Test Bank For Health Promotion Throughout the Life Span 8th Edition Edelman

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Health Promotion Throughout the Life Span 8th Edition Edelman

Chapter 01: Health Defined: Objectives for Promotion and Prevention

Edelman: Health Promotion Throughout the Life Span, 8th Edition

 

MULTIPLE CHOICE

 

  1. Which model of health is most likely used by a person who does not believe in preventive health care?
a. Clinical model
b. Role performance model
c. Adaptive model
d. Eudaimonistic model

 

 

ANS:  A

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.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 3

 

  1. 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?
a. Clinical model
b. Role performance model
c. Adaptive model
d. Eudaimonistic model

 

 

ANS:  D

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.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 3

 

  1. 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:
a. growth and development.
b. health.
c. functioning.
d. high-level wellness.

 

 

ANS:  B

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.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 5

 

  1. Which of the following best describes a client who has an illness?
a. Someone who has well-controlled diabetes
b. Someone with hypercholesterolemia
c. Someone with a headache
d. Someone with coronary artery disease without angina

 

 

ANS:  C

Someone with a headache represents a person with an illness. An illness is made up of the subjective experience of the individual and the physical manifestation of disease. It can be described as a response characterized by a mismatch between a person’s needs and the resources available to meet those needs. A person can have a disease without feeling ill. The other choices represent disease.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 6

 

  1. Which US report is considered a landmark document in creating a global approach to health?
a. The 1990 Health Objectives for the Nation: A Midcourse Review
b. Healthy People 2020
c. Healthy People 2000
d. The U.S. Surgeon General Report

 

 

ANS:  C

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.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 6

 

  1. Which of the following represents a method of primary prevention?
a. Informational session about healthy lifestyles
b. Blood pressure screening
c. Interventional cardiac catheterization
d. Diagnostic cardiac catheterization

 

 

ANS:  A

Primary prevention precedes disease or dysfunction. It includes health promotion and specific protection and encourages increased awareness; thus, education about healthy lifestyles fits this definition. Blood pressure screening does not prevent disease, but instead identifies it.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 11

 

  1. Which of the following represents a method of secondary prevention?
a. Self–breast examination education
b. Yearly mammograms
c. Chemotherapy for advanced breast cancer
d. Complete mastectomy for breast cancer

 

 

ANS:  B

Screening is secondary prevention because the principal goal of screenings is to identify individuals in an early, detectable stage of the disease process. A mammogram is a screening tool for breast cancer and thus is considered a method of secondary prevention.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 15

 

  1. Which of the following represents a method of tertiary prevention?
a. Drunk driving campaign
b. Road blocks for drunk driving
c. Emergency surgery for head trauma after a motor vehicle accident
d. Physical and occupational therapy after a motor vehicle accident with head trauma

 

 

ANS:  D

Physical therapy and occupational therapy are considered tertiary prevention. Tertiary prevention occurs when a defect or disability is permanent and irreversible. It involves minimizing the effect of disease and disability. The objective of tertiary prevention is to maximize remaining capacities.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 15

 

  1. In reviewing a person’s medical claims, a nurse realizes that the individual with moderate persistent asthma has had several emergency department visits and is not on inhaled steroids as recommended by the NHLBI asthma management guidelines. The nurse discusses this with the person’s primary care provider. In this scenario, the nurse is acting as a(n):
a. advocate.
b. care manager.
c. consultant.
d. educator.

 

 

ANS:  B

Care managers act to prevent duplication of service and reduce cost. Care managers base recommendation on reliable data sources such as evidence-based practices and protocols.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 15

 

  1. During a home visit, a nurse assists an individual to complete an application for disability services. The nurse is acting as a(n):
a. advocate.
b. care manager.
c. consultant.
d. educator.

 

 

ANS:  A

The advocacy role of the nurse helps individuals obtain what they are entitled to receive from the health care system, tries to make the system more responsive to individuals’ community needs, and assists individuals in developing skills to advocate for themselves.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 15

 

  1. During a home visit, a nurse discusses the dangers of smoking with an individual. In this scenario the nurse is acting as a(n):
a. advocate.
b. care manager.
c. consultant.
d. educator.

 

 

ANS:  D

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.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 16

 

  1. 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):
a. advocate.
b. care manager.
c. consultant.
d. educator.

 

 

ANS:  C

Nurses with a specialized area of expertise provide education about health promotion and disease prevention to individuals and groups as consultants.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 16

 

  1. 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?
a. Assess the motivation level of the individuals
b. Assess the knowledge level of the individuals
c. Establish teacher-learner goals with the individuals
d. Establish multiple teaching sessions with the individuals

 

 

ANS:  B

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.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 16

 

  1. The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individuals is known as:
a. health-related quality of life.
b. evidence-based practice.
c. a Healthy People 2010 goal.
d. the ecological model of health.

 

 

ANS:  B

Evidence-based practice is defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individuals.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 16

 

  1. Which research methodology should be used to address the question, “What is the difference in the infection rates between individuals who receive twice-a-day dressing changes versus once-a-day dressing changes?”
a. Evidence-based practice research
b. Qualitative research
c. Quantitative research
d. Clinical judgment research

 

 

ANS:  C

Quantitative research studies describe situations, correlate different variables related to care, or test causal relationships among variables related to care. Evidence-based practice research and clinical judgment research are not research methodologies; they are used to answer clinical questions.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 16

 

  1. The question, “What is the experience of teenagers who lose a sibling to cancer?” can best be answered by using which research methodology?
a. Evidence-based practice research
b. Qualitative research
c. Quantitative research
d. Clinical judgment research

 

 

ANS:  B

Qualitative research studies describe phenomena or define the historical nature, cultural relevance, or philosophical basis of aspects of nursing care. Evidence-based practice research and clinical judgment research are not research methodologies; they are used to answer clinical questions.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 16

 

  1. A nurse who uses findings from a randomized, controlled trial on the care of Foley catheters to change practice at an institution is practicing:
a. evidence-based medicine.
b. qualitative research.
c. quantitative research.
d. clinical judgment.

