Health Promotion

Question 1

What is prevention?

Answer 1

“Anticipatory action taken to prevent the occurrence of an event or to minimize its effect after it has occurred”. (Turnock, 2011, p. 530).

Question 2

What are the levels of Prevention?

Answer 2

Tertiary
Secondary
Primary
Primodial

Question 3

What is Primary prevention?

Answer 3

Focus
Health promotion and disease prevention

Purpose
Reduce or eliminate causative factors for disease

Examples
immunization, exercise, seat belts

Question 4

What is Secondary prevention?

Answer 4

Focus
Early detection and prompt interventions to alleviate health problems and prevent complications

Purpose
Identify patient at early stage and limit disability

Example
Screening programs
(Disease specific education)

Question 5

What are Tertiary prevention

Answer 5

Focus
restoring/rehabilitating patient

Purpose
optimize the management of a condition and minimize complications
to allow patient to return to optimal level of functioning

Example
Rehabilitative efforts to increase adherence to medication, nutrition, physical activity, and other disease management strategies

Question 6

What is Primordial prevention?

Answer 6

Focus
Seeks to avoid emergence and establishment of social, economic and cultural patterns of living that contribute to an elevated risk of disease

Purpose
Establish or maintain conditions to minimize hazards to health
Decrease a population’s risk of disease

Example
Removing lead from gasoline supply, programs aimed at reducing cost of healthy food

Question 7

What are the CDC priorities for Chronic Disease?

Answer 7

Preventing the development of chronic diseases.

Detecting chronic diseases early and slowing their progression.

Mitigating complications of chronic disease to optimize quality of life and to reduce demand on the health care system.

Question 8

What is morbidity?

Answer 8

The proportion of illness in a population

Question 9

What is Mortality?

Answer 9

The incidence of deaths in a population.

Question 10

Which nursing intervention exemplifies the nurse working in a health promotion role?
Select all that apply.

Administering an ordered antibiotic

Reinforcing desirable changes to the client’s lifestyle

Administering vaccines to a well child

Administering an inhaler to an asthmatic client

Obtaining a blood glucose sample on a hypoglycemic client

Answer 10

Reinforcing desirable changes to the client’s lifestyle

Question 11

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.

“An individual can have a disease and not feel ill.”

“Illness is synonymous with disease.”

“Illness is an alteration in body function, where disease is highly subjective.”

“An individual can feel ill without disease.”

“Illness and disease are never related to one another.”

Answer 11

“An individual can have a disease and not feel ill.”

Question 12

Illness behaviors

Answer 12

Any actions or reactions of an individual who feels unwell for the purpose of defining their state of health and obtaining physical or emotional relief from perceived or actual illness
Self-care behavior
Healthcare utilization behavior

Question 13

What are the eight dimensions of wellness?

Answer 13

environmental, emotional, financial, intellectual, physical, occupational, spiritual, social

Question 14

What is health promotion?

Answer 14

Activities with the goal of developing human attitudes and behaviors that maintain or enhance well-being which enable individuals, families, communities and systems to increase their control over and improve their health. (Stanhope & Lancaster, 2012, p. 380).*

Question 15

What is health literacy?

Answer 15

“…any combination of learning experiences designed to help individuals, families, communities or systems improve their health, by increasing their knowledge or influencing their attitudes.”
—World Health Organization, 2015

“…[the] process of helping people learn health-related behaviors so that they can incorporate these behaviors into everyday life.”
—Giddens, 2017

Question 16

Which of the following is the strongest predictors of an individual’s health status?

Age
Income
Health literacy skills
Education level
Racial or ethnic group

Answer 16

Health literacy skills

Question 17

Approximately what percentage of Americans have a literacy level at or below 8th grade?

10 percent
25 percent
37.5 percent
50 percent

Answer 17

50 percent

Question 18

What are high risk groups regarding health literacy?

