Health & Physical Assessment In Nursing 3rd Edition by Donita T D’Amico – Test Bank
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Sample
Test
D’Amico/Barbarito Health & Physical Assessment in
Nursing, 3/e
Chapter
3
Question 1
Type: MCSA
The nurse held a smoking cessation class prior to the
upcoming Great
American Smokeout, hoping to motivate many individuals to stop
smoking by promoting self-efficacy. Which statement made by a participant
indicates the highest level of positive self-efficacy according to the Health
Belief Model?
1. “I
think this time will be different.”
2. “I am
going to do the best that I can, so that I won’t get lung cancer.”
3. “I am
afraid of getting lung cancer like my father.”
4. “I
know that this time I will quit smoking permanently.”
Correct Answer: 4
Rationale 1: Stating that this
attempt at quitting smoking will be different shows a low level of commitment
to the action.
Rationale 2: Stating fear of getting
lung cancer represents an internal cue to action, based on the Health Belief
Model.
Rationale 3: Referring to a family
member with the disease represents an internal cue to action, based on the
Health Belief Model.
Rationale 4: Based on the Health
Belief Model, self-efficacy refers to the level of confidence an individual has
about the ability to perform the activity. The client’s statement, “I know that
this time I will quit smoking permanently,” shows the highest-level
determination and motivation.
Global Rationale: Based on the Health
Belief Model, self-efficacy refers to the level of confidence an individual has
about the ability to perform the activity. The client’s statement that he/she
intends to make a permanent change shows the highest-level determination and
motivation. Stating that this attempt at quitting smoking will be different
shows a low level of commitment to the action. Stating fear of getting lung
cancer and referring to a family member with the disease represents internal
cues to action, based on the Health Belief Model.
Cognitive Level: Applying
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
AACN Essentials Competencies: I.1.
Integrate theories and concepts from liberal education into nursing practice.
NLN Competencies: Context and
Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing
Process: Evaluation
Learning Outcome: 3.3: Relate
perspectives of health promotion to the individual, family, and community.
MNL Learning Outcome:
Page Number: p. 49
Question 2
Type: MCSA
A couple seeks genetic counseling as both have a positive family
history of sickle cell anemia, and are concerned about the potential of having
a child with this disease. Which statement indicates that the couple wishes to
participate in primary prevention?
1. “We
need to both be treated for sickle cell anemia before we can have a baby.”
2. “We
will have blood tests to determine if we are carriers.”
3. “We
need to see a genetics counselor to discuss the potential for having a child
with sickle cell disease.”
4. “Neither
one of us has sickle cell disease, so any baby we have will be safe from the
disease as well.”
Correct Answer: 3
Rationale 1: Indicating a need for
treatment would be considered secondary or tertiary prevention.
Rationale 2: Both individuals being
tested for carrier status would be considered secondary prevention, as it deals
with early diagnosis of health problems.
Rationale 3: Primary prevention
implies health and a high level of wellness for the individual. Seeking out a
genetics counselor to discuss the potential for having a child with sickle cell
disease is considered primary prevention.
Rationale 4: Stating that neither
has the disease, thus a child would not inherit the disease, indicates no level
of prevention.
Global Rationale: Primary prevention
implies health and a high level of wellness for the individual. Seeking out a
genetics counselor is considered primary prevention. Indicating a need for
treatment would be considered secondary or tertiary prevention. Both
individuals being tested for carrier status would be considered secondary
prevention, as it deals with early diagnosis of health problems. Stating that
neither has the disease, thus a child would not inherit the disease, indicates
no level of prevention.
Cognitive Level: Applying
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.A.1. Demonstrate
knowledge of basic scientific methods and processes.
AACN Essentials Competencies: I.1.
Integrate theories and concepts from liberal education into nursing practice.
NLN Competencies: Context and
Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing
Process: Evaluation
Learning Outcome: 3.2: Compare and
contrast selected theories of wellness.
MNL Learning Outcome:
Page Number: p. 48
Question 3
Type: MCSA
The nurse is interviewing a client who has experienced a
15-pound weight gain during the last year. The nurse obtains a 24-hour dietary
recall, as well as determining the client’s exercise habits and feelings
regarding plans to take off the excess weight. Which type of approach is the
nurse using to enhance the client’s health?
1. Psychosocial
perspective.
2. Illness
perspective.
3. Physiologic
perspective.
4. Wellness
perspective.
Correct Answer: 4
Rationale 1: A psychosocial
perspective would not take into account the physiologic alteration necessary
for a successful weight loss program.
Rationale 2: An illness perspective
does not include the positive attributes, such as motivation, that the client
possesses to address the 15-pound weight gain during the past year; rather, it
focuses on the illnesses, such as hypertension, that can result from the weight
gain.
Rationale 3: A physiologic
perspective could also be considered an illness perspective.
Rationale 4: When using a wellness
perspective, the nurse focuses on the client’s personal strengths and abilities
to enhance health.
Global Rationale: When using a wellness
perspective, the nurse focuses on the client’s personal strengths and abilities
to enhance health. An illness perspective does not include the positive
attributes that the client possesses to address the problem. A physiologic
perspective could also be considered an illness perspective. A psychosocial
perspective would not take into account the physiologic alteration necessary
for a successful weight loss program.
