Chapter 2 Exam Questions Health And Illness Care Of Adults - Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff by LeMone, Burke, Gerene Bauldoff. DOCX document preview.
LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)
Chapter 2 Health and Illness Care of Adults
1) The nurse is caring for a patient with heart failure. What should the nurse include when planning holistic care for this patient?
1. Spiritual needs
2. Measuring intake and output
3. Daily weights
4. Ambulating with assistance
Page Ref: 25
Cognitive Level: Applying
Client Need & Sub: Psychosocial Integrity: Religious and Spiritual Influences on Health
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Relationship-Centered Care; Knowledge; Factors that contribute to or threaten health | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 2.1 Define health and the health-illness continuum, and discuss factors affecting the health of individuals, families, communities, and special populations.
MNL Learning Outcome: 1. Consider the impact of health, wellness, illness, and injury to patients and their families.
2) A patient reports never experiencing major illnesses and has enjoyed good health without much effort. How should the nurse identify this patient's definition of health?
1. Absence of disease
2. Effortless
3. Fortunate
4. Integrated method of functioning
Page Ref: 25
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Relationship-Centered Care; Knowledge; Factors that contribute to or threaten health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.1 Define health and the health-illness continuum, and discuss factors affecting the health of individuals, families, communities, and special populations.
MNL Learning Outcome: 1. Consider the impact of health, wellness, illness, and injury to patients and their families.
3) During an assessment, the nurse learns that a patient has a genetic predisposition to the development of several disease processes. Which illness should the nurse realize is associated with genetic makeup?
1. Cancer
2. Hypertension
3. Osteoporosis
4. Myocardial infarction
Page Ref: 25
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.2. Conduct a health history, including environmental exposure and a family history that recognizes genetic risks, to identify current and future health problems | NLN Competencies: Relationship-Centered Care; Knowledge; Factors that contribute to or threaten health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.1 Define health and the health-illness continuum, and discuss factors affecting the health of individuals, families, communities, and special populations.
MNL Learning Outcome: 1. Consider the impact of health, wellness, illness, and injury to patients and their families.
4) The nurse is assessing a patient who is a Native American. For which health problem should the nurse assess the patient?
1. Diabetes mellitus
2. Eye disorders
3. Hypertension
4. Osteoporosis
Page Ref: 26
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.2. Conduct a health history, including environmental exposure and a family history that recognizes genetic risks, to identify current and future health problems | NLN Competencies: Relationship-Centered Care; Knowledge; Factors that contribute to or threaten health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.1 Define health and the health-illness continuum, and discuss factors affecting the health of individuals, families, communities, and special populations.
MNL Learning Outcome: 1. Consider the impact of health, wellness, illness, and injury to patients and their families.
5) During an assessment, a patient reports being lactose intolerant. Within which cultural group is this food intolerance common?
1. Mexican Americans
2. Scandinavian Americans
3. Indian Americans
4. Mediterranean Americans
Page Ref: 26
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.2. Conduct a health history, including environmental exposure and a family history that recognizes genetic risks, to identify current and future health problems | NLN Competencies: Relationship-Centered Care; Knowledge; Factors that contribute to or threaten health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.1 Define health and the health-illness continuum, and discuss factors affecting the health of individuals, families, communities, and special populations.
MNL Learning Outcome: 1. Consider the impact of health, wellness, illness, and injury to patients and their families.
6) A patient with a respiratory illness is a factory worker and uses public transportation to get to work. Which will be impacted by the patient's socioeconomic status?
1. Lifestyle
2. Cognitive abilities
3. Education level
4. Developmental level
Page Ref: 26
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.2. Conduct a health history, including environmental exposure and a family history that recognizes genetic risks, to identify current and future health problems | NLN Competencies: Relationship-Centered Care; Knowledge; Factors that contribute to or threaten health | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.1 Define health and the health-illness continuum, and discuss factors affecting the health of individuals, families, communities, and special populations.
