyle habits. The emotional component deals with the ability to manage stress and express emotions appropriately. The environmental component focuses on the health measures that improve the standard of living and quality of life in the community.
A group of nurses have volunteered to go on a health mission to rural Haiti. The majority of the people the nurses will be working with do not have access to health care and live in poverty. Based on this data, which level of wellness do the nurses’ anticipate when providing care during this mission trip?
A) An emergent high level of wellness in an unfavorable environment
B) Protected poor health in an unfavorable environment
C) Poor health in an unfavorable environment
D) Protected poor health in a favorable environment
C) Poor health in an unfavorable environment
Rationale: The health axis extends from peak wellness to death, and the environmental axis extends from very favorable to very unfavorable. A health mission to an environment such as rural Haiti would involve clients who are not being treated for problems because of poor access and who also live in poor environmental conditions such as poverty and substandard sanitation. An emergent high level of wellness in an unfavorable environment would include clients who have the knowledge to implement healthy lifestyle practices but cannot implement them because of other factors or demands. Protected poor health in a favorable environment is where clients have an illness but their needs are met by the healthcare system. These clients have adequate access to appropriate medications, diet, and health care instruction. Protected poor health in an unfavorable environment is not one of Dunn’s quadrants.
The nurse conducts teaching for a client recently diagnosed with type 2 diabetes mellitus. At the conclusion of the session, which client statement shows that teaching has been effective?
A) “I will take medication for a week for this acute illness.”
B) “I will have to take insulin for this disease for my entire life.”
C) “This chronic disease will become worse and lead to death.”
D) “I will have to make dietary changes to manage this chronic disease.”
D) “I will have to make dietary changes to manage this chronic disease.”
Rationale: The client is aware that dietary changes will be needed to manage this chronic disease, indicating that the client understands the teaching the nurse has instituted. Not all clients diagnosed with type 2 diabetes mellitus require medication, such as insulin, to manage the disease process. Diabetes is chronic, not acute. Depending on the client’s response to the disease, the outcome may not become worse or lead to death.
An occupational health nurse for a large corporation is planning programs to address health problems identified in the Healthy People 2020 report. Which programs should the nurse include for the company employees at the worksite?
Select all that apply.
A) Depression screening for all employees B) An abuse screening program C) A substance abuse education program D) An immunization program E) Injury and violence prevention
A) Depression screening for all employees
B) An abuse screening program
C) A substance abuse education program
E) Injury and violence prevention
Rationale: Healthy People 2020 identifies a variety of programs that can be used to promote health at the worksite, including information dissemination, health risk appraisal and wellness assessment, and lifestyle and behavior change. Specific programs can address depression, substance abuse, and injury and violence prevention. Immunization programs are not relevant to the worksite.
After conducting a physical assessment for an adult client, the nurse discusses the assessment with a co-worker and states that the client’s beliefs and actions regarding common health practices seem “weird.” Based on this data, which action by the nurse is the most appropriate?
A) Repeat the assessment later in the day.
B) Determine the culture with which the client identifies.
C) Write a nursing diagnosis to address the “weird” beliefs and actions.
D) Communicate the findings to the health-care team.
B) Determine the culture with which the client identifies.
Rationale: A thorough assessment is needed before proceeding with other steps of the nursing process. Behavior that is considered weird in one cultural context may be considered desirable in another. While findings will be communicated and used for nursing diagnosis formulation, these steps are built upon a thorough assessment. Repeating the assessment will most likely result in the same incomplete data. Writing a nursing diagnosis before investigating the client’s culture would be premature.
A nurse is promoting participation in The Great American Smokeout for clients who are participating in a smoking cessation class. The nurse knows this event may motivate many individuals to stop smoking by promoting self-efficacy. At the conclusion of the class, which statement leads the nurse to expect a positive outcome for this particular client?
A) “I am afraid of getting lung cancer like my father.”
B) “I think this time will be different.”
C) “I am going to do the best that I can, so that I won’t get lung cancer.”
D) “I know that this time I will quit smoking permanently.”
D) “I know that this time I will quit smoking permanently.”