 

 

ANS:  A

The practice of evidence-based medicine means integrating individual clinical expertise with the best available external clinical evidence from systematic research.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 16

 

  1. Which of the following is most influenced by the social and economic environment of a community?
a. Social health policies
b. Quality of care
c. Evidence-based practice
d. Practice guidelines

 

 

ANS:  A

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.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 17

 

  1. A major cause of death in the early twentieth century was:
a. cancer.
b. cerebrovascular disease.
c. heart disease.
d. infections.

 

 

ANS:  D

Infections and acute disease were the major causes of death in the early part of the twentieth century.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 17

 

  1. A mainstay of therapy for the management of chronic diseases is:
a. lifestyle changes.
b. occupational and physical therapy.
c. medications.
d. surgery.

 

 

ANS:  A

The application of complex technology is not only costly but contributes minimally to improvement of health. One needs to focus on the cause of disease. The needs of a person with chronic disease are related to and affected by the individual’s biochemical functioning, genetics, environment, and personal choices.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 17

 

  1. Which of the following demonstrates a nurse taking action to promote health and prevent disease?
a. Making a home visit to a person who is recovering from a heart attack
b. Administering medications to a cardiac client in the hospital
c. Providing cardiopulmonary resuscitation during a heart attack
d. Educating a person about the advantages of a heart-healthy diet during a home visit

 

 

ANS:  D

Solutions for health promotion are focused on individual and government involvement. To promote health and wellness, an emphasis must be placed on primary prevention. This is often related to actions such as education that influence lifestyle choices. In the preceding example, educating a person about the advantages of a heart-healthy diet during a home visit serves to influence lifestyle choices.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 17

 

  1. Which factor may have the most influence in changing the health behavior of a single, adult woman who smokes and is the care provider for her mother, her own children, and granddaughter?
a. Education regarding effects of smoking on her health
b. The satisfaction that she will not contribute to secondhand smoke
c. The availability of a weekly support group
d. A gift card for $10 to a local grocery store for every week she is smoke free

 

 

ANS:  D

Motivational factors play a role in influencing attitudinal changes. A financial incentive is an example of a motivating factor. For this woman, who is financially responsible for the health and well-being of other individuals, finances will likely play a significant role in motivating her actions. Remember that education regarding the benefits of not smoking is not enough. Thus, the $10 gift card may have the most influence in changing her health behavior.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 14 (Box 1-6) | p. 18

 

  1. An example of a Hispanic American nurse promoting cultural competency is:
a. providing translation services for all Hispanic Americans.
b. focusing on episodic care of illnesses with Hispanic Americans.
c. taking a class about the Hispanic American culture.
d. providing care for all Hispanic American persons in her clinic.

 

 

ANS:  C

Nurses must be aware of their beliefs, values, and customs. They should not assume that their perspective is correct and shared by others. Additionally, they should avoid stereotyping. Broadening one’s educational base regarding cultural beliefs is a way to develop and thus promote cultural competency.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 17 (Box 1-2)

 

  1. The devaluing of beliefs, values, and customs of others is known as:
a. ethnocentrism.
b. racism.
c. cultural competency.
d. empathy.

 

 

ANS:  B

Racism is defined as the devaluing of beliefs, values, and customs of others.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 7 (Box 1-2)

 

  1. Building a partnership with an obese individual who is trying to lose weight requires the nurse to:
a. schedule a day to exercise with the individual.
b. go grocery shopping for the individual.
c. learn about the methods of weight loss.
d. give the individual a weight loss goal.

 

 

ANS:  C

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.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 8 (Box 1-3)

 

  1. Assuming that an individual’s own perspective is correct and shared by others is known as:
a. ethnocentrism.
b. racism.
c. cultural competency.
d. empathy.

 

 

ANS:  A

Assuming that an individual’s own perspective is correct and shared by others is known as ethnocentrism.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 8 (Box 1-2)

 

MULTIPLE RESPONSE

 

  1. Which of the following “investment” themes has been identified by the National Institute of Nursing Research? (select all that apply)
a. Interprofessional collaboration
b. Improving quality of life
c. End-of-life care
d. Increasing physical activity among Americans

 

 

ANS:  B, C

The National Institute of Nursing Research has identified five themes that promote health and prevent disease, improve quality of life through symptom management, and support palliative and end-of-life care, innovation, and nurse scientists.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 16

 

  1. Which interventions address both the National Institute of Nursing Research themes and the overall goals of the Healthy People 2020 leading health indicators? (select all that apply)
a. Establishing a new park with a well-lit track
b. Establishing a smoking cessation campaign
c. Providing reduced-cost transportation passes to senior citizens
d. Providing free condoms at all federally funded health clinics

 

 

ANS:  A, B, D

Establishing a new park with a well-lit track, establishing a smoking cessation campaign, and providing free condoms at all federally funded health clinics all address the National Institute of Nursing Research themes and the Healthy People 2020 leading health indicators. A park, smoking cessation campaign, and free condoms address the themes of promoting health and preventing disease and the goal of increasing quality and years of healthy life. Providing reduced-cost transportation passes to senior citizens may indirectly affect the health of this population; however, it is not directly related to the themes of the National Institute of Research (promote health and prevent disease, improve quality of life through symptom management, and support palliative and end-of-life care, innovation, and nurse scientists) or the overall goals of Healthy People 2020 (increase quality and years of healthy life and eliminate health disparities).

