Health Promotion in Nursing 3rd Edition By Janice A. Maville, Carolina G. Huerta TEST BANK

Chapter 1 Health Promotion: Past, Present, and Future MULTIPLE CHOICE 1. Which one of the following major themes best defines the term health promotion? a. Changing behavior b. Empowering c. Increasing knowledge d. Developing skills ANS: B

PTS: 1

DIF:

Challenging

2. Which one of the following ancient civilizations is known for establishing regulations of sanitation? a. China b. Egypt c. Palestine d. Rome ANS: D

PTS: 1

DIF:

Easy

3. The life expectancy of a person born in the age of declining pandemics is reflected in which one of the following age ranges? a. 30–37 years b. 40–47 years c. 50–57 years d. 60–67 years ANS: B

PTS: 1

DIF:

Challenging

4. Nurses who are involved in epidemiology are focused on which one of the following? a. Considerations of culture, health, and wellness b. Influences of technology on treatment of disease c. Interactions among a team of health providers d. Relationships among disease, environment, individuals, and communities ANS: D

PTS: 1

DIF:

Challenging

5. Which of the following occurrences reflects the Industrial Revolution’s effect on health in Early America? a. Healthy soldiers were needed to fight in religious wars. b. The focus of medicine shifted from disease cure to disease prevention. c. The Surgeon General’s report outlined health objectives for the nation. d. There was a shift of the population from rural to urban settings.

ANS: D

PTS: 1

DIF:

Challenging

6. An amendment to the Social Security Act of 1935 established which one of the following for the United States? a. Healthy People 2000 b. Medicare Program c. Office of Disease Prevention and Health Promotion d. Women, Infants, and Children (WIC) Program

ANS: B

PTS: 1

DIF: Easy

7. A 62-year-old patient is confused about Medicare and Medicaid and has asked the nurse to explain the difference. Which one of the following provides the best answer for the nurse to use when describing Medicare? a. Medicare is financial assistance to pay hospital costs for the poor, medically needy, aged, disabled, and their dependent children and families. b. Medicare provides hospital insurance and supplemental medical insurance for people over age 65, disabled people receiving social security benefits, and those in end-stage renal disease. c. Medicare provides for only a portion of payments made by state welfare to health care agencies for the poor, medically needy, aged, disabled, and their dependent children and families. d. Medicare provides for hospital costs only for people over age 65, disabled people receiving social security benefits, and those in end-stage renal disease.

ANS: B

PTS: 1

DIF: Difficult

8. A 28-year-old client has requested help in obtaining financial assistance for her children’s health care costs. She says she has a friend who is receiving Medicaid benefits and asks the nurse to explain more about Medicaid. Which one of the following provides the best answer for the nurse to use when describing Medicaid? a. Medicaid is financial assistance to pay hospital costs for the poor, medically needy, aged, disabled, and their dependent children and families. b. Medicaid provides hospital insurance and supplemental medical insurance for people over age 65, disabled people receiving social security benefits, and those in end-stage renal disease. c. Medicaid provides for only a portion of payments made by state welfare to health care agencies for the poor, medically needy, aged, disabled, and their dependent children and families. d. Medicaid provides for hospital costs only for people over age 65, disabled people receiving social security benefits, and those in end-stage renal disease.

ANS: C

PTS: 1

DIF: Difficult

9. Which of the following questions would be appropriate for the nurse to ask a 65-year-old male who wants to receive Medicare benefits? a. Do you receive or qualify to receive Social Security benefits? b. Do you receive or qualify to receive Medicaid benefits? c. What is your yearly annual income? d. What is your yearly anticipated medical expense?

ANS: A

PTS: 1

DIF: Difficult

10. Which of the following provided the foundation for Medicare and Medicaid Programs? a. Alma Ata Declaration of 1978 b. Healthy People: Surgeon General’s Report of 1980 c. Sheppard-Towner Act of 1921 d. Social Security Act of 1935 ANS: D

PTS: 1

DIF: Challenging

11. Which of the following major efforts linked smoking and cancer? a. Doll and Hill study b. Framingham study

c. LaLonde Report d. Surgeon General’s report, Smoking and Health ANS: D

PTS: 1

DIF: Easy

12. Which of the following is a result of how cost containment has produced positive changes in nursing practice? a. There is an increase in opportunities for employment to work on unmet health needs. b. There is an increase in orientation toward a medical model of practice. c. There is less competition among providers of health care services. d. There is less need for rehabilitation centers and home health agencies.