Cognitive Level: Applying
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.A.1. Demonstrate
knowledge of basic scientific methods and processes.
AACN Essentials Competencies: I.1.
Integrate theories and concepts from liberal education into nursing practice.
NLN Competencies: Context and
Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing
Process: Assessment
Learning Outcome: 3.2: Compare and
contrast selected theories of wellness.
MNL Learning Outcome:
Page Number: pp. 48–49
Question 4
Type: MCSA
The nurse is discharging a client who was hospitalized for a
cerebral vascular accident (CVA). The client will be cared for at home by
family members. Which statement made by the family indicates understanding of
the client’s primary prevention needs after discharge?
1. “She
will need instruction on using her walker.”
2. “She
will need to have her flu shot this year.”
3. “She
must take her blood pressure medications regularly.”
4. “She
needs to have her cholesterol checked every 2 months.”
Correct Answer: 2
Rationale 1: Tertiary prevention
involves strategies for rehabilitation; instructing the client on proper use of
a walker is an example of tertiary prevention.
Rationale 2: Having a flu shot is a
primary prevention strategy.
Rationale 3: Taking blood pressure
medication is secondary prevention since the treatment is aimed at maintaining
normal blood pressure and preventing complications from the condition.
Rationale 4: Having a cholesterol
screening is an example of secondary prevention.
Global Rationale: Having a flu shot is a
primary prevention strategy. Taking blood pressure medication is secondary
prevention since the treatment is aimed at maintaining normal blood pressure
and preventing complications from the condition. Having a cholesterol screening
is also an example of secondary prevention. Tertiary prevention involves
strategies for rehabilitation, such as using a walker to aid ambulation.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk
Potential
QSEN Competencies: III.A.1. Demonstrate
knowledge of basic scientific methods and processes.
AACN Essentials Competencies: I.1.
Integrate theories and concepts from liberal education into nursing practice.
NLN Competencies: Context and
Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing
Process: Assessment
Learning Outcome: 3.2: Compare and
contrast selected theories of wellness.
MNL Learning Outcome:
Page Number: pp. 48–49
Question 5
Type: MCMA
The nurse is planning a weight reduction class and wants to use
the Health Belief Model to motivate the clients in losing weight. Which are
mediating factors in the Health Belief Model?
Standard Text: Select all that apply.
1. Likelihood
of the individuals developing complications from being overweight.
2. The
clients’ perception of the severity of an illness that could develop from being
overweight.
3. The
cost of the class that will be the client’s responsibility.
4. The
amount of time commitment for the individuals taking the class.
5. The
religion of the clients who will be taking the class.
Correct Answer: 1, 2, 3, 4
Rationale 1: Susceptibility refers
to how likely an individual is to develop an illness or condition and it is one
of the mediating factors according to the Health Belief Model; the likelihood
of the individuals developing complications from being overweight is an example.
Rationale 2: The perceived severity
of an illness is the second mediating factor that determines the motivation to
participating in health-promotion behaviors. The clients’ perception of the
severity of an illness that could develop from being overweight is an example.
Rationale 3: The actual cost of the
class would be considered the physical cost of the health-promoting activity
versus continuing the unhealthy behavior. Physical and psychologic perceived
cost is the fourth mediating variable.
Rationale 4: Time commitment
necessary for the class would be considered a psychologic cost of the health
promoting activity versus continuing the unhealthy behavior. Physical and
psychologic perceived cost is the fourth mediating variable.
Rationale 5: Religion is not
identified as one of the mediating variable according to the Health Belief
Model.
Global Rationale: Mediating factors
affect the health-promoting behaviors by influencing the perception of
susceptibility, severity, effectiveness, and cost (physical and psychologic).
Religion is not one of the identified mediating factors according to the Health
Belief Model.
Cognitive Level: Understanding
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
AACN Essentials Competencies: I.1.
Integrate theories and concepts from liberal education into nursing practice.
NLN Competencies: Context and
Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing
Process: Planning
Learning Outcome: 3.3: Relate
perspectives of health promotion to the individual, family, and community.
MNL Learning Outcome:
Page Number: p. 49
Question 6
Type: MCSA
A staff nurse is participating on a committee examining ways to
most effectively meet the goals of Healthy
People 2020. Which client would be the nurse’s highest priority
based on the goals of Healthy
People 2020?
1. An
adolescent female with her first pregnancy.
2. A
diabetic client who maintains optimal visual intactness.
3. An IV
drug abuser who converts to methadone use.
4. Several
obese school-age children.
Correct Answer: 2
Rationale 1: A 16 year old with a
pregnancy does not indicate healthy behavior across the life span.
Rationale 2: The diabetic client
maintaining visual intactness demonstrates the overall goal of Healthy People 2020 through
practicing healthy behavior in regards to controlling his diabetes and improved
long-term quality of life.
Rationale 3: An IV drug user still
using a drug does not demonstrate healthy behavior, nor improved quality of
life or elimination of health inequities.
Rationale 4: Obesity levels in the
school-aged population do not demonstrate healthy behavior across the life
span.