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 7 | p. 16

 

 

Chapter 03: Health Policy and the Delivery System

Edelman: Health Promotion Throughout the Life Span, 8th Edition

 

MULTIPLE CHOICE

 

  1. Which addition to a community best demonstrates the concept of the Healthy People 2020 report?
a. New cardiothoracic intensive care unit at a major hospital
b. New rehabilitation center
c. New recreational health center
d. New children’s hospital

 

 

ANS:  C

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.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 47 | p. 47 (Box 3-1)

 

  1. Which nurse is at risk of making a medical error?
a. Working overtime
b. Works in a hospital that advocates multidisciplinary care
c. Caring for four clients during the shift
d. Attends regular continuing education programs

 

 

ANS:  A

Health care systems are the basic cause of medical errors. Organizational and workforce management, work design, and organizational culture are problem areas that contribute to medical errors. Poor management leads to increased nurse turnover, the need for increased client-to-nurse ratios, increased need for overtime, and decreased number of nurses, all of which can lead to medical errors. A nurse working overtime is at risk of making a medical error.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 50

 

  1. What is the most effective policy a staff nurse can implement to help decrease medical errors on the unit?
a. Forgo opportunities for continuing education so the unit is never understaffed.
b. Foster a collaborative working environment on the unit.
c. Check all medications a minimum of three times before administering them.
d. Develop a policy that mandates the firing of any nurse who commits an error.

 

 

ANS:  B

Health care systems are the basic cause of medical errors. Organizational and workforce management, work design, and organizational culture are problem areas that contribute to medical errors. Creating a collaborative working environment helps improve organizational culture, thereby reducing the chance of medical errors.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 50

 

  1. The person known as the father of British and American public health is:
a. Lillian Wald.
b. Edwin Chadwick.
c. Lemuel Shattuck.
d. Paul Ehrlich.

 

 

ANS:  B

Edwin Chadwick is known as the father of British and American public health.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 51

 

  1. A community health nurse most effectively preserves the health of a person with tuberculosis (TB) and the community by:
a. administering and reading the purified protein derivative (PPD) of all close contacts
b. providing direct observed therapy (DOT) for the individual with TB
c. isolating the person because it is likely drug resistant
d. telling the person to wear a mask when leaving the home

 

 

ANS:  B

Community health nursing practice promotes, preserves, and maintains the health of populations and the effect of their health status on that of the community as a whole through care provided to individuals, families, and groups. Thus, the most effective strategy of treating the individual and preventing the spread of TB is to provide DOT.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 52

 

  1. A community planning committee is working on the development of a community nursing center. Which of the following essential components should be included in this center?
a. Physician as medical director
b. Interdisciplinary staff
c. Nurse as chief manager
d. Partnership with an academic institution

 

 

ANS:  C

The essential components of a community nursing center include a nurse as chief manager, a nursing staff that is accountable and responsible for care and professional practice, and nurses as the primary providers of care.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 54

 

  1. Considering the provider and client perspective, which of the following is the most autonomous form of insurance?
a. Fee-for-service plan
b. Health maintenance organization (HMO)
c. Preferred provider organization (PPO)
d. Independent practice association (IPA)

 

 

ANS:  A

In the fee-for-service plan, a provider provides a service and bills the individual’s insurance company. The individual is also allowed to choose his or her provider.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 55

 

  1. Which could result in a change in a nurse practitioner’s practice?
a. Holding a master’s degree or higher
b. Moving to another state when she gets married
c. Caring for Medicare clients
d. Changing to another office within the same practice

 

 

ANS:  B

Nurse practitioners generally hold master’s degrees or higher. The nurse practice act within their states may be more comprehensive than the institutions for which they work. Legislation exists for reimbursement of nurse practitioners by Medicare. However, practice acts and prescriptive authority vary from state to state and thus influence practice patterns.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 55 | p. 70

 

  1. Which health care provider represents a primary care provider?
a. Psychiatric advanced practice nurse
b. Clinical nurse specialist
c. Pediatric nurse practitioner
d. Acute care nurse practitioner

 

 

ANS:  C

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.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 55 | p. 56 (Box 3-5)

 

  1. Which form of managed care restricts providers to caring for individuals who are members of their organization?
a. Fee-for-service plan
b. Health maintenance organization (HMO)
c. Preferred provider organization (PPO)
d. Independent practice association (IPA)

 

 

ANS:  B

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.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 55

 

  1. 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?
a. The individual must see a primary care provider before being referred to a specialist.
b. The focus of care is prevention and management of individuals with chronic disease.
c. The individual has paid a membership fee to be part of this organization.
d. The focus of care is to conserve money in a health savings account.

 

 

ANS:  B

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.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   pp. 56-57

 

  1. An individual states that his family has insurance, but that paying for routine medical costs is very expensive because most routine services are paid for out of pocket. Which type of insurance plan does this individual most likely have?
a. High deductible health insurance plan (HDHP)
b. Point-of-service plan (POS)
c. Health maintenance organization (HMO)
d. Preferred provider organization (PPO)

 

 

ANS:  A

High deductible health insurance plans (HDHPs) are structured in a way similar to traditional managed care plans and fee-for-service plans but have a very high annual out-of-pocket deductible. Thus, a family with this type of insurance will pay out-of-pocket until they reach the deductible, which may make receiving health services expensive for them. Point-of-service plans allow members, for an additional fee and higher copayment, to use providers outside of the HMO network. Health maintenance organizations (HMOs) deliver comprehensive health maintenance and treatment services for a group of enrolled individuals who prepay a fixed fee. Preferred provider organizations (PPOs) have a preselected list of providers who have agreed to provide health services for those enrolled in the plan.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 58

 

  1. 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?
a. Health maintenance organization (HMO)
b. Health savings account (HSA)
c. Preferred provider organization (PPO)
d. Independent practice association (IPA)

 

 

ANS:  C

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).

