Fundamentals Nursing Vol 1 3rd Edition By Wilkinson Treas – Test Bank

Chapter 11. Experiencing Health & Illness

MULTIPLE CHOICE

1. A client’s risk of breast cancer is dramatically increased because both her sister and her mother have had breast cancer. Which of the multidimensional aspects of health does this scenario illustrate?
a) Personal relationships
b) Biological factors
c) Lifestyle choices
d) Environmental factors

ANS: B
Nurses respond to the physical, emotional, mental, and spiritual dimensions of health. Biological factors include genetic makeup, gender, age, and developmental stage. The risk of breast cancer increases dramatically in women who have a family history of a mother, sister, or daughter with breast cancer. Recently, a genetic marker for this type of breast cancer was discovered. This is an example of biological factors. Personal relationships are more psychosocial in nature; for example, family relationships can facilitate coping. Lifestyle choices involve such health behaviors as choosing not to use tobacco and other substances. Environmental factors involve, for example, environmental pollutants, or the psychosocial environment (a quiet versus a noisy hospital room).

Difficulty: Moderate
Client Need: Safe and Effective Care
Cognitive Level: Application

PTS: 1

2. Using the concept of the wellness–illness continuum, a nursing care plan for a chronically ill patient would outline steps to:
a) Educate the patient about every possible complication associated with the specific illness
b) Encourage positive health characteristics within the limits of the specific illness
c) Limit all activities because of the progressive deterioration associated with all chronic illnesses
d) Recommend activity beyond the scope of tolerance to prevent early deterioration

ANS: B
The health–illness continuum defines health and illness as a graduated spectrum that cannot be divided into parts. A person’s position on the continuum is constantly changing according to physiological changes, lifestyle choices, and the results of various choices. Encouraging positive health characteristics within the limits of the specific illness will promote maintenance of a personal state of health for the individual patient.

Difficulty: Moderate
Nursing Process: Planning
Client Need: HPM
Cognitive Level: Comprehension

PTS: 1

3. To establish a trusting relationship with a client, the nurse will focus on:
a) Providing solutions to the patient
b) Completing procedures and administering medication
c) Taking time to get to know the patient
d) The present, not the past

ANS: C
Take time to get to know your patient by setting a tone of caring, respect, and understanding. Establishing trust in your first contact with patients can go a long way toward relieving anxiety and preserving the energy needed for healing. Information gathered about the patient will include present illness and past history. Merely performing procedures, administering medications, or providing solutions to the patient does not allow you to support the patient transition from health to illness.

Difficulty: Moderate
Client Need: Safe and Effective Care
Cognitive Level: Knowledge

PTS: 1

4. The client is a 76-year-old man who is experiencing chronic illness. He has a genetic-linked anemia. He says he does not eat a balanced diet, as he prefers sweets to meat and vegetables. Which of the following dimensions of health can the nurse most likely influence by teaching and counseling him?
a) Age-related changes
b) Genetic anemia
c) Eating habits
d) Gender-related issues

ANS: C
The nurse is most likely to influence the patient’s eating habits because those are the dimensions over which he has the most control and, therefore, has the most potential for changing. Although people consider biological factors when they describe themselves as well or ill, they are not entirely within our control. Biological factors include age and developmental stage, genetic makeup, and gender.

Difficulty: Easy
Nursing Process: Planning
Client Need: HPM
Cognitive Level: Application

PTS: 1

5. What type of loss is most common among patients who are hospitalized for complex health conditions?
a) Privacy
b) Dignity
c) Functional
d) Identity

ANS: B
Hospitalized patients commonly experience the loss of dignity. Wearing a hospital gown, having their body exposed, invasive procedures, loss of control over body functions—all of these contribute to loss of dignity, and all are very common among hospitalized patients. Healthcare providers have a duty to protect privacy and confidentiality of patients, even though it is certainly threatened by some situations during hospitalization. Some patients lose functioning and identity during hospitalization, but they are not common occurrences.

Difficulty: Moderate
Nursing Process: Assessment
Client Need: PSI
Cognitive Level: Comprehension

PTS: 1

6. A 62-year-old patient is admitted to the hospital with hypertension. Which question by the nurse is most important when performing the initial assessment interview?
a) “What medications do you take at home?”
b) “Do you have any environmental, food, or drug allergies?”
c) “Do you have an advance directive?”
d) “What is the greatest concern you are dealing with today?”

ANS: D
It is most important for the nurse to ask the patient about his greatest concern. His concern can then be incorporated into the plan of care, making sure that his needs are met. Asking about medications, allergies, and an advance directive is also important but does not take priority over asking about the patient’s greatest concern.

Difficulty: Moderate
Nursing Process: Assessment
Client Need: PSI
Cognitive Level: Analysis

PTS: 1

7. Which of the following helps the body release growth hormone (growth hormone assists in tissue regeneration, synthesis of bone, and formation of red blood cells)?
a) A healthy diet
b) Physical activity
c) Restful sleep
d) Comfortable room temperature

ANS: C
During sleep, our bodies release the majority of our growth hormone, which assists in tissue regeneration, synthesis of bone, and formation of red blood cells. Consuming healthy foods helps prevent disease. Physical activity reduces the risk of chronic disease and promotes longevity. Keeping the body at a comfortable temperature helps maintain health but not release of growth hormone.

Difficulty: Moderate
Client Need: PHSI
Cognitive Level: Knowledge

PTS: 1

8. A client has been hospitalized for 6 weeks. All of the following interventions are good ones, but which intervention is specifically focused on helping the patient cope with the emotional responses to prolonged hospitalization?
a) Providing skin care every shift to prevent skin breakdown
b) Encouraging the patient to get up in a chair to eat meals
c) Assisting the patient to ambulate in the hallway for several minutes each day
d) Designating a corner of the patient’s room to display personal mementos

ANS: D
The patient’s environment can help nourish wellness. Helping the patient designate a corner of the room to display personal mementos can be healing and help the patient to cope with the prolonged hospitalization. The other interventions might be helpful to the patient but are not as helpful in specifically dealing with “hospitalization” as is designating a portion of the room that is uniquely hers.

Difficulty: Moderate
Nursing Process: Implementation
Client Need: PSI
Cognitive Level: Application

PTS: 1

9. Which of the following is particularly valuable in helping a patient with a terminal illness maintain a sense of self?
a) Family relationships
b) Spirituality
c) Nutrition
d) Sleep and rest

ANS: B
When patients are faced with a terminal illness, spirituality can help the patient maintain his sense of self. Family relationships can provide a loving, supportive source of comfort and reassurance, but sometimes cause the patient pain and a feeling of loneliness when faced with a terminal illness. Nutrition, sleep, and rest are healing but usually not as helpful to a patient with terminal illness as is spirituality.

Difficulty: Difficult
Client Need: PSI
Cognitive Level: Knowledge

PTS: 1

10. A client with a history of schizophrenia is diagnosed with a urinary tract infection. What is probably the most significant barrier this patient faces?
a) Chronic urinary incontinence
b) Stigma associated with mental illness
c) Risk for recurring infections
d) Auditory hallucinations (“hearing things”)

ANS: B
Mental illness is associated with a stigma that is usually a barrier, and even considered a debilitating handicap. Chronic urinary incontinence is not commonly associated with urinary tract infection, and nothing in the scenario suggests that the patient is incontinent. The patient is at risk for recurring urinary tract infections, but this is not considered a debilitating handicap. Auditory hallucinations are associated with schizophrenia but have not been described as the most debilitating handicap.

Difficulty: Moderate
Client Need: PSI
Cognitive Level: Application

PTS: 1