Answer 18

Elderly, people with limited education, ethnic minorities, recent immigrants, low income

Question 19

What are the cost of Low Health Literacy?

Answer 19

more medication errors 
excess hospitalizations 
longer hospital stays 
more E.D. visits 
generally higher level of illness 

Results in an excess cost of $106-238 billion per year to the US healthcare system

Question 20

When assessing social history, add questions about literacy skills in a sensitive manner:

Answer 20

“How happy are you with the way you read?”
“What do you like to read?”
Most newspapers are at the 10th grade level
Many news magazines are at the 12th grade level

Question 21

Teaching and Learning

Answer 21

Teaching
A system of activities designed to produce learning

Learning
A change in human disposition or capability that persists and that cannot be solely accounted for by growth
Represented by a change in behavior

Question 22

Characteristics of effective teaching

Answer 22

Is planned
Involves learner in process
Creates partnership
Sets realistic goals & outcomes
Directed at helping learner meet objectives
Supports learner with feedback
Accurate and current

Question 23

What are the learning domains?

Answer 23

Cognitive domain - Written material, lecture, discussion

Psychomotor domain - Demonstration, interaction

Affective domain - Motivational interviewing

Question 24

Adults are interested in learning if they can apply the information immediately.
This is what kind of concept?

Pedagogical = the teaching of children and adolescents.

Adherence = this is just some filler text so the line spacing works out

Geragogic = the teaching of the elderly client.

Andragogic = art and science of teaching adults.

Answer 24

Andragogic = art and science of teaching adults.

Question 25

The nurse is preparing to teach an adult client to self-administer insulin at home. The nurse recognizes that this type of skill is representative of which domain of learning? Sensorimotor = This is of Piaget’s stages of cognitive development Psychomotor = includes the motor skills of learning Cognitive = incorporates six intellectual abilities and thinking processes Affective = divided into categories that specify the degree of a “person's depth of emotional response

Answer 25

Psychomotor = includes the motor skills of learning

Question 26

Is determined by what teaching methods to use. | Is influenced by learning the domain used to achieve the outcome.

Answer 26

Planning

Question 27

Is influenced by the condition of the patient and competing priorities for the nurse.

Answer 27

Implementation

Question 28

Learning outcomes are consistent with the learning domain.

Answer 28

Evaluation

Question 29

Includes information taught and the patient's motivation, ability to learn, developmental level, and resources.

Answer 29

Documentation

Question 30

What inhibits learning?

Answer 30

Emotions, Cultural aspects, physiological events, and psychomotor ability

Question 31

The nurse is caring for a client who has been diagnosed with diabetes mellitus. The client must learn how to independently perform finger stick blood sugar analysis as part of the plan of care. The client says, "I already know what you are attempting to teach because I looked everything up on the internet." Which is the best action by the nurse based on the client’s statement? Document that the client understands teaching. Teach the client's support system how to perform the procedure. Give the client printed learning materials. Watch the client perform a return demonstration of the skill.

Answer 31

Watch the client perform a return demonstration of the skill.

Question 32

The nurse is planning discharge teaching to a client with a diabetic wound. Which is the priority action for the nurse prior to initiating teaching with this client? Asking the client to state what is known about the current dressing changes Teaching the client how to take blood sugars Assessing the client’s ability to self-administer insulin Determining the client’s reaction to being a diabetic

Answer 32

Assessing the client’s ability to self-administer insulin Determining the client’s reaction to being a diabetic

Question 33

A diabetic client asks the nurse why the nurse is teaching about dietary carbohydrates, not a dietician. What is the most appropriate response by the nurse? a "Teaching is something I enjoy doing." b "Teaching helps you realize that you need the nurse." c "If you prefer a dietician that is fine." d "One of the major roles of the nurse is to teach."

Answer 33

d "One of the major roles of the nurse is to teach."