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 58 | p. 56 (Box 3-5)

 

  1. Two working adults do not have access to health insurance for their family from their employers and do not meet the financial criteria for Medicaid. For which of the following federal programs may the children in this family be eligible?
a. Medicare
b. Civilian Health Medical Program for Uniformed Services (CHAMPUS)
c. State Children’s Health Insurance Program (SCHIP)
d. Veteran’s Administration Program

 

 

ANS:  C

The State Children’s Health Insurance Program is a public state insurance program established to provide insurance to uninsured children whose family is typically described as the working poor and do not meet Medicaid requirements. In this case, both parents work but do not have access to insurance through their employers. Additionally, they do not meet the financial Medicaid requirement.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 60

 

  1. A nurse complies with the Patient Self-Determination Act when asking:
a. a person upon admission to the hospital if he or she has an advanced directive
b. the family in the recovery room if the client has an advanced directive
c. a person before discharge from the hospital if he or she has an advance directive
d. the family about an advanced directive after the person has been intubated

 

 

ANS:  A

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.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 64

 

  1. A nurse discussing the care of a person on the surgical unit following gastric bypass surgery with a friend is in violation of the:
a. Patient Self-Determination Act
b. Health Insurance Portability and Accountability Act of 1996
c. Americans with Disabilities Act
d. Civil Rights Act

 

 

ANS:  B

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal privacy standard that requires safeguards to protect the security and confidentiality of health information. Disclosures without individual authorization are allowed only to public health authorities authorized by law to collect and receive information for the purpose of preventing or controlling disease, injury, or disability.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 64

 

  1. Which is a violation of the Health Insurance Portability and Accountability Act of 1996?
a. Nurse reporting a case of TB to the health department
b. Nurse reporting a case of child abuse to the Department of Human Services
c. Nurse discussing the person’s case with his or her physician
d. Nurse discussing the person’s case with his or her school nurse

 

 

ANS:  D

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal privacy standard that requires safeguards to protect the security and confidentiality of health information. Disclosures without individual authorization are allowed only to public health authorities authorized by law to collect and receive information for the purpose of preventing or controlling disease, injury, or disability. Before speaking to the school nurse, the nurse must obtain authorization from the client’s parents.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 64

 

  1. Which nurse is functioning as a care manager?
a. Nurse working with a family to coordinate care after their child experiences a second hospitalization for an asthma exacerbation
b. Nurse providing asthma education in the office setting to a child with moderate, persistent asthma
c. Nurse administering the appropriate antiinflammatory medication to a child admitted to the hospital with an asthma exacerbation
d. Nurse making a home visit for a respiratory assessment to a child following an admission for an asthma exacerbation

 

 

ANS:  A

Care managers help determine what medical care is necessary, monitor care, and arrange for individuals to receive the most cost-effective care in the most appropriate settings. They must collaborate with providers and with the client/family. Care managers are especially helpful following a client after discharge and clients with complex needs. A nurse working with a family to coordinate service after a hospitalization is a good example of services provided by a care manager.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 71

 

  1. A pregnant woman with two toddlers living at less than 135% of the federal poverty level would be eligible for:
a. Medicare Part A
b. Medicare Part B
c. Medicaid
d. State Children’s Health Insurance Program (SCHIP)

 

 

ANS:  C

State Medicaid programs must cover all pregnant women and children up to 6 years of age with a family income of less than 133% of the federal poverty level. States Children’s Health Insurance Program provides insurance coverage to children whose family income is below 200% of the federal poverty level or whose income is 50% higher than the state’s Medicaid eligibility threshold. In this case, the woman is pregnant, her children are under the age of 6, and they meet the financial criteria for Medicaid but not SCHIP.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   pp. 74-75

 

  1. Which of the following is a major factor limiting health care services in the United States?
a. Lack of nurses
b. Lack of health care facilities
c. Lack of funding
d. Lack of client interest in health promotion

 

 

ANS:  C

The lack of nurses may prevent health care providers from offering health promotional education activities. The cost of health care and prescription drugs is a major limitation to health care services. The United States has the highest proportion of population with no health insurance, thereby limiting health care services available to Americans.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    pp. 75-76

 

  1. Which person is at highest risk for being uninsured?
a. 68-year-old retired mailman
b. 48-year-old on renal dialysis
c. 2-year-old whose parents work but do not have benefits through their employers
d. 27-year-old who attends college and works part time in a small pizza parlor

 

 

ANS:  D

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.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   pp. 75-76

 

  1. Adoption of a Canadian-style health care system in the United States has the potential to:
a. decrease waiting times for tests and procedures.
b. create further health disparities.
c. increase the number of HMOs.
d. increase the amount of funding available for health care.

 

 

ANS:  B

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.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 77

 

  1. 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:
a. managed care
b. gate keeping
c. utilization review
d. capitation

 

 

ANS:  C

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.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 56 (Box 3-5)

 

  1. The country with the lowest infant mortality rate in 2011 was:
a. Canada
b. Mexico
c. Sweden
d. the United States

 

 

ANS:  C

Sweden had the lowest infant mortality in 2011 with a mortality rate of 2.74 per 1000 live births.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 48 (Table 3-1)

 

  1. The country with the highest life expectancy for women in 2011 was:
a. France
b. Germany
c. Sweden
d. the United States

 

 

ANS:  A

France was the country with the highest life expectancy for women (85 years of age) in 2011.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 48 (Table 3-1)

 

MULTIPLE RESPONSE

 

  1. A community health nurse is presenting information about the current health of the nation to a local political action group in 2011. Which of the following information would be included in this presentation? (select all that apply)
a. Funding of public health programs has improved the health of the nation.
b. Provision of health care has improved the health of the nation.
c. Advances in technology have improved the health of the nation.
d. Consumer education has improved the health of the nation.