MNL Learning Outcome: 1. Consider the impact of health, wellness, illness, and injury to patients and their families.
7) The nurse is reviewing the goals for Healthy People 2020 with a group of patients in an outpatient clinic. What should the nurse include in this presentation? Select all that apply.
1. Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
2. Achieving health equity, eliminating disparities, and improving the health of all groups.
3. Creating social and physical environments that promote good health for all.
4. Promoting healthy development and healthy behaviors across every stage of life.
5. Achieving a body weight 20% less than recommended in current standardized height/weight charts.
Page Ref: 35
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention; chronic disease management | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 2.2 Compare and contrast health risks, assessment, and health promotion for the young adult, middle adult, and older adult.
MNL Learning Outcome: 2. Recognize the health risks of individuals across the lifespan, families, and communities and the role of nursing in health promotion and maintenance.
8) The nurse is instructing a patient on nutritional needs by using MyPlate. What should the nurse emphasize when using this food guide?
1. Consuming nutrient-dense foods and beverages.
2. Ways to limit exposure to carcinogens
3. Activities to reduce the onset of diabetes mellitus
4. Avoiding overuse of aerobic exercise
Page Ref: 36
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention; chronic disease management | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning
Learning Outcome: 2.2 Compare and contrast health risks, assessment, and health promotion for the young adult, middle adult, and older adult.
MNL Learning Outcome: 2. Recognize the health risks of individuals across the lifespan, families, and communities and the role of nursing in health promotion and maintenance.
9) A patient asks for suggestions to help improve current health status. What should the nurse instruct this patient?
1. Participate in a continuous physical activity for 30 minutes, 5 or more days each week.
2. Obtain sun exposure every day.
3. Reduce tobacco use.
4. Sleep at least 6 hours each night.
Page Ref: 36
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; apply health promotion/disease prevention strategies; apply health policy | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.2 Compare and contrast health risks, assessment, and health promotion for the young adult, middle adult, and older adult.
MNL Learning Outcome: 2. Recognize the health risks of individuals across the lifespan, families, and communities and the role of nursing in health promotion and maintenance.
10) A patient reports drinking four alcoholic beverages every day and smoking one pack of cigarettes. Which is this patient predisposed to develop?
1. Disease
2. Illness
3. Injury
4. Infection
Page Ref: 36
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: High Risk Behaviors
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention, chronic disease management | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
11) A patient reports a new onset of a health problem. Which is the primary reason for a patient to seek medical attention?
1. Pain
2. Bleeding
3. Vomiting
4. Fatigue
Page Ref: 36
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.C.9. Recognize that patient expectations influence outcomes in management of pain or suffering | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality and Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
12) While being treated for one disease process, a patient begins demonstrating manifestations of another disease process. Which type of disease is the patient experiencing?
1. Iatrogenic
2. Communicable
3. Congenital
4. Degenerative
Page Ref: 37
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality and Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
13) A patient reports feeling fine even after being diagnosed with chronic kidney failure. What is the patient likely to manifest?
1. Signs of an illness
2. An iatrogenic disease
3. A psychosomatic illness
4. An idiopathic disorder
Page Ref: 36
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality and Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
14) A patient reports not feeling well for a few days and has been using an over-the-counter medication without improvement. Which illness behavior is this patient demonstrating?
1. Seeking medical care
2. Experiencing symptoms
3. Assuming the sick role
4. Assuming a dependent role
Page Ref: 38
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality and Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
15) A patient wants to be discharged to home and resume normal activities of daily living. In which stage of illness behavior is the patient entering?
1. Achieving recovery and rehabilitation
2. Seeking medical care
3. Assuming a dependent role
4. Experiencing symptoms
Page Ref: 38
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality and Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
16) A patient with a chronic illness is not currently experiencing any symptoms and plans to stop following the identified course of care because the disease is cured. How should the nurse respond to this patient?