Rationale: Self-efficacy refers to the level of confidence an individual has about the ability to perform the activity. The client’s intention to make a permanent change shows the highest level of determination and motivation. Stating that one will do the best one can or thinking that this attempt at quitting smoking will be different are not highly positive indicators of motivation. Stating fear of getting lung cancer does not address a positive activity.
Which nursing intervention exemplifies the nurse working in a health promotion role?
Select all that apply.
A) Administering an ordered antibiotic
B) Reinforcing desirable changes to the client’s lifestyle
C) Administering vaccines to a well child
D) Administering an inhaler to an asthmatic client
E) Obtaining a blood glucose sample on a hypoglycemic client
B) Reinforcing desirable changes to the client’s lifestyle
C) Administering vaccines to a well child
Rationale: The nurse acting in a health promotion role is performing interventions to prevent disease. Reinforcing desirable changes to the client’s lifestyle and administering vaccines to a well child exemplify health promotion. Administering an ordered antibiotic or inhaler to a client and obtaining a blood glucose sample from a symptomatic client exemplify nursing interventions that are in response to disease or illness.
A community health nurse is educating a group of clients on the difference between illness and disease. Which statements are appropriate for the nurse to include in the educational session?
Select all that apply.
A) “An individual can have a disease and not feel ill.”
B) “Illness is synonymous with disease.”
C) “Illness is an alteration in body function, where disease is highly subjective.”
D) “An individual can feel ill without disease.”
E) “Illness and disease are never related to one another.”
A) “An individual can have a disease and not feel ill.”
D) “An individual can feel ill without disease.”
Rationale: Illness is a highly personal state in which the individual’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished. It is not synonymous with disease and may or may not be related to disease. One individual can have a disease, such as a growth in the stomach, and not feel ill. Another individual can feel ill–that is, feel uncomfortable–and yet have no discernible disease. Disease can be described as an alteration in body functions that reduces the capacities or shortens the normal life span.
While planning care for a client who has been hospitalized for 2 weeks, the nurse selects the nursing diagnosis of Risk for Disuse Syndrome due to the extended hospitalization. The nurse is assisting the client with a bath and wants to encourage full range of motion in all the client’s joints. Which activity will best support range of motion for the client’s hand and arm?
A) Having the client brush the hair and teeth
B) Moving the wash basin farther toward the foot of the bed to encourage the client to reach for the items
C) Moving each of the client’s hand and arm joints through passive range of motion
D) Giving the client a washcloth to wash the face
A) Having the client brush the hair and teeth
Rationale: The best range of motion is the natural movement of the client’s joints in normal activity. Brushing the hair and teeth includes more of the joints of the hands and the arms than does washing the face. The wash basin should be close to the client to prevent overreaching and possible falls. Passive range of motion is a second-best choice after normal use of the joints.
A nurse is providing wellness teaching to a client who is interested in beginning an exercise program to reduce certain health risks. The nurse determines that the client understands the teaching when the client selects which health risks that can be reduced by regular exercise?
Select all that apply.
A) Skin cancer B) Hypertension C) Cardiovascular disease D) Colon cancer E) Renal disease
A) Skin cancer
C) Cardiovascular disease
D) Colon cancer
Rationale: Regular physical activity results in a decreased risk of cardiovascular disease, colon cancer, and hypertension. It does not decrease the risk of skin cancer or renal disease.
The nurse is providing care to an older adult client who was recently diagnosed with early osteoporosis. Which intervention is most appropriate for the nurse to implement with this client?
A) Providing the client with assisted range of motion exercising twice daily
B) Instituting an exercise plan that includes weight-bearing activities
C) Protecting the client’s bones with strict bed rest
D) Increasing the amount of calcium in the client’s diet
B) Instituting an exercise plan that includes weight-bearing activities
Rationale: Osteoporosis is a demineralization of the bone in which calcium leaves the bone matrix. One causative factor is lack of weight-bearing activity. Weight bearing helps to move calcium back into the bone, thereby strengthening it. A standard intervention for those attempting to prevent or reverse osteoporosis is beginning an exercise plan that includes weight-bearing activities. Additional calcium in the diet after osteoporosis has begun is not thought to be effective. Strict bed rest may well make the osteoporosis worse because there is no weight-bearing activity. Assisted range of motion exercises are not weight bearing and do not help delay or reverse osteoporosis.