 

 

ANS:  A, B, D

According to the 2010 Report of Health, the health of the nation has improved in many areas as a result of substantial funding of public health programs, research, provision of health care, and initiatives to support consumer education.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 42

 

  1. Which of the following statements about the financing of health care in the United States is accurate? (select all that apply)
a. Employee-sponsored health insurance premiums experienced minimal increases from 2001 to 2011.
b. State tax dollars must fund at least 50% of a state’s Medicaid cost.
c. The largest percentage of health care dollars is spent on hospital care.
d. Most workers who have an employer-sponsored health insurance plan are enrolled in preferred provider organizations (PPOs).

 

 

ANS:  C, D

In 2010, almost one third (31%) of health care dollars was spent on hospital care. The majority of employee-covered workers were enrolled in PPOs (55%). Employee-sponsored health insurance premiums rose dramatically from 2001 to 2011 by 113%. Federal dollars must fund a minimum of 50% of a state’s Medicaid cost; the state is responsible for contributing whatever percentage is not funded by the federal government.

 

DIF:    Cognitive Level: Understand (Comprehension)               REF:   p. 67

 

  1. Which of the following would be considered part of a vulnerable population? (select all that apply)
a. Deaf man
b. Cocaine-addicted teenage girl
c. Handicapped child
d. College graduate

 

 

ANS:  A, B, C

Those who are physically disabled or handicapped, substance abusers, and those with communication difficulties are considered part of the vulnerable population in the United States.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 47 (Box 3-2)

 

Chapter 11: Nutrition Counseling for Health Promotion

Edelman: Health Promotion Throughout the Life Span, 8th Edition

 

MULTIPLE CHOICE

 

  1. Which of the following statements about the current prevalence of obesity is accurate?
a. The current generation of children may be less healthy and have a shorter life expectancy than their parents.
b. The current incidence of obesity among American adults has stabilized.
c. The current statistics show that greater than 75% of American adults are either overweight or obese.
d. The current statistics report that about 50% of American children are either overweight or obese.

 

 

ANS:  A

Because of the increasing rates of obesity, unhealthy eating habits, and physical inactivity, we may see the first generation that will be less healthy and have a shorter life expectancy than their parents. The current statistics show that two in three American adults and one in three children are either overweight or obese.

 

DIF:    Cognitive Level: Understand (Comprehension)               REF:   p. 231

 

  1. A nurse is working with a family that is experiencing food insecurity. Which of the following statements best describes this family?
a. Members of this family are susceptible to food-borne illness.
b. This family’s access to adequate food is limited by lack of money.
c. This family is unable to purchase fresh fruits and vegetables.
d. Members of this family are obese.

 

 

ANS:  B

When a family experiences food insecurity it means that their access to adequate food is limited by a lack of money and other resources. Individuals and families may be more likely to be overweight or obese, potentially because the relatively lower cost of junk foods can promote overconsumption of calories.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 234

 

  1. Which of the following statements about the Dietary Reference Intakes (DRI) is correct?
a. The DRI is used to monitor deficiencies in nutritional intakes of obese populations.
b. The DRI is used to establish minimal amounts of nutrients needed to protect against nutrient deficiency.
c. The DRI is used to plan and assess diets of healthy people.
d. The DRI is used to set minimal guidelines to reduce risk of adverse outcomes from inadequate consumption of nutrients.

 

 

ANS:  C

The DRI are a set of values for the dietary nutrient intakes of healthy people in the United States and Canada. They are used for planning and assessing diets. The four sets of values included in the DRI are Recommended Daily Allowance (RDA), Adequate Intake, Estimated Average Requirement, and Tolerable Upper Intake Levels. The previous RDA, which existed before 1997, established minimal amounts of nutrients needed to protect against nutrient deficiency.

 

DIF:    Cognitive Level: Understand (Comprehension)               REF:   p. 235

 

  1. A community health nurse is using the Dietary Reference Intakes (DRIs) as a guide while developing an education presentation about nutrition for a community group. How will the use of the DRIs be helpful in developing this presentation?
a. It considers the unique differences among children, pregnant women, and elderly people.
b. It contains well-researched data that are reviewed on an annual basis.
c. It is prescriptive in the amount of nutrients that are needed on a daily basis.
d. It serves as an overall guideline for the population.

 

 

ANS:  D

Dietary Reference Intakes may be used for individuals; however, ideally they are guidelines for population groups and apply over time. It is the trend that matters not the amount on a certain day. The DRIs are created even when limited data are available as this is deemed better than no guidance at all. The DRIs are only updated when deemed necessary. There are limited data relating to genetic diversity in the population or specific groups such as children, pregnant women, and elderly people.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 235

 

  1. After the 2010 Dietary Guidelines were released, a community health nurse updated a nutrition presentation that was being used to educate various community groups about healthy eating habits. Which of the following information would have been added to the presentation?
a. Consumption of increased amounts of carbohydrates
b. Impact of the environment on the public’s food, drink, and activity choices
c. Revised guidelines for the use of MyPyramid
d. Inclusion of physical activity standards

 

 

ANS:  B

For the first time, the 2010 Dietary Guidelines have an entire chapter devoted to addressing the impact of the broader food and physical environment on the public’s food, drink, and activity choices using the Social-Ecological model. Physical activity standards were included in the 2005 guidelines. MyPyramid was replaced with MyPlate. There was a shift in food intake patterns emphasizing more vegetables, cooked dried beans, fruits, whole grains, nuts and seeds.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 236

 

  1. A community health nurse is educating a community group about the 2010 Dietary Guidelines for Americans. Which of the following information would be included in this presentation?
a. Limit consumption of dairy products.
b. Purchase organic fruits and vegetables.
c. Make at least half of your grains whole grains.
d. Consume fish on a daily basis.