1. "The treatment plan is the reason you are not experiencing symptoms, so it would be best if you did not stop the plan."
2. "That does sound like a good idea."
3. "You can always resume the plan if the symptoms return."
4. "Plan to wean yourself off the treatment plan and not discontinue it all at once."
Page Ref: 39
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Self-Care
Standards: QSEN Competencies: I.C.1. Value seeing healthcare situations "through patients' eyes" | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality and Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
17) The nurse is planning care for a patient with a chronic illness. What intervention should the nurse include in the plan of care?
1. Instruct on ways to minimize the impact of the chronic illness.
2. Encourage to seek medical care weekly.
3. Limit activities until symptoms subside.
4. Suggest lifestyle alterations to prepare for more challenging symptom management in the future.
Page Ref: 39
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Self-Care
Standards: QSEN Competencies: I.C.1. Value seeing healthcare situations "through patients' eyes" | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Quality and Safety; Knowledge; Current best practices | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
18) The nurse is planning an education session to discuss primary levels of disease prevention. Which topics should the nurse include in this presentation?
1. Elimination of smoking and alcohol use
2. Locations for diabetes screening
3. Schedule colonoscopy examinations as prescribed
4. Use of available community rehabilitation facilities
Page Ref: 40
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
19) The nurse is planning interventions to meet a patient's tertiary care needs. Which would be applicable for the patient?
1. Providing preoperative instructions
2. Instruction in self-examination of breasts
3. Screening for glaucoma
4. Counseling on healthy nutrition
Page Ref: 40
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
20) A patient is diagnosed with an ear infection and has been prescribed antibiotics. Which level of intervention has the patient received?
1. Secondary
2. Primary
3. Tertiary
4. Acute
Page Ref: 40
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
21) A middle-aged patient voices concerns about gaining 12 pounds over the past 2 years without changing any dietary habits. Which response by the nurse is most appropriate?
1. "Age-related weight gain can occur because of consistent dietary intake and less physical activity."
2. "Are you exercising?"
3. "You might be eating more than you think."
4. "You are getting older."
Page Ref: 28
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Aging Process
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.1 Define health and the health-illness continuum, and discuss factors affecting the health of individuals, families, communities, and special populations.
MNL Learning Outcome: 1. Consider the impact of health, wellness, illness, and injury to patients and their families.
22) The nurse is assisting an adolescent female patient to strategize ways to avoid the onset of disease with aging. What should the nurse include in this plan? Select all that apply.
1. Maintain a healthy weight.
2. Avoid smoking.
3. Avoid substance abuse.
4. Schedule an annual mammogram.
5. Plan for a colonoscopy every 2 years.
Page Ref: 28, 36
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 2.2 Compare and contrast health risks, assessment, and health promotion for the young adult, middle adult, and older adult.
MNL Learning Outcome: 2. Recognize the health risks of individuals across the lifespan, families, and communities and the role of nursing in health promotion and maintenance.
23) A middle-aged female patient is having a routine examination and has no significant personal or family medical history. What information concerning health-promotion behaviors should the nurse provide to this patient?
1. Have bone density evaluated.
2. Plan to have a mammogram every other year.
3. Measure blood pressure every 3 years.
4. Exercise for at least 15 minutes a day 3 days each week.
Page Ref: 28
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.1 Define health and the health-illness continuum, and discuss factors affecting the health of individuals, families, communities, and special populations.
MNL Learning Outcome: 1. Consider the impact of health, wellness, illness, and injury to patients and their families.
24) An older patient experiences extreme drowsiness after taking an over-the-counter cold medication at the prescribed dose. What should this information suggest to the nurse?
1. Older age is influencing the patient's response to the medication.
2. More medication was taken than was reported.
3. A reaction between the cold medication and other routine medications has occurred.
4. An allergic reaction to the cold medication occurred.
Page Ref: 32
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention; | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.1 Define health and the health-illness continuum, and discuss factors affecting the health of individuals, families, communities, and special populations.