Global Rationale: The overriding goals
for Healthy People
2020 are to eliminate preventable diseases and health
inequities, as well as promotion of healthy behavior across the entire life
span of an individual. The diabetic client maintaining visual intactness
demonstrates healthy behavior in regards to controlling his diabetes and
improved long-term quality of life. A 16 year old with a pregnancy does not
indicate healthy behavior across the life span. An IV drug user still using a
drug does not demonstrate healthy behavior, nor improved quality of life or
elimination of health inequities. Obesity levels in the school-aged population
do not demonstrate healthy behavior across the life span.
Cognitive Level: Applying
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
AACN Essentials Competencies: VII.11.
Participate in clinical prevention and population-focused interventions with
attention to effectiveness, efficiency, cost-effectiveness, and equity.
NLN Competencies: Context and
Environment: Apply health promotion/disease prevention strategies; Apply health
policy.
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3.4: Apply the goals
and objectives for each topic area in Healthy
People 2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 54–66
Question 7
Type: MCMA
The nurse is planning an exercise class for a group of young
adults. When promoting the benefits of regular exercise, which topics will the
nurse include?
Standard Text: Select all that apply.
1. Reducing
risk of cardiovascular disease.
2. Reducing
risk of skin cancer.
3. Reducing
risk of colon cancer.
4. Reducing
risk of renal disease.
5. Reduced
risk of hypertension.
Correct Answer: 1, 3, 5
Rationale 1: Regular physical
activity has been found to decrease the risk of developing or dying from
cardiovascular disease.
Rationale 2: The development of skin
cancer is not related to physical activity.
Rationale 3: Regular physical
activity has been found to decrease the risk of developing or dying from colon
cancer.
Rationale 4: The development of
renal disease is not related to physical activity.
Rationale 5: Regular physical
activity has been found to decrease the risk of developing or dying from
hypertension.
Global Rationale: According to Healthy People 2020,
regular physical activity results in a decreased risk of cardiovascular
disease, colon cancer, and hypertension. It does not result in decreasing the
risk of skin cancer or renal disease.
Cognitive Level: Remembering
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
AACN Essentials Competencies: VII.11.
Participate in clinical prevention and population-focused interventions with
attention to effectiveness, efficiency, cost-effectiveness, and equity.
NLN Competencies: Context and
Environment: Apply health promotion/disease prevention strategies; Apply health
policy.
Nursing/Integrated Concepts: Nursing
Process: Assessment
Learning Outcome: 3.4: Apply the goals
and objectives for each topic area in Healthy
People 2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 54–66
Question 8
Type: MCSA
The school nurse is working with several adolescents during gym
class. Which adolescent is meeting the age-appropriate recommendations for
physical activity developed by the Centers for Disease Control (CDC)?
1. A 17
year old who runs at a fast pace for 30 minutes five times per week and
practices yoga for 30 minutes two times per week.
2. A 16
year old who swims for 60 minutes 5 times per week and jogs for 60 minutes the
other 2 days per week.
3. A 15
year old who lifts moderately heavy weights 15 minutes three times per week.
4. A 13
year old who speed-walks 60 minutes five times per week.
Correct Answer: 2
Rationale 1: Running for 30 minutes
five times per week and practicing yoga for 30 minutes two times per week does
not meet the CDC recommendation of 1 hour of moderate to vigorous exercise
daily for children and adolescents ages 6 to 17.
Rationale 2: Swimming for 60 minutes
five times per week and jogging for 60 minutes the remaining 2 days per week
meets the CDC recommendation of 1 hour of moderate to vigorous exercise daily
for children and adolescents ages 6 to 17.
Rationale 3: Lifting weights for 15
minutes three times per week does not meet the CDC recommendation of 1 hour of
moderate to vigorous exercise daily for children and adolescents ages 6 to 17.
Rationale 4: Speed walking for 60
minutes five times per week does not meet the CDC recommendation of 1 hour of
moderate to vigorous exercise daily for children and adolescents ages 6 to 17.
Global Rationale: The CDC recommendation
for physical activity for children and adolescents, ages 6 to 17, are: 1 hour
or more of physical activity every day with most of the hour consisting of
moderate- or vigorous-intensity aerobic activity. The CDC also recommends that
during the daily hour of physical activity, muscle- and bone-strengthening
activity should each be included at least 3 days per week. Therefore, the 16
year old who swims for 1 hour 5 days per week and jogs for 60 minutes the
remaining 2 days per week meets the CDC recommendations. The swimming would
also be considered a muscle-strengthening activity and the jogging would be
considered a bone-strengthening activity. The other options do not meet CDC
recommendations.
Cognitive Level: Applying
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
AACN Essentials Competencies: VII.11.
Participate in clinical prevention and population-focused interventions with
attention to effectiveness, efficiency, cost-effectiveness, and equity.
NLN Competencies: Context and
Environment: Apply health promotion/disease prevention strategies; Apply health
policy.
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3.4: Apply the goals
and objectives for each topic area in Healthy
People 2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 54–66
Question 9
Type: MCSA
The school nurse is working with several school-aged children in
health class. Which child is meeting age-appropriate recommendations for
physical activity developed by the Centers for Disease Control (CDC)?
1. A
12-year-old who plays soccer 4 days per week at the neighborhood playground and
3 days per week for a soccer team.
2. A
10-year-old who runs wind sprints for 15 minutes for PE class 1 day per week.
3. An
8-year-old who plays on the monkey bars at both 30-minute recess periods three
times per week.
