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TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

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Chapter04:HealthEducationandPromotion  1.

AnursehasbeenworkingwithMrs.Griffin,a71-year-oldpatientwhosepoorlycontrolledtype1 diabeteshasledtonumeroushealthproblems.OverthepastseveralyearsMrs.Griffinhashadseveral admissionstothehospitalmedicalunit,andthenursehasoftencarriedouthealthpromotion interventions.WhoisultimatelyresponsibleformaintainingandpromotingMrs.Griffinshealth?

A)

Themedicalnurse

B)

ThecommunityhealthnursewhohasalsoworkedwithMrs.Griffin

C)

Mrs.Griffinsprimarycareprovider

D)

Mrs.Griffin

Ans:

D Feedback: Americansocietyplacesagreatimportanceonhealthandtheresponsibilitythateachofushasto maintainandpromoteourownhealth.Therefore,theotheroptionsareincorrect.

2.

Anelderlyfemalepatienthascometotheclinicforascheduledfollow-upappointment.Thenurse learnsfromthepatientsdaughterthatthepatientisnotfollowingtheinstructionsshereceivedupon dischargefromthehospitallastmonth.Whatisthemostlikelyfactorcausingthepatientnottoadhereto hertherapeuticregimen?

A)

Ethnicbackgroundofhealthcareprovider

B)

Costsoftheprescribedregimen

C)

Presenceofalearningdisability

D)

Personalityofthephysician

Ans:

B Feedback: Variablesthatappeartoinfluencethedegreeofadherencetoaprescribedtherapeuticregimeninclude gender,race,education,illness,complexityoftheregimen,andthecostoftreatments.Theethnic backgroundofthehealthcareproviderandthepersonalityofthephysicianarenotconsideredvariables thatappeartoinfluencethedegreeofadherencetoaprescribedtherapeuticregimen.Alearning disabilitycouldgreatlyaffectadherence,butcostisamorelikelybarrier.

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

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Agerontologicnursehasobservedthatpatientsoftenfailtoadheretoatherapeuticregimen.What strategyshouldthenurseadopttobestassistanolderadultinadheringtoatherapeuticregimen involvingwoundcare?

A)

Demonstrateadressingchangeandallowthepatienttopractice.

B)

Provideadetailedpamphletonadressingchange.

C)

Verballyinstructthepatienthowtochangeadressingandcheckforcomprehension.

D)

Delegatethedressingchangetoatrustedfamilymember.

Ans:

A Feedback: Thenursemustconsiderthatolderadultsmayhavedeficitsintheabilitytodrawinferences,apply information,orunderstandmajorteachingpoints.Demonstrationandpracticeareessentialinmeeting theirlearningneeds.Theotheroptionsareincorrectbecausetheelderlymayhaveproblemsreading and/orunderstandingawrittenpamphletorverbalinstructions.Havingafamilymemberchangethe dressingwhenthepatientiscapableofdoingitimpedesself-careandindependence.

4.

A20-year-oldmannewlydiagnosedwithtype1diabetesneedstolearnhowtoself-administerinsulin. Whenplanningtheappropriateeducationalinterventionsandconsideringvariablesthatwillaffecthis learning,thenurseshouldprioritizewhichofthefollowingfactors?

A)

Patientsexpectedlifespan

B)

Patientsgender

C)

Patientsoccupation

D)

Patientsculture

Ans:

D Feedback: Oneofthemajorvariablesthatinfluencesapatientsreadinesstolearnisthepatientsculture,becauseit affectshowapersonlearnsandwhatinformationislearned.Othervariablesincludeillnessstates, values,emotionalreadiness,andphysicalreadiness.Lifespan,occupation,andgenderarevariablesthat areusuallylesssalient.

5.

Thenurseisplanningtoteacha75-year-oldpatientwithcoronaryarterydiseaseaboutadministeringher prescribedantiplateletmedication.Howcanthenursebestenhancethepatientsabilitytolearn?

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

A)

ProvidelinkstoWebsitesthatcontainevidence-basedinformation.

B)

Excludefamilymembersfromthesessiontopreventdistraction.

C)

Usecolor-codedmaterialsthataresuccinctandengaging.

D)

Maketheinformationdirectlyrelevanttothepatientscondition.

Ans:

D

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Feedback: Studieshaveshownthatolderadultscanlearnandrememberiftheinformationispacedappropriately, relevant,andfollowedbyappropriatefeedback.Familymembersshouldbeincludedinhealtheducation Thenurseshouldnotassumethatthepatientscolorvisionisintactorthatthepatientpossessesadequate computerskills. 6.