MNL Learning Outcome: 1. Consider the impact of health, wellness, illness, and injury to patients and their families.
25) The nurse is preparing discharge instructions for an African American patient recovering from a same-day surgical procedure. What genetic, racial, ethnic, and cultural factors affecting health and well-being should the nurse consider prior to giving discharge instructions? Select all that apply.
1. Hypertension
2. Sickle cell anemia
3. Lactose intolerance
4. Diabetes
5. Osteoporosis
Page Ref: 26
Cognitive Level: Applying
Client Need & Sub: Psychosocial Integrity: Cultural Awareness/Cultural Influences on Health
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning
Learning Outcome: 2.1 Define health and the health-illness continuum, and discuss factors affecting the health of individuals, families, communities, and special populations.
MNL Learning Outcome: 1. Consider the impact of health, wellness, illness, and injury to patients and their families.
26) The nurse is reviewing the health history with a young adult patient. For which vaccination should the nurse assess this patient? Select all that apply.
1. Measles, mumps, rubella (MMR)
2. Hepatitis B
3. HPV
4. Influenza
5. Tetanus, diphtheria, pertussis every 10 years
Page Ref: 37
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Reduction of Risk Potential
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention; chronic disease management | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.2 Compare and contrast health risks, assessment, and health promotion for the young adult, middle adult, and older adult.
MNL Learning Outcome: 2. Recognize the health risks of individuals across the lifespan, families, and communities and the role of nursing in health promotion and maintenance.
27) A patient is diagnosed with an acute onset of pulmonary embolism. Rank the illness behaviors that this patient may demonstrate in the commonly recognized sequence. Place the five behaviors in the correct order.
Choice 1. Experiencing symptoms
Choice 2. Assuming a dependent role
Choice 3. Seeking medical care
Choice 4. Assuming the sick role
Choice 5. Recovery and rehabilitation
Page Ref: 38
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
28) The overall mission of Healthy People 2020 is to improve the nation's health. What topic is addressed to achieve this goal? Select all that apply.
1. Access to health services
2. Nutrition and weight status
3. Reproductive health
4. Injury and violence
5. Outpatient surgery
Page Ref: 35
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.2 Compare and contrast health risks, assessment, and health promotion for the young adult, middle adult, and older adult.
MNL Learning Outcome: 2. Recognize the health risks of individuals across the lifespan, families, and communities and the role of nursing in health promotion and maintenance.
29) A patient with seizures is being monitored to determine if the seizure activity was present at birth or has been slowly developing. For which classifications of diseases is this patient's seizure activity being evaluated?
1. Congenital versus chronic
2. Acute versus chronic
3. Communicable versus functional
4. Idiopathic versus iatrogenic
Page Ref: 37
Cognitive Level: Applying
Client Need & Sub: Physiological Integrity: Physiological Adaptation
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; chronic disease management | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
30) A patient with a family history of breast cancer is participating in activities to prevent illness. Which primary prevention action is the patient performing?
1. Genetic testing to determine genetic predisposition
2. Obtaining a mammogram and performing monthly breast self-examinations
3. Taking lipid-reducing agent to reduce cholesterol levels
4. Supporting breast cancer research by running in a half marathon
Page Ref: 40
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.3 Differentiate between disease, illness, and injury, and describe illness behaviors and needs of the patient with acute, critical, and chronic illness.
MNL Learning Outcome: 3. Consider the differences between disease, illness, and injury and the behaviors and needs of the patient with various levels of illness.
31) A middle-aged female is having a routine wellness evaluation. Which statement reflects the changes that occur in middle adulthood? Select all that apply.
1. "I am embarrassed by the amount of weight I have gained each year."
2. "I have recently been put on a lipid-lowering agent for an increase in my cholesterol levels."
3. "I worry about getting breast cancer like my friend who is the same age."