4. A
9-year-old who plays kickball at one 20-minute recess daily five times per week
and plays basketball for a team 2 days per week.
Correct Answer: 1
Rationale 1: The 12-year-old who
plays soccer 4 days per week at the neighborhood playground and 3 days per week
for a soccer team is meeting the recommended 60 minutes per day of moderate- to
vigorous-intensity aerobic activity.
Rationale 2: The 10-year-old who
runs wind sprints for 15 minutes for PE class 1 day per week is not meeting the
recommended 60 minutes per day of moderate- to vigorous-intensity aerobic
activity.
Rationale 3: The 8-year-old who
plays on the monkey bars at both 30-minute recess periods three times per week
is not meeting the recommended 60 minutes per day of moderate- to
vigorous-intensity aerobic activity.
Rationale 4: The 9-year-old who
plays kickball at one 20-minute recess daily five times per week and plays
basketball for a team 2 days per week is not meeting the recommended 60 minutes
per day of moderate- to vigorous-intensity aerobic activity.
Global Rationale: The CDC recommendation
for physical activity for children and adolescents, ages 6 to 17, are: 1 hour
or more of physical activity every day with most of the hour consisting of
moderate- or vigorous-intensity aerobic activity. The CDC also recommends that
during the daily hour of physical activity, muscle- and bone-strengthening
activity should each be included at least 3 days per week. Only the child who
plays soccer each day meets the recommended activity levels for age. The
10-year-old is exercising only 15 minutes once per week. The 8-year-old is
exercising 60 minutes per day, but only three times per week, which does not
meet the criteria for 60 minutes of daily exercise. The 9-year-old is only
exercising for 20 minutes 5 days while playing kickball and 2 days of
basketball, which does not meet the minimum criteria.
Cognitive Level: Applying
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
AACN Essentials Competencies: VII.11.
Participate in clinical prevention and population-focused interventions with
attention to effectiveness, efficiency, cost-effectiveness, and equity.
NLN Competencies: Context and
Environment: Apply health promotion/disease prevention strategies; Apply health
policy.
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3.4: Apply the goals
and objectives for each topic area in Healthy
People 2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp.54–66
Question 10
Type: MCSA
A nurse teaching a smoking cessation class includes the
following statements in the presentation: “Everyone here tonight has the
ability to control the urge to smoke. You are all rational people who
understand that smoking is the cause of many significant health problems, and
that it is a voluntary event that you are going to learn to do without.
Regardless of your motivation, you will get help here to understand your
triggers to smoke, and how to control them.” Which theory or model is the nurse
using to promote smoking cessation?
1. The
Self-Efficacy Model.
2. The
Theory of Reasoned Action.
3. The
Health Promotion Model.
4. The
Health Belief Model.
Correct Answer: 2
Rationale 1: Self-efficacy is part
of the Health Belief Model, and not its own theory. Self-efficacy refers to how
confident individuals are in their own ability to perform a behavior.
Rationale 2: The Theory of Reasoned
Action/Planned Behavior is a prediction theory based on the assumptions that
behavior is under volitional control and that people are rational beings. The
theory also suggests that individuals are more likely to participate in healthy
behaviors if they believe the benefit outweighs the cost of the behavior. The
statement by the nurse indicates these principles.
Rationale 3: The Health Promotion
Model depicts people as multidimensional in interactions with their
environments, and focuses on variables that impact behavior. Variables that
impact behavior include personal factors such as age, strength, and agility;
cognitive factors such as an individual’s perceived benefit of a health
promoting action; and intrapersonal influences such as the influence of family
members, friends, or a health care provider. The statement by the nurse does
not depict this model.
Rationale 4: The Health Belief Model
relates to cues to action for a change in behavior. The cues to action in this
model refer to internal and external stimuli that motivate a person to
participate in health promoting behavior. An example of a cue to action is a
female getting yearly mammograms due to a family member having breast cancer.
The statement by the nurse does not depict this model.
Global Rationale: The Theory of Reasoned
Action/Planned Behavior is a prediction theory based on the assumptions that
behavior is under volitional control and that people are rational beings. The
theory also suggests that individuals are more likely to participate in healthy
behaviors if they believe the benefit outweighs the cost of the behavior.
Self-efficacy refers to how confident individuals are in their own ability to
perform a behavior, and is part of the Health Belief Model, not its own theory.
The Health Promotion Model depicts people as multidimensional in interactions
with their environments, and focuses on variables that impact behavior.
Variables that impact behavior include personal factors such as age, strength,
and agility; cognitive factors such as an individual’s perceived benefit of a
health-promoting action; and intrapersonal influences such as the influence of
family members, friends, or a health care provider. The Health Belief Model
relates to cues to action. The cues to action in this model refer to internal
and external stimuli that motivate a person to participate in health-promoting
behavior. An example of a cue to action is a female getting yearly mammograms
due to a family member having breast cancer.
Cognitive Level: Applying
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
AACN Essentials Competencies: I.1.
Integrate theories and concepts from liberal education into nursing practice.
NLN Competencies: Context and
Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3.3: Relate
perspectives of health promotion to the individual, family, and community.