ANS: A

PTS: 1

DIF: Challenging

13. Healthy People 2010 identified which one of the following as the top leading health indicator? a. Access to health care b. Environmental quality c. Immunizations d. Overweight and obesity ANS: A

PTS: 1

DIF: Easy

14. One of the four overarching goals of Healthy People 2020 is which of the following? a. Advance the access to care for all and reduce tobacco use among adolescents b. Achieve health equity, eliminate disparities, and improve the health of all groups. c. Reduce fraud in health care spending and increase aid to dependent children d. Support research in finding disease cures and increase focus on technology ANS: B

PTS: 1

DIF: Difficult

15. The American Nurses Association’s publication of Nursing’s Social Policy Statement in 1995 is important to health promotion for which of the following reasons? a. It expanded the definition of health and reflects a greater commitment to clients. b. It established a code for nurses outlining an ethical commitment to client care. c. It provided for a moral commitment of nurses to health promotion of clients. d. It provided guidelines for and limitations on the contribution of nurses to client health.

ANS: A

PTS: 1

DIF: Challenging

16. A nurse is working with a community organization to improve sanitation in a poor area of the city.

Which one of the following actions represents a “wide-angle” perspective for facilitating change? a. Arrange for a town-hall type meeting to hear the residents’ concerns. b. Campaign for a law supporting a ban on trash dumping in the area. c. Plan an educational program on food and water safety. d. Report violations to the city health commissioner for action.

ANS: A

PTS: 1

DIF: Challenging

TRUE/FALSE 1. Health education is not the same as but is part of the larger concept of health promotion.

ANS: T

PTS: 1

DIF: Easy

2. Prior to the World Health Organization’s campaign for global public health, efforts to improve health centered more on health promotion than health education.

ANS: F

PTS: 1

DIF: Easy

3. Health promotion is a relatively recent term that has various meanings among individuals and societies.

ANS: T

PTS: 1

DIF: Easy

4. Control of health behaviors, compliance with medical regimes, and commitment to wellness are major themes that serve to unify concepts related to health promotion.

ANS: F

PTS: 1

DIF: Challenging

5. Galen was a famous physician in ancient Greece who identified the importance of incorporating social, environmental, mental, and physical factors in treating the whole person.

ANS: F

PTS: 1

DIF: Easy

6. Ancient civilizations were more focused on promoting health than the civilizations of today.

ANS: F

PTS: 1

DIF: Challenging

7. Health promotion specifically studies when diseases occur, how they are distributed in a population, the cause of the disease, the natural history of the course of a disease, and factors influencing health promotion and protection.

ANS: F

PTS: 1

DIF: Challenging

MATCHING Match each item to a statement or sentence listed below. a. Babylonia b. Greece c. Rome d. China 1. Striving to be more like mythological gods and goddesses such as Apollo, Asclepius, and Hygeia signified a strong belief in staying healthy.

2. Galen was a famous physician who is credited with formulating the beginnings of a definition of health.

3. Hippocrates identified the importance of incorporating social, environmental, mental, and physical factors in treating the whole person.

4. The Code of Hammurabi established standards and practices of living.

5. Infused health-promoting practices from regions they had conquered.

6. Healthy life is staying in harmony with the universe by maintaining balance between opposite forces.

1. ANS: 2. ANS: 3. ANS: 4. ANS:

C C B A

PTS: PTS: PTS: PTS:

1 1 1 1

DIF: DIF: DIF: DIF:

Easy Easy Easy Easy

5. ANS: C 6. ANS: D

PTS: 1 PTS: 1

DIF: Easy DIF: Easy

Chapter 2 Nursing Concepts and Health Promotion MULTIPLE CHOICE 1. The American Nurses Association’s Nursing Scope and Standards of Practice: a. addresses the profession’s concern with the quality and accountability of nursing. b. describes both professional and vocational nursing standards of care. c. describes the profession’s non-negotiable ethical standards. d. focuses on standards of care strictly applicable to clinical practice.

ANS: A

PTS: 1

DIF: Challenging

2. Nursing’s metaparadigm refers to: a. a global definition of health care. b. nursing theory. c. standards that are applicable to the profession. d. common concepts that describe nursing and are specific to the discipline.