 

 

ANS:  C

One of the principal messages for consumers is “make at least half of your grains whole grains.” Other messages include “switch to fat-free or low-fat (1%) milk” and “make half your plate fruits and vegetables.” There is not an essential message to consume fish on a daily basis.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 236

 

  1. A person states to the nurse, “The guidelines for what we should eat as Americans is constantly changing, just when I got used to using MyPyramid they changed it to MyPlate. I wonder what will be next and if they really know what they are doing with all of this change.” Which of the following would be the best response from the nurse?
a. “The USDA is constantly making changes in order to decrease the alarming rates of obesity in our country.”
b. “MyPyramid was developed in 2005, so it was time for this graphic to be revised.”
c. “The creation of MyPlate has decreased the need for additional teaching resources for nutrition.”
d. “MyPlate serves as a better visual aid, reminding Americans what a healthy ‘plate’ looks like.”

 

 

ANS:  D

MyPate was released in June 2011 providing Americans easy to understand and useful advice. MyPlate visually “reminds” consumers what a healthy “plate” looks like using a familiar place setting. It is not meant to stand alone as a teaching tool.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    pp. 238-239

 

  1. A person asks the nurse if it is safe to use dietary supplements. Which of the following would be the best reply from the nurse?
a. “It is important to be cautious when using any supplements.”
b. “All dietary supplements must be approved by the FDA before they can be sold and are safe.”
c. “No, dietary supplements have very limited regulations and should not be used.”
d. “Be sure to read the product label before using the supplement to see what health claims have been made by the product.”

 

 

ANS:  A

The desirable way for the general public to obtain recommended levels of nutrients is by eating a variety of foods. Low-dose supplements that contain the recommended intakes for micronutrients appear to be generally safe. Caution is advised when using supplements, as natural is not always better. Dietary supplements are unregulated by the FDA in the sense that they do not require premarket review or approval by the FDA.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 240

 

  1. A woman has asked the nurse about the benefits and risks of using ginseng to control her hot flashes associated with menopause. Which of the following governmental offices would most likely serve as a resource to answer the woman’s question?
a. American Dietetic Association (ADA)
b. National Center for Complementary and Alternative Medicine (NCCAM)
c. Food and Drug Administration (FDA)
d. United States Department of Agriculture (USDA)

 

 

ANS:  B

The National Center for Complementary and Alternative Medicine (NCCAM) promotes and conducts the scientific study of the benefits and risks of dietary supplements, including medicinal herbs, in health maintenance and disease prevention.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 240

 

  1. A 37-year-old woman asks the nurse if she should take a daily nutritional supplement. Which of the following would be the best reply by the nurse?
a. “Postmenopausal women should take a calcium supplement to prevent osteoporosis.”
b. “Many people use supplements as drugs instead of as supplements.”
c. “Supplements can enhance the medications that you take.”
d. “The best way to obtain nutrients is by eating a variety of foods.”

 

 

ANS:  D

The desirable way for the general public to obtain nutrients is by eating a variety of foods. Dietary supplements needs to be used cautiously so that excess amounts are not consumed, which could lead to possible adverse effects.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   pp. 240-241

 

  1. A client who is taking Coumadin tells the nurse that she has started taking a vitamin E supplement as she has heard that this will help decrease the likelihood of her developing cancer. Which of the following would be the most appropriate response by the nurse?
a. “Vitamin E supplements are unnecessary, so I don’t recommend you use this supplement.”
b. “Vitamin E can interfere with the actions of vitamin K and enhance the effects of Coumadin .”
c. “Vitamin E supplements can interfere with the absorption of iron and create additional health problems.”
d. “Vitamin E must be used cautiously, as it is easy to experience a toxicity of this nutrient.”

 

 

ANS:  B

High doses of vitamin E can interfere with vitamin K action and enhance the effect of Coumadin as one of the anticoagulant drugs. Because of this interaction, she should probably not be taking a supplement of vitamin E while taking the Coumadin. If she continues on the supplement, it may be necessary to adjust the dosage of Coumadin the woman is prescribed.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 241

 

  1. A nurse is investigating an outbreak of a food-borne illness occurring at a local school. Which of the following would contribute to a chemical contamination resulting in food-borne illness?
a. Unintended allergen added to food
b. Bacteria on the countertops
c. Pesticide on the fresh fruit
d. Metal shavings in the food from a dull can opener

 

 

ANS:  C

Food-borne illness is classified according to the source of its contamination. Food contaminants may be categorized as biological (bacteria), chemical (pesticides), or physical (metal shavings and unintended allergens).

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 242

 

  1. A school nurse is preparing to discuss food safety practices with high school students enrolled in a family and consumer science “foods” course. Which of the following information would be included in the presentation?
a. Wash hands thoroughly with running warm water with soap for 30 seconds.
b. Scrub firm services of all fruits and vegetables with a produce brush before eating.
c. Pay close attention to assure that meat is cooked all of the way through.
d. Refrigerate leftovers within 30 minutes of serving.