MNL Learning Outcome:
Page Number: pp. 48–54
Question 11
Type: MCSA
The nurse is working with several clients in a fitness setting. Which
client is meeting the age-appropriate recommendations for physical activity
developed by the Centers for Disease Control (CDC)?
1. A
37-year-old who lifts weights for one hour twice per week.
2. A
42-year-old who walks at a slow pace for 60 minutes 4 days per week.
3. A
45-year-old who walks briskly for 30 minutes 6 days per week.
4. A
57-year-old who swims for 20 minutes twice per week.
Correct Answer: 3
Rationale 1: The weight lifter is
not exercising the minimum number of hours per week of the recommended moderate-intensity
physical activities, for at least 2 hours and 30 minutes per week or 1 hour and
15 minutes of vigorous-intensity aerobic physical activity per week; or an
equivalent combination of moderate- and vigorous-intensity aerobic activity.
Rationale 2: The 42-year-old who is
walking at a slow pace is not meeting the minimum criteria for moderate
exercise.
Rationale 3: The adult who walks
briskly for 30 minutes 6 days per week is meeting the criteria of
moderate-intensity physical activities for at least 2 hours and 30 minutes per
week or 1 hour and 15 minutes of vigorous-intensity aerobic physical activity
per week; or an equivalent combination of moderate- and vigorous-intensity
aerobic activity, as well as the suggested aerobic activity occurring for at
least 10 minute episodes throughout the week.
Rationale 4: The swimmer is only
exercising twice per week for a total of 40 minutes, which does not meet the
minimum requirements for moderate physical activity.
Global Rationale: The recommendations
for physical activity for adults are: moderate-intensity physical activities
for at least 2 hours and 30 minutes per week or 1 hour and 15 minutes of
vigorous-intensity aerobic physical activity per week, or an equivalent
combination of moderate- and vigorous-intensity aerobic activity. Aerobic
activity should occur for at least 10-minute episodes throughout the week. Only
the adult who walks briskly is meeting the criteria of moderate-intensity
physical activities for at least 2 hours and 30 minutes per week or 1 hour and
15 minutes of vigorous-intensity aerobic physical activity per week, or an
equivalent combination of moderate- and vigorous-intensity aerobic activity.
The weight lifter is not exercising the minimum number of hours per week. The
42-year-old who is walking at a slow pace is not meeting the minimum criteria
for moderate exercise. The swimmer is only exercising twice per week for a
total of 40 minutes.
Cognitive Level: Applying
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
AACN Essentials Competencies: VII.11.
Participate in clinical prevention and population-focused interventions with
attention to effectiveness, efficiency, cost-effectiveness, and equity.
NLN Competencies: Context and
Environment: Apply health promotion/disease prevention strategies; Apply health
policy.
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3.4: Apply the goals
and objectives for each topic area in Healthy
People 2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 54–66
Question 12
Type: MCSA
The nurse is working with a 60-year-old female client in a
fitness setting. Which is the correct maximum desired heart rate target zone
for both moderate- and vigorous-intensity workouts for this client?
1. 66–80,
and 112–124.
2. 60–85,
and 85–110.
3. 80–110,
and 120–130.
4. 80–112,
and 112–136.
Correct Answer: 4
Rationale 1: Utilizing the proper calculation
method, 66–80, and 112–124 beats per minute are not the desired heart rate
target zones for moderate- and vigorous-intensity workouts for a 60 year old.
Rationale 2: Utilizing the proper
calculation method, 60–85, and 85–110 beats per minute are not the desired
heart rate target zones for moderate- and vigorous-intensity workouts for a 60
year old.
Rationale 3: Utilizing the proper
calculation method, 80–110, and 120–130 beats per minute are not the desired
heart rate target zones for moderate- and vigorous-intensity workouts for a 60
year old.
Rationale 4: Utilizing the proper
calculation method, 80–112, and 112–136 beats per minute are the desired heart
rate target zones for moderate- and vigorous-intensity workouts for a 60 year
old.
Global Rationale: Moderate intensity
exercise should raise the heart rate 50–70%. Vigorous intensity exercise should
raise the heart rate 70–85%. To calculate the minimum and maximum targets zones
from each type of activity, you must first determine the maximum heart rate.
This is done by subtracting the individual’s age from 220. Therefore, 220 – 60
= 160. 160 × 0.5 (50%) = 80; 160 × 0.7 (70%) = 112. For vigorous activity, 160
× 0.7 = 112; 160 × 0.85 (85%) = 136. Therefore, 80–112, and 112–136 is the
correct answer.
Cognitive Level: Applying
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
AACN Essentials Competencies: VII.11.
Participate in clinical prevention and population-focused interventions with
attention to effectiveness, efficiency, cost-effectiveness, and equity.
NLN Competencies: Context and
Environment: Apply health promotion/disease prevention strategies; Apply health
policy.
Nursing/Integrated Concepts: Nursing
Process: Assessment
Learning Outcome: 3.4: Apply the goals
and objectives for each topic area in Healthy
People 2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 54–66
Question 13
Type: MCMA
The client inquires about isotonic exercises that will increase
muscle tone. Which activities will the nurse recommend to the client?
Standard Text: Select all that apply.
1. Running.
2. Weight
lifting.
3. Walking.
4. Pushing
against a wall.
5. Cycling.
Correct Answer: 1, 3, 5
Rationale 1: Running is an example
of isotonic exercise which increases muscle tone.