ANS: D

PTS: 1

DIF: Challenging

3. According to Maslow’s Hierarchy of Needs, before an individual can address safety and security needs, he or she must first satisfy their: a. love and belonging needs. b. physiological needs. c. self-actualization needs. d. self-esteem needs.

ANS: B

PTS: 1

DIF: Easy

4. Which of the following is a subcategory of Self-Esteem Needs according to Maslow? a. Approval b. Intimacy c. Rules d. Structure ANS: A

PTS: 1

DIF: Easy

5. Nursing is considered a profession because it fits well with which of the following criteria commonly found in a profession? a. Belongs to the medical discipline b. Has established professional standards c. Is accredited by the National League for Nursing d. Is taught in community colleges and vocational schools ANS: B

PTS: 1

DIF: Challenging

6. Which of the following would be most likely to engage in health-promotion nursing research? a. Associate degree prepared nurse b. Baccalaureate of Science in Nursing prepared nurse c. Diploma prepared nurse d. Doctorate in Nursing prepared nurse ANS: D

PTS: 1

DIF: Easy

7. A career ladder approach in nursing refers to: a. associate or diploma educational pathways. b. employment according to the educational level of the nurse. c. nursing education at the university level. d. transitioning of nursing from one educational level to the next.

ANS: D

PTS: 1

DIF: Challenging

8. The difference in health-promotion competencies between a nurse educated at the associate degree level and a baccalaureate prepared nurse (BSN) is that the BSN prepared nurse: a. develops teaching plans concerning health promotion, maintenance, and restoration of health. b. implements nursing care to promote health and manage acute and chronic health problems. c. manages nursing care for a limited number of patients. d. performs comprehensive assessments of patients relative to those factors impacting each patient’s health status.

ANS: D

PTS: 1

DIF: Difficult

9. Systems Theory proposes that change is: a. health care directed. b. impacted by a person’s environment. c. never haphazard. d. dependent on the extent of individual behaviors.

ANS: B

PTS: 1

DIF: Difficult

10. Which of the following theories would be most appropriate for the nurse to use when educating a 38-year-old diabetic Asian patient about her diet? a. Adaptation Theory b. Change Theory c. Transcultural Theory d. Values Theory ANS: C

PTS: 1

DIF: Difficult

11. Which of the following theories is most closely related to Needs Theory? a. Adaptation Theory b. Motivation Theory c. Systems Theory d. Transcultural Theory ANS: B

PTS: 1

DIF: Challenging

12. Which of the following nursing metaparadigm concepts is most closely associated with Florence Nightingale’s Theory of Nursing? a. Environment b. Health c. Nursing d. Person ANS: A

PTS: 1

DIF: Easy

13. Which of the following theorists is most closely associated with Systems Theory? a. Imogene King b. Jean Watson

c. Martha Rogers d. Virginia Henderson ANS: C

PTS: 1

DIF: Challenging

14. Health promotion is an essential concept useful to nursing in: a. defining nursing practice. b. identifying nursing’s need for change. c. identifying professional assumptions. d. providing theoretical frameworks.

ANS: A

PTS: 1

DIF: Challenging

15. Nursing theorists organize nursing theory by: a. accessing nursing definitions. b. addressing nursing’s metaparadigm concepts. c. describing nursing’s philosophy of health care. d. providing standards of nursing practice.

ANS: B

PTS: 1

DIF: Challenging

TRUE/FALSE 1. The concept of health promotion is a new one to the nursing profession.

ANS: F

PTS: 1

DIF: Easy

2. Nursing’s metaparadigm helps to critically unify and evaluate concepts that are characteristic of nursing.

ANS: T

PTS: 1

DIF: Easy

3. The four concepts that are addressed in nursing’s metaparadigm are person, disease prevention, environment, and nursing.

ANS: F

PTS: 1

DIF: Easy

4. There is no current consensus on what constitutes health.

ANS: T

PTS: 1

DIF: Easy

5. Health can be described in terms of the role of a person in society.

ANS: T

PTS: 1

DIF: Easy

6. General Systems Theory was originally described in 2002.

ANS: F

PTS: 1

DIF: Challenging

7. Needs Theory may be used interchangeably with Adaptation Theory.

ANS: F

PTS: 1

DIF: Challenging

MATCHING Match each nurse theorist to their Nursing Theory a. Florence Nightingale b. Dorothea Orem c. Imogene King d. Jean Watson e. Madeleine Leininger f. Martha Rogers g. Rosemarie Parse h. Sister Callista Roy 1.