 

 

ANS:  A

There are four principles at the cornerstones of Fight BAC!, a national food safety education campaign (Clean, Separate, Cook, and Chill). Clean—wash all parts of hands thoroughly with running warm water with soap and friction for about 20-30 seconds. Scrub firm surfaces like cantaloupe and cucumbers with a produce brush, other fresh fruits and vegetables can be rinsed under running water. A food thermometer should be used to make sure that food is cooked all the way through. Leftovers should be refrigerated within 2 hours or 1 hour in temperatures greater than 90° F.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 243

 

  1. A community health nurse is working with a low-income family who is experiencing food insecurity. To assist the family in getting nutritious foods in their home, the family should be referred to which of the following programs?
a. Nutrition Service Incentive Program (NSIP)
b. Supplemental Nutrition for Women Infants and Children (WIC)
c. National School Lunch Program (NSLP)
d. Supplemental Nutrition Assistance Program (SNAP)

 

 

ANS:  D

Supplemental Nutrition Assistance Program (SNAP) supplements the food-buying power of eligible low-income households and is the foundation of the Nations’ nutrition safety net. The program is designed to help low-income families and individuals purchase nutritionally adequate foods.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   pp. 244-245

 

  1. A school nurse is discussing the income eligibility requirements for free and reduced-price school meals with a family who is new to the school district. Which of the following statements would the nurse most likely make?
a. “If the employed member of your family earns less than $50,000 per year, your child will qualify for reduced-price meals.”
b. “If your family’s income is less than 185% above the federal poverty level, your child will qualify for free or reduced-price meals.”
c. “If you have more than five members living in your household, your child will qualify for reduced-price meals.”
d. “If your family has an income above the federal poverty level, your child will not qualify for free or reduced-price meals.”

 

 

ANS:  B

Children from families with incomes greater than 130% to 185% of the federal poverty level are eligible for reduced-price school meals. Children from families with incomes at or less than 130% of the federal poverty level are eligible for free school meals. Consideration is given to both income level and number of members living in the household when interpreting the federal poverty guidelines.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 245

 

  1. A nurse is counseling a person with heart disease. Which of the following statements made by the individual would require the nurse to provide additional education?
a. “I drink skim milk on a regular basis.”
b. “I try not to eat foods that have added salt on the label.”
c. “I eat American cheese about once every 2 weeks.”
d. “I add salt to many of the food that I eat to enhance the flavor.”

 

 

ANS:  D

The 2006 AHA diet and lifestyle recommendations include the suggestion to reduce salt intake by comparing the sodium content of similar products and choosing products with less salt or sodium; choosing versions of processed foods, including cereals and baked goods, that are reduced in salt or sodium; and limited condiments. Sodium ingestion leads to retention of fluids and may be harmful to the cardiovascular system of someone who has heart disease.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 248

 

  1. A 45-year-old man has been diagnosed with metabolic syndrome. Which of the following characteristics would this man exhibit?
a. Blood pressure: 146/88 mm Hg
b. Waist measurement: 36 inches
c. HDL: 48 mg/dL
d. Triglycerides: 140 mg/dL

 

 

ANS:  A

Metabolic syndrome is diagnosed when a person has three or more of these factors: excessive abdominal fat, as indicated by too large a waist measurement (greater than 40 inches in men); elevated blood pressure (higher than 130/85 mm Hg), low HDL level (lower than 40 mg/dL), and elevated triglyceride level (higher than 150 mg/dL).

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 249

 

  1. Which of the following individuals has a modifiable, nutrition-related risk factor for stroke?
a. African American man, age 65, who has a low salt intake
b. White woman, age 32, who follows the MyPlate recommendations
c. Russian man, age 40, who drinks 3 oz of vodka daily
d. Hispanic man, age 42, who exercises regularly

 

 

ANS:  C

Modifiable risk factors are those that the person can control. Race, age, and gender are nonmodifiable risk factors. Habitual alcohol intake is a modifiable risk factor for stroke.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 250

 

  1. A community health nurse is providing education about the “Dietary Approaches to Stop Hypertension” (DASH) eating plan to people attending cardiac rehabilitation. Which of the following recommendations would be included in this presentation?
a. The use of this dietary plan has the same health effects as a daily exercise program.
b. The use of this dietary plan will eliminate the need for medication to treat hypertension.
c. This dietary plan is excludes the consumption of processed foods.
d. This dietary plan includes eating greater amounts of fruits and vegetables.

 

 

ANS:  D

Clinical studies show that blood pressure can be lowered by following the DASH eating plan. The DASH eating plan includes abundant fruits and vegetables, more fat-free or low-fat milk and milk products, whole grains, fish, poultry, beans, seeds, and nuts. Depending on the severity of hypertension, the plan may allow for a reduction or elimination of medication.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   pp. 250-251

 

  1. A man states that he would like to change his dietary habits to decrease his risk of developing cancer in the future. Which of the following statements would be the best response for the nurse?
a. “Consume at least  cups of fruits and vegetables each day.”
b. “Dietary habits have minimal effect in reducing your risk of developing cancer.”
c. “A glass of red wine should be consumed daily.”
d. “Dietary supplements of specific nutrients will maximize the effects of dietary changes.”

 

 

ANS:  A

Eating at least  cups of a variety of fruits and vegetables can help protect against cancers at many sites, particularly for cancers of the gastrointestinal and respiratory tracks. Following the dietary recommendations included in the 2010 Dietary guidelines for Americans and MyPlate are consistent with those recommended by the ACS. Food appears to have a protective effect by itself that dietary supplements do not provide.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   pp. 251-252

 

  1. Which of the following people is at greatest risk for a hip fracture secondary to osteoporosis?
a. A 66-year-old White woman
b. A 66-year-old African American woman
c. A 66-year-old White man
d. A 66-year-old African American man

 

 

ANS:  A

White postmenopausal women have the greatest prevalence of osteoporosis and incidence of hip fracture by gender and race.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 252

 

  1. A school nurse is using height and weight measurements to calculate the body mass index (BMI) of the students. How will the nurse use these data?
a. BMI can be correlated to a specific percentage of body fat.
b. BMI can be used to determine if a child is obese or underweight.
c. BMI can be used to determine if a child will develop Type 2 diabetes.
d. BMI can be compared with others of the same ethnic background.