4. "I have been lonely since my children all married and moved far away."
5. "I am concerned about coping with an unplanned pregnancy."
Page Ref: 28-29
Cognitive Level: Analyzing
Client Need & Sub: Psychosocial Integrity: Coping Mechanisms
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.1 Define health and the health-illness continuum, and discuss factors affecting the health of individuals, families, communities, and special populations.
MNL Learning Outcome: 1. Consider the impact of health, wellness, illness, and injury to patients and their families.
32) An older patient is experiencing confusion and lethargy after taking routine doses of medication. Which age-related change should the nurse identify that could predispose this patient to toxic drug effects? Select all that apply.
1. Changes in tissue and organ structure
2. Decrease in liver function
3. Taking several drugs at once
4. Decrease in renal function
5. Decrease in taste sensation
Page Ref: 32
Cognitive Level: Analyzing
Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; chronic disease management | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.1 Define health and the health-illness continuum, and discuss factors affecting the health of individuals, families, communities, and special populations.
MNL Learning Outcome: 1. Consider the impact of health, wellness, illness, and injury to patients and their families.
33) In a healthcare provider's office, the nurse case manager approaches a patient with type 2 diabetes mellitus to review the patient-centered medical home (PCMH) approach to care. What benefits of this approach should the case manager include in this discussion? Select all that apply.
1. Prevents acute disease crises
2. Encourages preventive services
3. Eliminates health insurance billing
4. Comprehensive and coordinated care
5. Focus on all levels of illness prevention
Page Ref: 42
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.4 Describe essential elements and goals of coordinated primary care models; the services, settings, and essential components of community-based care and home healthcare; and nursing interventions to deliver safe, effective, and competent care to patients in their homes.
MNL Learning Outcome: 4. Recognize the various care approaches and settings for nursing care.
34) The nurse is preparing to provide disease management care to a patient with heart failure. On what should the nurse focus when caring for this patient? Select all that apply.
1. Disease process
2. Daily monitoring
3. Medication management
4. Transfer to long-term care
5. Frequency of hospitalization
Page Ref: 42
Cognitive Level: Applying
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.4 Describe essential elements and goals of coordinated primary care models; the services, settings, and essential components of community-based care and home healthcare; and nursing interventions to deliver safe, effective, and competent care to patients in their homes.
MNL Learning Outcome: 4. Recognize the various care approaches and settings for nursing care.
35) The nurse is preparing to transition a patient with chronic obstructive pulmonary disease from a rehabilitation facility back to home. What preparations has the nurse made to support this patient's transition? Select all that apply.
1. Instructing on symptoms to report
2. Scheduling healthcare provider visits
3. Submitting facility charges to Medicare
4. Creating an evidence-based plan of care
5. Reviewing health insurance coverage plans
Page Ref: 42
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 2.4 Describe essential elements and goals of coordinated primary care models; the services, settings, and essential components of community-based care and home healthcare; and nursing interventions to deliver safe, effective, and competent care to patients in their homes.
MNL Learning Outcome: 4. Recognize the various care approaches and settings for nursing care.
36) The nurse notes that a patient with osteoarthritis receiving transition care has achieved the goals for this care delivery approach. What did the nurse observe to come to this conclusion? Select all that apply.
1. Safety bars installed in the bathroom
2. Oldest daughter moved out of the patient's home
3. Monthly pension from previous employer reduced
4. Adhering to exercise, pain medication, and dietary plans
5. Last hospitalization for treatment from a fall 9 months ago
Page Ref: 42
Cognitive Level: Analyzing
Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: VII.5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral and follow-up throughout the lifespan | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 2.4 Describe essential elements and goals of coordinated primary care models; the services, settings, and essential components of community-based care and home healthcare; and nursing interventions to deliver safe, effective, and competent care to patients in their homes.
MNL Learning Outcome: 4. Recognize the various care approaches and settings for nursing care.