Anurseisplanningcareforanolderadultwholiveswithanumberofchronichealthproblems.For whichofthefollowingnursingdiagnoseswouldeducationofthepatientbethenurseshighestpriority?

A)

Riskforimpairedphysicalmobilityrelatedtojointpain

B)

Functionalurinaryincontinencerelateddecreasedmobility

C)

Activityintolerancerelatedtocontractures

D)

Riskforineffectivehealthmaintenancerelatedtononadherencetotherapeuticregimen

Ans:

D Feedback: Forsomenursingdiagnoses,educationisaprimarynursingintervention.Thesediagnosesincluderisk forineffectivemanagementoftherapeuticregimen,riskforimpairedhomemanagement,health-seeking behaviors,anddecisionalconflict.Theotheroptionsdonothavepatienteducationasthehighest priority,thougheachnecessitatesacertaindegreeofeducation.

7.

Thenursinginstructorhasgivenanassignmenttoagroupofcertifiednursepractitioner(CNP)students. Theyaretobreakintogroupsoffourandcompleteahealth-promotionteachingprojectandpresenta reporttotheirfellowstudents.Whatprojectmostclearlydemonstratestheprinciplesofhealthpromotionteaching?

A)

Demonstratinganinjectiontechniquetoapatientforanticoagulanttherapy

B)

Explainingthesideeffectsofamedicationtoanadultpatient

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

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C)

Discussingtheimportanceofpreventingsexuallytransmittedinfections(STI)toagroupofhigh schoolstudents

D)

Instructinganadolescentpatientaboutsafeandnutritiousfoodpreparation

Ans:

C Feedback: Healthpromotionencouragespeopletoliveahealthylifestyleandtoachieveahighlevelofwellness. DiscussingtheimportanceofSTIpreventiontoagroupofhighschoolstudentsisthebestexampleofa health-promotionteachingproject.Thisproactiveinterventionisamorepreciseexampleofhealth promotionthantheothercitedexamples.

8.

Healthpromotionrankshighonthelistofhealth-relatedconcernsoftheAmericanpublic.Basedon currentknowledge,whatfactorshouldthenurseprioritizeinanefforttopromotehealth,longevity,and weightcontrolinpatients?

A)

Goodnutrition

B)

Stressreduction

C)

Useofvitamins

D)

Screeningforhealthrisks

Ans:

A Feedback: Ithasbeensuggestedthatgoodnutritionisthesinglemostsignificantfactorindetermininghealthstatus longevity,andweightcontrol.Abalanceddietthatusesfewartificialingredientsandislowinfat, caffeine,andsodiumconstitutesahealthydiet.Stressreductionandscreeningforhealthrisksarecorrect answers,justnotthemostsignificantfactors.Vitaminuseisnotnormallynecessarywhenanindividual eatsahealthydiet,exceptinspecificcircumstances.

9.

Thenursingprofessionandnursesasindividualshavearesponsibilitytopromoteactivitiesthatfoster well-being.Whatfactorhasmostinfluencednursesabilitiestoplaythisvitalrole?

A)

Nursesareseenasnurturingprofessionals.

B)

Nursespossessabaccalaureatedegreeastheentrytopractice.

C)

Nursespossessanauthenticdesiretohelpothers.

D)

Nurseshavelong-establishedcredibilitywiththepublic.

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

Ans:

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D Feedback: Nurses,byvirtueoftheirexpertiseinhealthandhealthcareandtheirlong-establishedcredibilitywith consumers,playavitalroleinhealthpromotion.Theotheroptionsareincorrectbecausetheyarenotthe mostinfluentialwhenitcomestohealthpromotionbynursingandnurses.

10. Thenurseisteachingalocalcommunitygroupabouttheimportanceofdiseaseprevention.Whyisthe nursejustifiedinemphasizingdiseasepreventionasacomponentofhealthpromotion? A)

Preventionisemphasizedasthelinkbetweenpersonalbehaviorandhealth.

B)

MostAmericansdieofpreventablecauses.

C)

Healthmaintenanceorganizations(HMOs)nowemphasizepreventionasthemaincriterionof healthcare.

D)

Externalenvironmentaffectstheoutcomeofmostdiseaseprocesses.