 

 

ANS:  B

Body mass index (BMI) is a helpful indicator of obesity and being underweight. Height and weight measurements are needed in the calculation to determine BMI. BMI is a good indicator of body fat, but it cannot be interpreted as a specific percentage of body fat. BMI is used to screen and monitor a population to detect the risk of health or nutritional disorders. In an individual, other data must be used to determine if a high BMI is associated with increased risk of disease; BMI alone is not diagnostic. The growth charts released in 2000 by the CDC more accurately reflect the nation’s cultural and racial diversity, but there is not a different chart for each ethnic background.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 255

 

  1. A community health nurse is educating health care providers in a local clinic about steps to take to help their clients improve their health-related behaviors. Which of the following would be included as the nurse teaches about the acronym LEARN?
a. Explain how small changes can affect health.
b. Acknowledge that action needs to be taken.
c. Negotiate an agreement.
d. Refer to community resources.

 

 

ANS:  C

LEARN refers to the steps nurses can take to help the person who needs to improve health-related behavior. L = Listen with sympathy and understanding to the person’s perception of the problem, E = Explain personal perceptions of the problem, A = Acknowledge and discuss differences and similarities, R = Recommend treatment, N = Negotiate an agreement.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 256

 

  1. Which of the following individuals would be at greatest risk to develop Type 2 diabetes?
a. White, 50-year-old woman, obese, second child weighed 10 pounds at birth
b. African American, 55-year-old man, hypertension, exercises regularly
c. Hispanic, 22-year-old woman, healthy weight, family history of diabetes
d. White, 75-year-old man, history of prostate cancer and high triglycerides

 

 

ANS:  A

Risk factors for Type 2 diabetes include: having prediabetes (impaired glucose tolerance [IGT] and/or impaired fasting glucose [IFG]), age greater than 45, being overweight or obese, not exercising regularly, having a family history of diabetes, a personal history of gestational diabetes or a baby of at least 9 pounds at birth, other risk factors such as high blood pressure, a low HDL cholesterol or high triglycerides, and one’s race and ethnicity. The White, 50-year-old woman who is obese and gave birth to a child weighing 10 pounds has the most risk factors of the clients described.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 256

 

  1. A nurse is counseling a person who was recently diagnosed with diabetes about how to prevent the complications of this disease. Which of the following interventions would be stressed the most by the nurse?
a. Adjusting sliding scale insulin therapy as needed
b. Taking oral hypoglycemic medication as prescribed
c. Monitoring blood glucose daily
d. Adhering to medical nutrition therapy

 

 

ANS:  D

Medicine may be used to control blood glucose level, and measuring the blood glucose daily helps in controlling its level. But the key to maintaining diabetic control is individualized medical nutrition therapy, the purpose of which is to delay or prevent diabetic complications.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   pp. 257-258

 

  1. A nurse is conducting an initial nutritional assessment on a person who is HIV positive. Which of the following questions would be most important for the nurse to ask?
a. What fresh fruits and vegetables do you like to eat?
b. Are you taking a daily multivitamin?
c. How often do you eat at restaurants?
d. Do you have any questions about your current medications?

 

 

ANS:  B

Evidence suggests that micronutrient deficiencies are common among those with HIV and that those not taking vitamin supplementation have increased morbidity and mortality. Thus, asking about use of a daily multivitamin is the most important information for the nurse to collect. A nutrient-dense, protein-rich, well-balanced diet should be stressed as well as vitamin and mineral supplementation. Because of an altered immune function, they get sicker when exposed to food-borne organisms, so discussion about how to avoid food-borne illness is also important.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 259

 

MULTIPLE RESPONSE

 

  1. Which of the following causes of death is/are directly associated with diet? (select all that apply)
a. Diabetes mellitus
b. Cirrhosis of the liver
c. Stroke
d. Coronary heart disease (CHD)

 

 

ANS:  A, C, D

Four leading causes of death directly associated with diet are coronary heart disease (CHD), some types of cancer, stroke, and diabetes mellitus. Four more major causes of death—accidents, cirrhosis of the liver, suicide, and homicide—are associated with excessive alcohol intake.

 

DIF:    Cognitive Level: Remember (Knowledge)                                 REF:    p. 231

 

  1. A community health nurse is preparing an educational brochure about improving the nutritional behaviors of Americans. Which of the following topics would most likely be included in the brochure? (select all that apply)
a. Increasing daily intake of milk and dairy products
b. Decreasing daily sodium intake
c. Increasing daily intake of fruits and vegetables
d. Decreasing daily intake of sugar-sweetened drinks

 

 

ANS:  B, C, D

Fewer than 15% of adults and 10% of adolescents eat the recommended amounts of fruits and vegetables every day. Sixty-three percent of adults and 84% of adolescents consume at least one sugar-sweetened drink each day. Most American adults consume more than twice the recommended average daily sodium intake level.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   pp. 233-234

 

  1. A community health nurse is developing educational materials related to nutrition. Which of the following resources would be most appropriate for the nurse to use? (select all that apply)
a. Recommended dietary allowances (RDAs)
b. MyPyramid
c. Dietary reference intakes (DRIs)
d. MyPlate

 

 

ANS:  C, D

The most current food and nutrition recommendations are found using the dietary reference intakes (DRIs) and MyPlate. These two resources replaced the previously issued recommended dietary allowances (RDAs) and MyPyramid.

 

DIF:    Cognitive Level: Analyze (Analysis)                                         REF:    p. 234

 

  1. A person has been diagnosed with salmonellosis. Which of the following symptoms would the person most likely exhibit?  (select all that apply)
a. Bloody diarrhea
b. Vomiting
c. Hypoactive bowel sounds
d. Abdominal cramping

 

 

ANS:  B, D

Symptoms of salmonellosis include abdominal cramping, mild to severe diarrhea, nausea, vomiting, and fever within 8 to 72 hours after infection. Bloody diarrhea is more likely seen with E. coli infection.

 

DIF:    Cognitive Level: Apply (Application)                             REF:   p. 242

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