37) The nurse working in an acute care hospital is considering a position working with patients in the community. What care settings should the nurse consider before making a final decision? Select all that apply.
1. Parish nursing
2. Homeless shelters
3. Adoption agencies
4. County health department
5. Ambulatory surgical center
Page Ref: 42
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.C.4. Seek learning opportunities with patients who represent all aspects of human diversity | AACN Essentials Competencies: II.1. Apply leadership concepts, skills and decision making in the provision of high quality nursing care, healthcare team coordination and the oversight and accountability for care delivery in a variety of settings | NLN Competencies: Context and Environment; Knowledge; health promotion/disease prevention | Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 2.4 Describe essential elements and goals of coordinated primary care models; the services, settings, and essential components of community-based care and home healthcare; and nursing interventions to deliver safe, effective, and competent care to patients in their homes.
MNL Learning Outcome: 4. Recognize the various care approaches and settings for nursing care.
38) A patient recovering from total hip replacement surgery is being transferred to a rehabilitation facility. When discussing this facility with the patient, what should the nurse include? Select all that apply.
1. An assessment of functional abilities will be completed.
2. The patient should expect to provide all self-care.
3. A team of therapists and nurses will be working with the patient.
4. The focus will include interpersonal relationships and family support.
5. Plans will be made to transition the patient to a long-term care facility.
Page Ref: 43
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Knowledge and Science; Knowledge; Integration of knowledge from nursing and other disciplines | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.4 Describe essential elements and goals of coordinated primary care models; the services, settings, and essential components of community-based care and home healthcare; and nursing interventions to deliver safe, effective, and competent care to patients in their homes.
MNL Learning Outcome: 4. Recognize the various care approaches and settings for nursing care.
39) The nurse is determining if a patient recovering from abdominal surgery is a candidate for home care. Which information should the nurse use to help make this decision? Select all that apply.
1. The patient needs intermittent skilled nursing care.
2. The patient prefers to use an agency that is Medicare certified.
3. The patient plans to attend the upcoming senior citizen bingo night.
4. The patient can walk to a shopping mall to do banking and purchase groceries.
5. The patient is unable to change the abdominal wound dressing because of limited upper-extremity mobility.
Page Ref: 44
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; healthcare systems | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.4 Describe essential elements and goals of coordinated primary care models; the services, settings, and essential components of community-based care and home healthcare; and nursing interventions to deliver safe, effective, and competent care to patients in their homes.
MNL Learning Outcome: 4. Recognize the various care approaches and settings for nursing care.
40) The primary caregiver for a patient with Alzheimer disease receiving care in the home wants to attend a granddaughter's high school graduation in a city 50 miles from the patient's home. What should the home care nurse suggest so that the caregiver can attend this event?
1. Admit the patient to hospice.
2. Schedule respite care for the caregiver.
3. Admit the patient to an inpatient facility.
4. Transport the patient with the caregiver to the graduation.
Page Ref: 47
Cognitive Level: Applying
Client Need & Sub: Psychosocial Integrity: Support Systems
Standards: QSEN Competencies: I.A.6. Describe strategies to empower patients or families in all aspects of the healthcare process | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences | NLN Competencies: Context and Environment; Knowledge; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.4 Describe essential elements and goals of coordinated primary care models; the services, settings, and essential components of community-based care and home healthcare; and nursing interventions to deliver safe, effective, and competent care to patients in their homes.
MNL Learning Outcome: 4. Recognize the various care approaches and settings for nursing care.
41) The nurse is visiting the home of a patient recovering from an acute gastrointestinal bleed. Which action should the nurse take to limit distractions during this home visit? Select all that apply.