Rationale 2: Resistive exercises do
not increase muscle tone. An example of resistive exercise includes weight
lifting.
Rationale 3: Walking is an example
of isotonic exercise which increases muscle tone.
Rationale 4: Isometric exercises
include those that affect muscle tension but do not result in muscle or joint
movement. Isometric exercises are useful for strengthening abdominal, gluteal,
and quadriceps muscles, for maintaining strength of immobilized muscles, and
for endurance training. Examples of isometric exercise would include tensing of
thigh muscles and extending the arms and pushing against a wall.
Rationale 5: Cycling is an example of
isotonic exercise which increases muscle tone.
Global Rationale: Isotonic exercises
increase tone, and involve activities such as running, walking, and cycling.
Resistive exercises such as weight lifting do not increase muscle tone.
Isometric exercises include those that affect muscle tension but do not result
in muscle or joint movement. Isometric exercises are useful for strengthening
abdominal, gluteal, and quadriceps muscles, for maintaining strength of
immobilized muscles, and for endurance training. Examples of isometric exercise
would include tensing of thigh muscles and extending the arms and pushing
against a wall. Cycling is an example of isotonic exercise which increases
muscle tone.
Cognitive Level: Applying
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
AACN Essentials Competencies: VII.11.
Participate in clinical prevention and population-focused interventions with
attention to effectiveness, efficiency, cost-effectiveness, and equity.
NLN Competencies: Context and
Environment: Apply health promotion/disease prevention strategies; Apply health
policy.
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3.4: Apply the goals
and objectives for each topic area in Healthy
People 2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 63–64
Question 14
Type: MCSA
The nurse is preparing a seminar presentation regarding causes
of death in the United States. Which cause of death with the nurse include as
being responsible for more deaths in the United States than all of the others
combined?
1. HIV
and AIDS.
2. Cigarette
smoking.
3. Automobile
crashes.
4. Drug
abuse.
Correct Answer: 2
Rationale 1: HIV and AIDS are not
responsible for the most deaths in the United States.
Rationale 2: Cigarette smoking is
responsible for more deaths in the United States than death from HIV/AIDS, drug
abuse, homicide, suicide, automobile crashes, and fire combined.
Rationale 3: Automobile crashes are
not responsible for the most deaths in the United States.
Rationale 4: Drug abuse is not
responsible for the most deaths in the United States.
Global Rationale: Cigarette smoking is
responsible for more deaths in the United States than death from HIV/AIDS, drug
abuse, homicide, suicide, automobile crashes, and fire combined. Smoking is a
risk factor for heart disease, breathing disorders, and lung cancer. Secondary
smoke increases the incidence of asthma and bronchitis in children, and heart
and lung diseases in adults.
Cognitive Level: Remembering
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
AACN Essentials Competencies: VII.11.
Participate in clinical prevention and population-focused interventions with
attention to effectiveness, efficiency, cost-effectiveness, and equity.
NLN Competencies: Context and
Environment: Apply health promotion/disease prevention strategies; Apply health
policy.
Nursing/Integrated Concepts: Nursing
Process: Assessment
Learning Outcome: 3.4: Apply the goals
and objectives for each topic area in Healthy
People 2020 to nursing practice.
MNL Learning Outcome:
Page Number: pp. 54–66
Question 15
Type: MCSA
A nursing student is preparing an educational program concerning
breast cancer. The focus of the program is secondary prevention. Which topic
would be most appropriate?
1. A
dietary discussion concerning the connection between breast cancer and dietary
intake.
2. Techniques
for performing self-breast examination.
3. Radical
mastectomy.
4. Chemotherapy
and radiation treatments.
Correct Answer: 2
Rationale 1: Primary prevention
implies that an individual is healthy and focuses on health promotion and
disease prevention. Primary prevention is demonstrated by the discussion of
dietary recommendations for prevention of breast cancer.
Rationale 2: Secondary prevention
emphasizes early diagnosis and treatment of health problems, and includes
screenings such as teaching clients about self-breast examination.
Rationale 3: Tertiary prevention is
aimed toward treatment of a condition and restoration of health to the highest
level of wellness possible. Treatment options for breast cancer, such as a
radical mastectomy, would be considered a form of tertiary prevention.
Rationale 4: Tertiary prevention is
aimed toward treatment of a condition and restoration of health to the highest
level of wellness possible. Treatment options for breast cancer, such as
chemotherapy and radiation, would be considered a form of tertiary prevention.
Global Rationale: Secondary prevention
emphasizes early diagnosis and treatment of health problems, and includes
screenings such as teaching clients about self-breast examination and mammography.
Primary prevention has a focus geared toward health promotion and disease
prevention, which is demonstrated by the discussion of dietary recommendations.
Tertiary prevention is aimed toward treatment of a condition and restoration of
health to the highest level of wellness possible. Treatment options for breast
cancer such as a radical mastectomy, chemotherapy, and radiation would be
considered forms of tertiary prevention.
Cognitive Level: Applying
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.A.1. Demonstrate
knowledge of basic scientific methods and processes.
AACN Essentials Competencies: I.1.
Integrate theories and concepts from liberal education into nursing practice.