2.

3.

4.

5.

6.

7.

8.

Adaptation Model Cultural Care Diversity and Universality Theory Environmental Theory of Nursing Self-Care Theory Science of Unitary Human Beings Theory Theory of Goal Attainment Theory of Human Becoming Theory of Transpersonal Caring

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS: 8. ANS:

H E A B F C G D

PTS: PTS: PTS: PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1 1 1 1

DIF: DIF: DIF: DIF: DIF: DIF: DIF: DIF:

Easy Easy Easy Easy Easy Easy Easy Easy

Chapter 3 Theoretical Foundations and Planning of Health Promotion MULTIPLE CHOICE 1. Which of the following terms refers to a dynamic state of health that encompasses the capability and potential of the individual in functioning at the individual, environmental, cultural, and social levels? a. Disease prevention b. Health promotion c. Health protection d. High level wellness ANS: D

PTS: 1

DIF: Easy

2. Which of the following terms represents a disease-related focus? a. Health promotion b. Health protection c. High level wellness d. Holistic health perspective ANS: B

PTS: 1

DIF: Easy

3. Risk reduction would be an important activity of which of the following concepts? a. Health behavior b. Health promotion c. Health protection d. Self-efficacy ANS: C

PTS: 1

DIF: Moderate

4. The major themes of empowerment, lifestyle change, health enhancement, and well-being are central in defining: a. health promotion. b. health protection. c. disease prevention. d. wellness.

ANS: A

PTS: 1

DIF: Moderate

5. Theories and models of human behavior and health are helpful in: a. explaining factors and interactions among issues that influence the health of individuals or groups. b. promoting a better understanding of the relationship between environment and disease and individual characteristics. c. proving that health-care providers perform services vital to the promotion of health of individuals and groups. d. showing a connection between psychology, sociology, and physical well-being in individuals and groups.

ANS: A

PTS: 1

DIF: Difficult

6. Any activity that helps people to change or to maintain lifestyles that support a stake of optimal health would be placed in which one of the following categories? a. Common information

b. Disease prevention c. Health promotion d. Human behavior ANS: C

PTS: 1

DIF: Easy

7. Statistics from the National Center for Health Statistics show that the leading cause of death in the United States is a result of which one of the following? a. Accidents b. Cancer c. Diabetes d. Heart disease ANS: D

PTS: 1

DIF: Easy

8. A patient expresses a sense of lack of control over achieving a sustained program of exercise. This behavior could best be explained through which of the following? a. Health Promotion Model b. PRECEDE-PROCEED Model c. Theory of Planned Behavior d. Theory of Social Behavior ANS: C

PTS: 1

DIF: Difficult

9. A nurse assisting a client to appraise perceived benefits of and barriers to taking a particular action for better health is applying principles of which one of the following theories or model? a. Health Belief Model b. Protection Motivation Theory c. Theory of Planned Behavior d. Theory of Social Behavior ANS: A

PTS: 1

DIF: Difficult

10. Which of the following is fear-driven based on the appraisal of threats to health and individual coping mechanisms that move an individual toward adopting a health behavior? a. Consumer Information Processing Model b. Protection Motivation Theory c. Theory of Planned Behavior d. Transtheoretical Model of Behavior Change ANS: B

PTS: 1

DIF: Difficult

11. The first stage in the Transtheoretical Model of Behavior Change is: a. action. b. contemplation. c. precontemplation. d. preparation.

ANS: C

PTS: 1

DIF: Moderate

12. A client is thinking about making a change in behavior toward a healthier lifestyle. This is representative of what stage of the Transtheoretical Model of Behavior Change? a. Contemplation b. Precontemplation c. Preparation d. Maintenance

ANS: A

PTS: 1

DIF: Moderate

13. The Transtheoretical Model of Behavior Change is most helpful in understanding which of the following? a. Age-related psychosocial factors impacting decision-making for behavior change b. How various models work together to motivate individuals to change behavior c. The effect of developmental stages on making behavior change decisions d. Why individuals do or do not become involved in making healthy behavior changes ANS: D

PTS: 1

DIF: Difficult

14. Which of the following outcomes reflects concepts in the Consumer Information Processing Model? a. Child safety seat law b. Easy-to-read food labels c. Quarantine of fruits, vegetables, and plants from foreign countries d. Tobacco sales to minors ANS: B

PTS: 1

DIF: Moderate

15. The Diffusion of Innovations Model has been found to be most useful for which of the following activities? a. Designing comprehensive community initiatives b. Developing programs for immediate effects c. Evaluating individual achievement of health-promotion goals d. Planning for short-term changes in communities ANS: A

PTS: 1

DIF: Difficult

TRUE/FALSE 1. Health promotion and disease prevention are two terms that can be used interchangeably.