1. Establishing short- and long-term goals
2. Explaining the primary goal of home care
3. Exploring the patient's and family's expectations of home care
4. Asking the patient if the television could be turned off during the visit
5. Asking the patient if the visit could be conducted in the bedroom away from small children and pets
Page Ref: 45
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Management of Care
Standards: QSEN Competencies: I.A.6. Describe strategies to empower patients or families in all aspects of the healthcare process | AACN Essentials Competencies: IX.5. Deliver compassionate, patient-centered, evidence-based care that respects patient and family preferences | NLN Competencies: Context and Environment; Knowledge; family dynamics | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.4 Describe essential elements and goals of coordinated primary care models; the services, settings, and essential components of community-based care and home healthcare; and nursing interventions to deliver safe, effective, and competent care to patients in their homes.
MNL Learning Outcome: 4. Recognize the various care approaches and settings for nursing care.
42) After completing a home assessment, the nurse determines that safety hazards exist in a patient's bathroom. What did the nurse assess to come to this conclusion? Select all that apply.
1. Water temperature of 150°F
2. Grab bars around the toilet only
3. Scatter rug outside the shower stall
4. Smoke detector battery with a low reading
5. Electrical outlet on the wall near the shower door
Page Ref: 46
Cognitive Level: Analyzing
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.4. Communicate observations or concerns related to hazards and errors to patients, families and the healthcare team | AACN Essentials Competencies: II.7. Promote factors that create a culture of safety and caring | NLN Competencies: Quality and Safety; Practice-Know-How; Communicate potential risk factors and actual errors | Nursing/Integrated Concepts: Nursing Process: Evaluation
Learning Outcome: 2.4 Describe essential elements and goals of coordinated primary care models; the services, settings, and essential components of community-based care and home healthcare; and nursing interventions to deliver safe, effective, and competent care to patients in their homes.
MNL Learning Outcome: 4. Recognize the various care approaches and settings for nursing care.
43) While making a home visit, the nurse learns that a patient self-administering insulin injections is placing the used needles and syringes in the family's trash can. What action should the nurse take?
1. Instruct the patient to place the needles and syringes in a separate plastic bag.
2. Nothing, because these needles and syringes are harmless to the general population.
3. Ask the patient to save all used syringes and needles after use for the nurse to dispose of.
4. Teach the patient to place all used syringes and needles into the red biohazard sharps box.
Page Ref: 46
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.4. Communicate observations or concerns related to hazards and errors to patients, families and the healthcare team | AACN Essentials Competencies: II.7. Promote factors that create a culture of safety and caring | NLN Competencies: Quality and Safety; Practice-Know-How; Communicate potential risk factors and actual errors | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.4 Describe essential elements and goals of coordinated primary care models; the services, settings, and essential components of community-based care and home healthcare; and nursing interventions to deliver safe, effective, and competent care to patients in their homes.
MNL Learning Outcome: 4. Recognize the various care approaches and settings for nursing care.
44) During a home visit, the nurse notes that the caregiver does not apply clean gloves before removing the patient's leg wound dressings. What should the nurse do to encourage infection control practices in this home?
1. Place the box of gloves next to the sink in the bathroom.
2. Remind the caregiver to wash hands after completing wound care.
3. Place the box of gloves next to the bag used to discard soiled dressings.
4. Encourage the caregiver to touch only the edges of the soiled dressings.
Page Ref: 46
Cognitive Level: Applying
Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control
Standards: QSEN Competencies: V.B.4. Communicate observations or concerns related to hazards and errors to patients, families and the healthcare team | AACN Essentials Competencies: II.7. Promote factors that create a culture of safety and caring | NLN Competencies: Quality and Safety; Practice-Know-How; Communicate potential risk factors and actual errors | Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 2.4 Describe essential elements and goals of coordinated primary care models; the services, settings, and essential components of community-based care and home healthcare; and nursing interventions to deliver safe, effective, and competent care to patients in their homes.
MNL Learning Outcome: 4. Recognize the various care approaches and settings for nursing care.
Document Information
Connected Book
Medical Surgical Nursing 7e | Test Bank by LeMone, Burke, Bauldoff
By LeMone, Burke, Gerene Bauldoff