Question 34

Words that cause misunderstanding

Answer 34

Medical words Words frequently used by health care providers and in health care instructions Concept words Words used to describe an idea, metaphor, or notion Category words Words that describe a group or sub-set, and may be unfamiliar Value judgment words

Question 35

Value Judgment Words

Answer 35

``` Adequate Enough Adjust Fine-tune; change Cautiously With care; slowly Excessive Too much Increase Add to Moderately Not too much Progressive Gets worse (or better) Routinely Often Significantly Enough to make a difference Temporary For a limited time; for about (an hour, day...) ```

Question 36

The client with heart disease may need to know the effects of smoking before recognizing the need to quit smoking. In this situation, what factor can best facilitate client learning? a Active involvement b Readiness c Allotted time d Motivation

Answer 36

d

Question 37

The ________________ domain, known as the "feeling" domain, is divided into categories that specify the degree of a "person's depth of emotional response to tasks

Answer 37

affective

Question 38

The ________________ or "thinking" domain incorporates five intellectual abilities and thinking processes, including knowing, comprehending, applying to analysis, synthesis, and evaluation.

Answer 38

cognitive

Question 39

____________________ is a phase of cognitive development in a theory developed by Piaget, which occurs from the age of 0 to 2 years.

Answer 39

Sensorimotor

Question 40

Prior to teaching a client on self-care of a colostomy, the nurse assesses the client's readiness to learn by evaluating: a The client's recognition of a need to learn and belief that learning will lead to self-care ability. b The client's knowledge and previous experience with colostomies c The client's pain and comfort levels, as well as the client's willingness to learn d The client's cognitive and sensory abilities

Answer 40

c

Question 41

Which is one responsibility of the nurse in providing client education? a Inform clients of reputable Internet sites for health care information. b Insist that all clients use the Internet for medical information. c Tell clients that if they do not know how to use the Internet, they should take a course. d Tell clients that the Internet is not useful in providing medical advice.

Answer 41

a

Question 42

Which client behavior may cause a nurse to suspect a literacy problem? a The client reads the instructions slowly. b The client displays a pattern of compliance. c The client displays a pattern of making excuses for not reading the instructions. d The client recognizes that he does not know the information.

Answer 42

c

Question 43

Which nursing diagnosis is not an example of learning needs as evidenced by the client's primary concern or problem? a Deficient knowledge b Anxiety related to knowledge deficit c Health-seeking behavior d Noncompliance

Answer 43

b

Question 44

Which guideline in organizing learning experiences is most appropriate when teaching clients about self-catheterization? a While explaining the procedure, demonstrate how the procedure is performed. b Teach the basics before any variations of self-catheterization. c Start by giving a lecture and visual presentation. d Cover all the aspects of catheterization.

Answer 44

b

Question 45

When teaching a client, the nurse will be more successful if: a There is a rapport between the client and nurse. b The nurse uses medical language. c The nurse gives written instructions. d The client has an acute problem.

Answer 45

a,c

Question 46

The nurse is giving instructions to a non-English speaking client who does not have an interpreter. An alternative is to: a Tell the client not to use cultural healing practices. b Respect the misinterpretation of the client. c Give written instructions in English and tell the client to have them interpreted at home. d Obtain pamphlets, teaching materials, and instructions in the language of the client.

Answer 46

d

Question 47

A nurse who is evaluating the learner for behavior changes knows that: a New behavior may emerge gradually. b New behavior should replace the old behavior immediately. c Modification is what the client knows. d Evaluation can only occur via direct observation.

Answer 47

a

Question 48

The nurse demonstrates that a client has understood teaching about a disease process by documenting: a That the teaching was done b The responses of the client c A family member's opinion d That feedback questionnaires were used

Answer 48

b

Question 49