ANS: F

PTS: 1

DIF: Easy

2. The concepts of wellness, disease prevention, and health protection are subsumed in the definition of health promotion.

ANS: T

PTS: 1

DIF: Easy

3. It is reported that 75% of all premature deaths are the result of unhealthy lifestyle choices related to tobacco use, misuse of drugs and alcohol, sedentary lifestyles, and accidents.

ANS: F

PTS: 1

DIF: Moderate

4. Theories of human behavior and health are expansions of health-promotion models.

ANS: F

PTS: 1

DIF: Moderate

5. The Protection Motivation Theory has been most widely applied to areas related to disease prevention and lifestyle enhancement.

ANS: T

PTS: 1

DIF: Moderate

6. The stages of the Transtheoretical Model of Behavior Change involve thought and action over time.

ANS: T

PTS: 1

DIF: Moderate

7. Health-promotion models for groups, organizations, and communities are re-designed individual health-promotion models.

ANS: F

PTS: 1

DIF: Moderate

8. The major limitation of the PRECEDE-PROCEED Model is that it does not go beyond developing educational interventions.

ANS: F

PTS: 1

DIF: Moderate

9. Pender’s Health Promotion Model shows how individual characteristics have both a direct and indirect effect on health-promotion behaviors.

ANS: T

PTS: 1

DIF: Easy

10. The O’Donnell Model of Health Promotion Behavior differs from Pender’s Health Promotion Model in that it shows how intentions toward a behavior are influenced by beliefs and values.

ANS: T

PTS: 1

DIF: Moderate

MATCHING Match the category of focus with the theory or model below to which it is associated. Note that categories of focus may be used more than once.

Categories of focus: a. Human behavior b. Human behavior and health c. Individual health promotion d. Organizations and community health protection 1.

2.

3.

4.

5.

6.

Pender’s Model of Health Promotion Theory of Planned Behavior Transtheoretical Model PRECEDE-PROCEED Model Health Belief Model Consumer Information Processing Model

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS:

C A B D A D

PTS: PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1 1

DIF: DIF: DIF: DIF: DIF: DIF:

Easy Easy Easy Easy Easy Easy

Chapter 4 The Role of the Nurse in Health Promotion MULTIPLE CHOICE 1. The biological, psychological, sociological, environmental, political, spiritual, intellectual, sexual, and technological domains are: a. areas of concern affecting a person’s optimal health. b. dependent on conditions beyond a person’s individual control. c. fundamental nursing health-care goals. d. negative dimensions impacted by the disease process.

ANS: A

PTS: 1

DIF: Challenging

2. Mr. & Mrs. Smith and their seven children live in a two-bedroom housing project. The school nurse is concerned with the Smith children’s frequent absences due to recurrent upper respiratory infections. Which of the following health domains should the nurse consider when addressing the children’s health-promotion needs? a. Environmental b. Political c. Spiritual d. Technological ANS: A

PTS: 1

DIF: Moderate

3. Cultural values are considered a dimension of which of the following domains? a. Biological b. Intellectual c. Political d. Sociological ANS: D

PTS: 1

DIF: Easy

4. The technological domain: a. affects all of the other domains. b. determines realistic outcomes. c. primarily addresses computerized patient data. d. refers to digital technology.

ANS: A

PTS: 1

DIF: Moderate

5. The term Nursing Process refers to: a. a health-care approach focusing on patient compliance and trust. b. a problem-solving method for developing a plan of care. c. health-promotion approaches that focus on wellness outcomes. d. legal standards guiding nursing care.