Ans:

A Feedback: HealthyPeople2020definesthecurrentnationalhealth-promotionanddisease-preventioninitiativefor thenation.Theoverallgoalsareto(1)increasethequalityandyearsofhealthylifeforpeopleand(2) eliminatehealthdisparitiesamongvarioussegmentsofthepopulation.Mostdeathsarenotclassifiedas beingpreventable.HMOprioritiesdonotunderliethisemphasis.Theexternalenvironmentaffectsmany diseaseprocesses,butthecourseofillnessisprimarilydeterminedbyfactorsintrinsictothepatient.

11. Thenurseispreparingdischargeteachingfora51-year-oldwomandiagnosedwithurinaryretention secondarytomultiplesclerosis.Thenursewillteachthepatienttoself-catheterizeathomeupon discharge.Whatteachingmethodismostlikelytobeeffectiveforthispatient? A)

Alistofclearinstructionswrittenatasixth-gradelevel

B)

Ashortvideoprovidingusefulinformationanddemonstrations

C)

Anaudio-recordedversionofdischargeinstructionsthatcanbeaccessedathome

D)

Adiscussionanddemonstrationbetweenthenurseandthepatient

Ans:

D Feedback:

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

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Demonstrationandpracticeareessentialingredientsofateachingprogram,especiallywhenteaching skills.Itisbesttodemonstratetheskillandthengivethelearnerampleopportunityforpractice.When specialequipmentisinvolved,suchasurinarycatheters,itisimportanttoteachwiththesameequipment thatwillbeusedinthehomesetting.Alistofinstructions,avideo,andanaudiorecordingareeffective methodsofreinforcingteachingafterthediscussionanddemonstrationhavetakenplace. 12. Youarethenurseplanningtoteachtracheostomycaretoapatientwhowillbedischargedhome followingaspinalcordinjury.Whenpreparingyourteaching,whichofthefollowingisthemost importantcomponentofyourteachingplan? A)

Citingtheevidencethatunderlieseachofyourteachingpoints

B)

Alleviatingthepatientsguiltassociatedwithnotknowingappropriateself-care

C)

Determiningthepatientsreadinesstolearnnewinformation

D)

Includingyournursingcolleaguesintheplanningprocess

Ans:

C Feedback: Assessmentintheteachinglearningprocessisdirectedtowardthesystematiccollectionofdataaboutthe personandfamilyslearningneedsandreadinesstolearn.Patientreadinessiscriticaltoacceptingand integratingnewinformation.Unlessthepatientisreadytoacceptnewinformation,patientteachingwill beineffective.Citingtheevidencebasewillnotlikelyenhancelearning.Patientguiltcannotbe alleviateduntilthepatientunderstandstheintricaciesoftheconditionandhisphysiologicresponseto thedisease.Inclusionofcolleaguescanbebeneficial,butthisdoesnotdeterminethesuccessorfailure ofteaching.

13. Apublichealthnurseispreparingtoholdaseriesofhealth-promotionclassesformiddle-agedadults thatwilladdressavarietyoftopics.Whichsitewouldbestmeetthelearningneedsofthispopulation? A)

Awell-respectedphysiciansoffice

B)

Alarge,localworkplace

C)

Thelocalhospital

D)

Anambulatoryclinic

Ans:

B Feedback: Theworkplacehasbecomeacenterforhealth-promotionactivity.Health-promotionprogramscan

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

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generallybeofferedalmostanywhereinthecommunity,buttheworkplaceisoftenmoreconvenientfor theadult,workingpopulation.Thismakesthisoptionpreferabletoahospital,doctorsoffice,or ambulatoryclinic. 14. Anursehasbeenstudyingresearchthatexaminestheassociationbetweenstresslevelsandnegative healthoutcomes.Whichrelationshipshouldunderlietheeducationalinterventionsthatthenursechooses toteach? A)

Stressimpairssleeppatterns.

B)

Stressdecreasesimmunefunction.

C)

Stressincreasesweight.

D)

Stressdecreasesconcentration.

Ans:

B Feedback: Studieshaveshownthenegativeeffectsofstressonhealthandacause-and-effectrelationshipbetween stressandinfectiousdiseases,traumaticinjuries(e.g.,motorvehiclecrashes),andsomechronic illnesses.Itiswellknownthatstressdecreasestheimmuneresponse,therebymakingindividualsmore susceptibletoinfectiousdiseases.Theotheroptionscanalsobecorrectincertainindividuals,butthey arenotthosethatbestsupportstress-reductioninitiatives.