NLN Competencies: Context and Environment:
Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing
Process: Planning
Learning Outcome: 3.2: Compare and
contrast selected theories of wellness.
MNL Learning Outcome:
Page Number: p. 48
Question 16
Type: MCSA
During a routine health examination, a client reports concern
about her potential for the development of heart disease. During the
assessment, the nurse reviews the client’s risk factors. Which of the client’s
risk factors are considered modifiable?
1. Age,
heredity, and weight.
2. Family
history, self-history of diabetes mellitus type 1, and age
3. Weight,
dietary intake, and environmental risks.
4. Biological
characteristics, lifestyle factors, and family history.
Correct Answer: 3
Rationale 1: Age and heredity are non-modifiable
risk factors (cannot be changed by the client’s actions); while weight is a
modifiable risk factor (can be changed by the client’s actions).
Rationale 2: Family history,
self-history of diabetes mellitus type 1, and age are all non-modifiable risk
factors (cannot be changed by the client’s actions).
Rationale 3: Weight, dietary intake,
and environmental risks are all modifiable risk factor (can be changed by the
client’s actions).
Rationale 4: Biological
characteristics and family history are non-modifiable risk factors (cannot be
changed by the client’s actions); while lifestyle factors are modifiable risk
factors (can be changed by the client’s actions).
Global Rationale: Risk factors that can
be controlled by client action are termed modifiable. Those risk factors which
cannot be changed by the client, such as age, heredity, genetic factors,
certain health conditions, and biological characteristics, are called
non-modifiable factors.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Reduction of Risk
Potential
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
AACN Essentials Competencies: I.1.
Integrate theories and concepts from liberal education into nursing practice.
NLN Competencies: Context and
Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing
Process: Assessment
Learning Outcome: 3.3: Relate
perspectives of health promotion to the individual, family, and community.
MNL Learning Outcome:
Page Number: p. 66
Question 17
Type: MCSA
The Health Promotion Model is being used by a nurse to analyze
the potential impact of the importance of regular exercise. According to the
model, which participant is most likely to initiate and consistently
participate in a successful program of exercise after attending the session?
1. An
overweight female who has never participated in an exercise program.
2. A
30-year-old male who admits frequently joining and quitting exercise groups.
3. A
teenaged male who has low self-esteem.
4. A
24-year-old female who reports she is anxious to begin exercising with her
husband.
Correct Answer: 4
Rationale 1: The overweight female
who has never participated in an exercise program would most likely have less
motivation to initiate and consistently participate in a successful exercise
program than the 24-year-old female who is anxious to begin exercise with her
husband, who would be a source of support, according to the Health Promotion
Model.
Rationale 2: A 30-year-old male who
frequently joins and quits exercise groups is less likely to initiate and
consistently participate in a successful exercise program than the 24-year-old
female who is anxious to begin exercise with her husband, who would be a source
of support, according to the Health Promotion Model.
Rationale 3: A teenaged male with
low self-esteem is less likely to initiate and consistently participate in a
successful exercise program than the 24-year-old female who is anxious to begin
exercise with her husband, who would be a source of support, according to the
Health Promotion Model.
Rationale 4: The 24-year-old female who
reports she is anxious to begin exercising with her husband displays the
motivational characteristics of the Health Promotion Model to most likely
initiate and consistently participate in a successful exercise program.
Global Rationale: The Health Promotion
Model views persons as “multidimensional and in interaction with interpersonal
and physical environments as they pursue health.” The model can be used to make
inferences about people’s motivational and behavioral outcomes. The female who
has a strong motivation and social support demonstrates the strongest
likelihood of following through with the program. Variables such as low self-esteem,
prior negative outcomes, and a lack of experience can reduce the individual’s
willingness to engage in the health-promoting activities.
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Client Need Sub:
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
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: Apply health promotion/disease prevention strategies; Apply health
policy.
Nursing/Integrated Concepts: Nursing
Process: Evaluation
Learning Outcome: 3.5: Demonstrate how
to use the nursing process to encourage health promotion.
MNL Learning Outcome:
Page Number: pp. 66–67
Question 18
Type: MCMA
The nurse is planning a presentation to a group of middle-school
students regarding health promotion and wellness. Which concepts will the nurse
plan to include in the presentation?
Standard Text: Select all that apply.
1. Individuals
are more knowledgeable in today’s society in regard to health care issues.
2. Consumers
of health care in today’s society demonstrate less decision-making capabilities
concerning their health care than in the past.
3. The
focus of Healthy
People 2020 is on the early treatment of disease and
pathologic conditions.
4. The
roles of health care providers in today’s society have expanded.
5. Individuals,
in general, are proactive regarding health care practices and desire care that
promotes health and prevents disease.
Correct Answer: 1, 4, 5
Rationale 1: Individuals in today’s
society are more knowledgeable regarding health care issues than in the past.
Rationale 2: Clients are actively
involved in the decision-making process related to their health care.
Rationale 3: The focus of Healthy People 2020 is
on health promotion and disease prevention rather than early treatment of
disease and pathologic conditions.
Rationale 4: Due to the complexity
of the health care system of today, the role of health care providers has
changed and expanded.
Rationale 5: Individuals in today’s
society are proactive in regard to their health care needs and an emphasis is
placed on health promotion and disease prevention.