The nurse understands that anticipatory guidance may be used at any time during the client's lifetime. Anticipatory guidance does not include: a Prenatal visits b Lab tests to diagnose disease c Health fairs d Well-child visits

Answer 49

b

Question 50

During orientation, a graduate nurse experiences times when actual practice seems to conflict with what was taught in school. The nurse would look to which career development tool for resolution? a A coach b Other nurses at different hospitals c The assigned preceptor d A mentor

Answer 50

c

Question 51

A​ 64-year-old male client is admitted for treatment of dehydration and diagnosed with diabetes. While the nurse is teaching the client about the signs and symptoms of​ hypoglycemia, the​ client's wife​ states, "While you two are​ talking, I'm going to get some​ coffee." Which nursing action best reflects application of the adult learning​ theory? a Explaining to the​ client's wife that she may be the first to recognize the signs and symptoms of her​ husband's hypoglycemia, which may help him get treatment sooner b Considering the​ wife's lack of interest in the teaching from the standpoint of​ biologic, psychologic,​ cultural, social, and spiritual​ perspectives; including her marital beliefs and social status c Giving the​ client's wife a cup of coffee if she stays for the teaching d Recognizing that the​ client's wife has personal​ characteristics, such as impatience and appreciation for​ coffee, that influence her perception of the​ nurse's teaching

Answer 51

a

Question 52

The nurse is teaching a​ 7-year-old client about hand washing. The client is resistant to washing her hands after playing with her pet hamster. Which teaching strategy reflects the​ nurse's application of the behaviorist theory of​ learning? a Giving the client a healthy treat each time she washes her hands after playing with her pet hamster b Explaining to the client how the benefits of handwashing apply to her c Recognizing that the client has personal​ characteristics, such as shyness and love of​ animals, that influence her perception of the​ nurse's teaching d Asessing the​ client's aversion to handwashing through viewing her from​ biologic, psychologic,​ cultural, social, and spiritual​ standpoints, including her health status and psychologic state

Answer 52

a

Question 53

Which factors influence the​ nurse's choice of educational content and have the most impact on required documentation of educational​ sessions? a Federal regulations b ​Client-specific characteristics c Widespread availability of Internet resources d Advances in health care and research

Answer 53

a

Question 54

Which teaching strategy best exemplifies a characteristic of effective​ teaching? a Evaluating the​ client's comprehension of the content b Minimizing​ question-answer interactions to avoid distracting the client c Avoiding​ goal-setting to prevent intimidating the client d Using one teaching method for the client

Answer 54

a

Question 55

Which learning theory proposes that positively or negatively reinforcing an​ individual's response to a stimulus produces​ learning? a Adult learning theory b Cognitive theory c Humanist theory d Behaviorist theory

Answer 55

d

Question 56

The nurse is developing a teaching plan for clients with hypertension. Which statement by the nurse indicates correct understanding of the principles of effective​ teaching? a ​"To avoid​ distractions, I should ask the clients to hold their questions until​ I'm finished​ teaching, then have a​ question-and-answer session." b ​"To help keep the clients from feeling​ intimidated, I should avoid setting goals for​ them." c ​"I need to find out the ages of the clients who will be attending this​ class." d ​"I should choose one method of teaching and use that throughout this​ class."

Answer 56

c

Question 57

The nurse teaches principles of diet and nutrition at a community health center. When evaluating one​ client's comprehension of the content during the third teaching​ session, the client​ states, "My friend says I​ don't know anything about what foods are good for me. I feel like​ I've learned a lot about​ nutrition, though. ​ I've started eating​ healthier, and I already lost two​ pounds." Which nursing response best reflects application of humanist learning​ theory? a Perhaps we should explore how knowledge of diet and nutrition applies to you. b Because of individual​ differences, your perception of the teaching material will be different from your​ friend's perception of the content. c Your opinion of how much​ you've learned is more important than is your​ friend's opinion. d Perhaps we should try a different way of teaching this material to you to help you better understand.