15. Apublichealthnurseunderstandsthathealthpromotionshouldcontinueacrossthelifespan.When planninghealthpromotioninitiatives,wheninthelifespanshouldhealthpromotionbegin? A)

Adolescence

B)

Schoolage

C)

Preschool

D)

Beforebirth

Ans:

D Feedback: Healthpromotionshouldbeginpriortobirthbecausethehealthpracticesofamotherpriortothebirthof herchildcanbeinfluencedpositivelyornegatively.Thismakestheotheroptionsincorrect.

16. Anurseisworkingwithateenageboywhowasrecentlydiagnosedwithasthma.Duringthecurrent session,thenursehastaughttheboyhowtoadministerhisbronchodilatorbymetered-doseinhaler.How shouldthenurseevaluatetheteachinglearningprocess?

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

A)

Asktheboyspecificquestionsabouthismedication.

B)

Asktheboywhetherhenowunderstandshowtousehisinhaler.

C)

Directlyobservetheboyusinghisinhalertogivehimselfadose.

D)

Assesstheboysrespiratoryhealthatthenextscheduledvisit.

Ans:

C

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Feedback: Demonstrationandpracticeareessentialingredientsofateachingprogram,especiallywhenteaching skills.Itisbesttodemonstratetheskillandthengivethelearnerampleopportunityforpractice.By observingthepatientusingtheinhaler,thenursemayidentifywhatlearningneedstobeenhancedor reinforced.Askingquestionsisnotasanaccurategaugeoflearning.Respiratoryassessmentisa relevant,butindirect,indicatoroflearning.Delayingtheappraisalofthepatientstechniqueuntilalater clinicvisitisinappropriatebecausehealthproblemscouldoccurintheinterval. 17. Ateamofpublichealthnursesaredoingstrategicplanningandarediscussinghealthpromotion activitiesforthenextyear.Whichofthefollowinginitiativesbestexemplifiestheprinciplesofhealth promotion? A)

Abloodpressureclinicatalocalfactory

B)

Afamilyplanningclinicatacommunitycenter

C)

Animmunizationclinicatthelargestlocalmall

D)

Aworkplacesafetyseminar

Ans:

B Feedback: Healthpromotionmaybedefinedasthoseactivitiesthatassistpeopleindevelopingresourcesthat maintainorenhancewell-beingandimprovetheirqualityoflife.Afamilyplanningclinicmeetsthese criteriamostclosely.Workplacehealthandsafetywouldbeconsideredaprotectionservice.Ablood pressureclinicandimmunizationclinicwouldfallunderthecategoryofpreventiveservices.

18. Youaretheoncomingnurseandyouhavejusttakenend-of-shiftreportonyourpatients.Oneofyour patientsnewlydiagnosedwithdiabeteswasadmittedwithdiabeticketoacidosis.Whichbehaviorbest demonstratesthispatientswillingnesstolearn? A)

Thepatientrequestsavisitfromthehospitalsdiabeticeducator.

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

B)

Thepatientsetsasideadessertbroughtinbyafamilymember.

C)

Thepatientwantsafamilymembertomeetwiththedieticiantodiscussmeals.

D)

Thepatientreadilyallowsthenursetomeasurehisbloodglucoselevel.

Ans:

A

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Feedback: Emotionalreadinessalsoaffectsthemotivationtolearn.Apersonwhohasnotacceptedanexisting illnessorthethreatofillnessisnotmotivatedtolearn.Thepatientswilinesstolearnisexpressed throughtheactionofseekinginformationonhisorherownaccord.Seekinginformationshowsan emotionalreadinesstolearn.Theotheroptionsdonotasclearlydemonstrateawillingnesstolearn. 19. Anurseisplanninganeducationaleventforalocalgroupofcitizenswholivewithavarietyofphysical andcognitivedisabilities.Whatvariableshouldthenurseprioritizewhenplanningthisevent? A)

Health-promotionneedsofthegroup

B)

Relationshipsbetweenparticipantsandcaregivers

C)

Wellnessstateofeachindividual

D)

Learningneedsofcaregivers

Ans:

A Feedback: Thenursemustbeawareoftheparticipantsspecifichealth-promotionneedswhenteachingspecific groupsofpeoplewithphysicalandmentaldisabilities.Thisisapriorityovertherelationshipsbetween participantsandcaregivers,eachpersonswellnessstate,orcaregiverslearningneeds.

20. ApublichealthnurseisplanningeducationalinterventionsthatarebasedonBeckersH...