Global Rationale: Individuals in today’s
society are more knowledgeable in regard to health care issues; thus,
individuals demonstrate control in decision-making capabilities concerning
their health care. Healthy
People 2020 focuses on health and wellness, rather than early
treatment of disease and pathologic conditions. Due to the complexity of
today’s health care system, the role of health care providers has changed and
expanded. Lastly, individuals are more proactive in regard to health care
practices of today and desire care that emphasizes health promotion.
Cognitive Level: Remembering
Client Need: Health Promotion and
Maintenance
Client Need Sub:
QSEN Competencies: III.A.1. Demonstrate
knowledge of basic scientific methods and processes.
AACN Essentials Competencies: I.1.
Integrate theories and concepts from liberal education into nursing practice.
NLN Competencies: Context and
Environment: Health promotion/disease prevention.
Nursing/Integrated Concepts: Nursing
Process: Planning
Learning Outcome: 3.1: Distinguish
between concepts of wellness and health promotion.
MNL Learning Outcome:
Page Number: pp. 48–49
Question 19
Type: MCSA
A client who has recently experienced a fracture is concerned
about maintaining muscle strength during recuperation. Which type of exercise
will the nurse recommend for this client?
1. Isometric
exercise.
2. Isotonic
exercise.
3. Resistive
exercise.
4. Anaerobic
exercise.
Correct Answer: 1
Rationale 1: Isometric exercises affect
muscle tension. Joint movement does not occur during isometric exercises. This
type of exercise can be used for strength maintenance for immobilized clients
and can be achieved with tensing the muscles in the affected arm or extending
the arm.
Rationale 2: Isotonic exercises
increase tone and involve activities such as running, walking, and cycling.
These types of activities may be contraindicated by clients having a fracture.
Rationale 3: Resistive exercises use
resistance. An example of resistive exercise includes weight lifting. This
activity may be contraindicated by a client with a fracture.
Rationale 4: Anaerobic exercises are
activities used to promote endurance training by participating in short periods
of vigorous activity. This type of activity would not be indicated for a client
with a fracture.
Global Rationale: Isometric exercises
affect muscle tension. Joint movement does not occur during isometric
exercises. Examples of isometric exercise would include tensing of thigh
muscles, extending the arms, and pushing against a wall. For this client, the
best isometric exercise would be tensing the muscles in the affected arm or
extending the arm. This type of exercise can be used for strength maintenance
for immobilized clients. Isotonic exercises increase tone and involve
activities such as running, walking, and cycling. These types of activities may
be contraindicated by clients having a fracture. Resistive exercises use
resistance. An example of resistive exercise includes weight lifting. Anaerobic
exercises are activities used to promote endurance.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Physiological
Adaptation
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
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: Apply health promotion/disease prevention strategies; Apply health
policy.
Nursing/Integrated Concepts: Nursing
Process: Planning
Learning Outcome: 3.5: Demonstrate how
to use the nursing process to encourage health promotion.
MNL Learning Outcome:
Page Number: pp. 63–64
Question 20
Type: MCMA
The client who reports having difficulty sleeping at night asks
the nurse for suggestions to enhance getting a good night’s sleep. Which
recommendations may be beneficial to this client?
Standard Text: Select all that apply.
1. Performing
30 minutes of exercise prior to going bedtime.
2. Setting
a regular bedtime.
3. Establishing
a relaxation routine at bedtime.
4. Avoiding
alcohol.
5. Watching
television to assist in falling asleep.
Correct Answer: 2, 3, 4
Rationale 1: Performing exercises 30
minutes prior to going to bed will most likely stimulate the individual rather
than promote sleep.
Rationale 2: Setting a regular
bedtime, as well as a regular waking time, promotes a more restful sleep.
Rationale 3: A relaxation routine
prior to bedtime promotes sleep.
Rationale 4: Avoiding alcohol will
promote restful sleep since alcohol interferes with a normal sleep pattern.
Rationale 5: Watching television
prior to attempting to fall asleep will most likely stimulate the individual
rather than promote sleep.
Global Rationale: Establishing a routine
including a regular bedtime and relaxation promote a restful sleep. Alcohol may
be associated with altered sleep patterns. Performing exercises prior to going
to bed and watching television will stimulate the individual rather than
promote sleep.
Cognitive Level: Applying
Client Need: Physiological Integrity
Client Need Sub: Basic Care and Comfort
QSEN Competencies: III.B.3. Base
individualized care plan on patient values, clinical expertise, and evidence.
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: Apply health promotion/disease prevention strategies; Apply health
policy.
Nursing/Integrated Concepts: Nursing
Process: Implementation
Learning Outcome: 3.5: Demonstrate how
to use the nursing process to encourage health promotion.
MNL Learning Outcome:
Page Number: pp. 64–65
Question 21
Type: MCSA
During a routine pediatric health maintenance appointment, the
parents of a newborn report being concerned their baby is sleeping too much.
The nursing assessment reveals the newborn sleeps 16 hours each day. Which
response by the nurse is the most appropriate?
1. “The
recommendation for a newborn is 16 to 18 hours of sleep per day.”
2. “Your
newborn is sleeping too much.”
3. “Do
not allow your newborn to nap as often.”
4. “I
would recommend putting your baby to sleep later in the evening.”
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