Answer 57

c

Question 58

The nurse is planning a teaching session on diet and nutrition for a group of teenage mothers who are students at a local high school. When planning the​ teaching, which​ client-specific factors should the nurse seek to​ learn? a Age b Level of education c Cultural background d Gender

Answer 58

c

Question 59

The nurse at a college health center is discharging a​ 19-year-old female client following her annual sports physical and gynecological exam. As the nurse is completing the​ client's discharge​ teaching, the client​ states, "I read online that you​ can't get pregnant while​ you're on your​ period." Which information should the nurse include in her​ response? ​(Select all that​ apply.) a ​"That's foolishness. Of course you can get pregnant while​ you're on your​ period." b ​"I'm glad you brought this up. A lot of people believe that you​ can't get pregnant while​ you're on your​ period, but you​ can." c ​"Tell me more about your understanding of the times when a woman is most likely to get​ pregnant." d ​"Don't believe what you read on the Internet. Almost all online information is​ incorrect." e ​"Most of what​ you'll find on the Internet is​ accurate, but that is not. Where did you read that you​ couldn't get pregnant while you were on your​ period?"

Answer 59

b,c

Question 60

A 73-year-old female Native American client is hospitalized with an exacerbation of chronic obstructive pulmonary disease​ (COPD). The​ client, who has a 55​ pack-year history, reports that she still smokes cigarettes. She also reports that she smokes tobacco during certain important religious rituals and tribal celebrations. Which nursing interventions best reflect the​ nurse's application of HUMANIST theory of​ learning? ​(Select all that​ apply.) a Exploring how the​ client's cultural background influences her decision to continue to smoke b Encouraging the​ client's family members and loved ones to praise the client for not smoking c Recognizing that the client has personal​ characteristics, such as stoicism and mistrust for traditional​ medicine, that may influence her perception of the​ nurse's teaching d Explaining to the client how smoking cessation at this stage of life still promotes lung​ healing, and can lead to fewer exacerbations of COPD and improved quality of life e Considering the​ client's tobacco use from the standpoint of her religious beliefs

Answer 60

a,e

Question 61

What is the Primary level of prevention Intervention Education domain Impediments of type 2 diabetes?

Answer 61

Level of prevention Preventing diabetes from occurring Intervention - Lose weight and increase their physical activity Education domain - Cognitive, psychomotor, and affective Impediments - Weight loss is hard

Question 62

What is the Secondary level of prevention Intervention Education domain Impediments of type 2 diabetes?

Answer 62

Level of prevention Increase the probability of diagnosis/prevent complications Intervention - Screen high risk individuals/optimize glycemic control Education domain - Cognitive, psychomotor, and affective Impediments - Needle sticks hurt

Question 63

What is the Tertiary level of prevention Intervention Education domain Impediments of type 2 diabetes?

Answer 63

Level of prevention Limit disability and promote rehabilitation Intervention - Early detection and prevention of diabetic complications Education domain - Cognitive, psychomotor, and affective Impediments - I don't like taking my shoes off

Question 64

Health Equity

Answer 64

When all people have “the opportunity to ‘attain their full health potential’ and no one is ‘disadvantaged from achieving this potential because of their social position or other socially determined circumstance'”[5].

Question 65

Health Inequality

Answer 65

Differences, variations, and disparities in the health achievements of individuals and groups of people [6].

Question 66

Health Inequity

Answer 66

A difference or disparity in health outcomes that is systematic, avoidable, and unjust [5, 7].

Question 67

Health Literacy

Answer 67

Whether a person can obtain, process, and understand basic health information and services that are needed to make suitable health decisions. Health literacy includes the ability to understand instructions on prescription drug bottles, appointment cards, medical education brochures, doctor’s directions, and consent forms. It also includes the ability to navigate complex health care systems. Health literacy is not simply the ability to read. It requires a complex group of reading, listening, analytical, and decision-making skills and the ability to apply these skills to health situations [8].

Question 68

Index of disparity

Answer 68

A regression-based measure that is used by scientists and retains the inherent order of categories like education or income but incorporates the population weights of the categories. The size of each category is taken into account by placing the groups on an axis that reflects the cumulative proportion of the population represented by the ordered groups. The index of disparity can be absolute (slope referred to as Slope Index of Inequality) or relative (slope referred to as Relative Index of Inequality) [1].

Question 69

Health

Answer 69

A state of complete physical, mental, and social well-being and not just the absence of sickness or frailty [3].

Question 70

Health Disparity

Answer 70

A type of difference in health that is closely linked with social or economic disadvantage. Health disparities negatively affect groups of people who have systematically experienced greater social or economic obstacles to health. These obstacles stem from characteristics historically linked to discrimination or exclusion such as race or ethnicity, religion, socioeconomic status, gender, mental health, sexual orientation, or geographic location. Other characteristics include cognitive, sensory, or physical disability [4].

Question 71

Determinants of Health

Answer 71

Factors that contribute to a person’s current state of health. These factors may be biological, socioeconomic, psychosocial, behavioral, or social in nature. Scientists generally recognize five determinants of health of a population: Biology and genetics. Examples: sex and age Individual behavior. Examples: alcohol use, injection drug use (needles), unprotected sex, and smoking Social environment. Examples: discrimination, income, and gender Physical environment. Examples: where a person lives and crowding conditions Health services. Examples: Access to quality health care and having or not having health insurance [3,4].

Question 72

Wish

Answer 72

Wisconsin interactive statistics health

Question 73

Three main causes of morbidity/mortality for prenatal?

Answer 73

Congenital Abnormalities Short Gestation Maternal Pregnancy Complications

Question 74

Three main causes of morbidity/mortality for Perinatal/Neonatal?

Answer 74

Congenital abnormalities Short gestation Maternal pregnancy complications

Question 75

Three main causes of morbidity/mortality for Infant?

Answer 75

Congenital abnormalities Low birth weight Maternal complications

Question 76

Three main causes of morbidity/mortality for Toddler and Preschool?

Answer 76

1. Unintentional injury 2. Congenital Abnormalities 3. Malignant Neoplasms

Question 77

Three main causes of morbidity/mortality for School age?

Answer 77

Unintentional injuries Malignant neoplasms Congenital anomalies

Question 78

Three main causes of morbidity/mortality for Adolescent?

Answer 78

Unintentional Injury Suicide Homicide

Question 79

Three main causes of morbidity/mortality for Young Adult?

Answer 79

1. Unintentional injury 2. Suicide 3. Homicide

Question 80

Three main causes of morbidity/mortality for Middle Adult?

Answer 80

Malignant Neoplasm Heart Disease Unintentional Injury

Question 81

Three main causes of morbidity/mortality for Older Adult?

Answer 81

Heart disease,Malignant Neoplasms, Chronic low respiratory disease

Question 82

What are health determinants?

Answer 82

"Factors that contribute to a person’s current state of health. These factors may be biological, socioeconomic, psychosocial, behavioral, or social in nature.”

Question 83

Biological/Genetic determinants of health?

Answer 83

``` Age Biological Sex Inherited conditions (e.g. sickle cell) Genetic vulnerability (e.g. BRCA) Family history of heart disease HIV status ```

Question 84

Socioeconomic determinants of health?

Answer 84

``` (Un)employment Food (in)security Housing (in)stability Wealth/Poverty Individual Concentrated/societal Social status ```

Question 85

Psychosocial determinants fo health?

Answer 85

Stressful living circumstances Stressful relationships (Lack of) social supports (Lack of) coping styles

Question 86

Behavioral determinants of health?

Answer 86

Diet Physical activity Alcohol, tobacco, drug use

Question 87

Social determinants of health?

Answer 87

``` Social norms and attitudes (e.g. discrimination) Exposure to crime, violence, Exposure to social disorder (e.g. trash, vacant lots) Messaging from to mass media School quality Transportation options Public safety Residential segregation ```