ANS: B

PTS: 1

DIF: Easy

6. Mrs. Cruz, a 68-year-old post–hip replacement surgery patient, is being discharged but does not have anyone at home to help her during her recovery period. Her nurse is aware of this and speaks to her doctor about her concerns about Mrs. Cruz. In this situation the nurse has assumed which of the following health-promotion roles? a. Advocate b. Consultant

c. Educator d. Role model ANS: A

PTS: 1

DIF: Easy

7. When developing a plan of care for a patient, the nurse must first: a. address nursing diagnoses that are specific to the patient. b. collect data as part of the assessment phase. c. identify realistic and measurable outcome goals. d. establish goals for evaluation of the care plan.

ANS: B

PTS: 1

DIF: Moderate

8. Which of the following most influences a person’s understanding of his or her disease process? a. Access to health care b. Educational level c. Gender d. Socioeconomic level ANS: B

PTS: 1

DIF: Easy

9. Mary ‘s doctor suggests that Mary receive a mammogram. This is considered to be a (an): a. initial prevention. b. primary prevention. c. secondary intervention. d. tertiary prevention.

ANS: C

PTS: 1

DIF: Difficult

10. The nurse acts as an empowering agent in health promotion by: a. coordinating all of a patient’s health care. b. focusing on the patient’s anxiety and fears related to change. c. including the patient in every aspect of care. d. motivating patient behavior through description of negative outcomes.

ANS: C

PTS: 1

DIF: Difficult

11. Mr. Pesci is recuperating in a rehabilitation center following hospitalization for surgery. Mr. Pesci’s rehabilitation at the center is an example of: a. initial intervention. b. primary prevention. c. secondary intervention. d. tertiary prevention.

ANS: D

PTS: 1

DIF: Difficult

12. Mrs. Lopez has a severe visual impairment and has been hospitalized twice for falls occurring at home. Which of the following might be an appropriate nursing diagnosis for her? a. Ineffective health maintenance related to knowledge deficit b. Ineffective health maintenance related to safety hazards c. Potential risk for further development d. Potential risk for infection ANS: B

PTS: 1

DIF: Difficult

13. Controllable risk factors impacting health promotion include:

a. b. c. d.

age. culture. genetics. lifestyle.

ANS: D

PTS: 1

DIF: Easy

14. Which of the following is essential for a successful health-promotion plan? a. Assumption of personal responsibility b. Detection of disease c. Early implementation of therapy d. Virginia Henderson ANS: A

PTS: 1

DIF: Moderate

15. The North American Nursing Diagnosis Association: a. defines appropriate interventions for uncommon nursing problems. b. identifies nursing’s need for patient documentation. c. identifies outcomes for common nursing problems. d. provides a taxonomy or classification structure for nursing diagnoses.

ANS: D

PTS: 1

DIF: Difficult

TRUE/FALSE 1. Health promotion has been a fundamental goal of nursing for years.

ANS: T

PTS: 1

DIF: Easy

2. Diseases can be ethnic-specific.

ANS: T

PTS: 1

DIF: Easy

3. Lifestyle behavior changes cannot influence the biological domain.

ANS: F

PTS: 1

DIF: Easy

4. Leadership abilities are required for the nurse coordinating care.

ANS: T

PTS: 1

DIF: Easy

5. Nurses who empower clients emphasize the passive role of the patient.

ANS: F

PTS: 1

DIF: Moderate

6. Women are more at risk for high blood pressure than are men.

ANS: F

PTS: 1

DIF: Moderate

7. Health promotion activities occur only in hospital settings.

ANS: F

PTS: 1

DIF: Moderate

8. Nurses are viewed as role models by students.

ANS: T

PTS: 1

DIF: Easy

9. The nursing care plan is developed with the patient’s potential problems or needs in mind.

ANS: T

PTS: 1

DIF: Moderate

10. In primary prevention, the detrimental effects of a health condition have occurred.

ANS: F

PTS: 1

DIF: Easy

MATCHING Match each nurse theorist to the description of their role. a. Advocate b. Coordinator of care c. Empowering agent d. Role model e. Educator f. Proactive change agent 1.

2.

3.

4.

5.

6.

Assures appropriate sequence of events in patient care Emphasizes the highest ideals of nursing care Emphasizes self-directed, self-regulated care Focuses on the person’s ability to change Increases public awareness of potential and actual health risks One who pleads a cause before another person

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS:

B D C F E A

PTS: PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1 1

DIF: DIF: DIF: DIF: DIF: DIF:

Easy Easy Easy Easy Easy Easy

Chapter 5 Communication MULTIPLE CHOICE 1. The nurse is communicating with a patient by sending a message in a form that is understandable.

Which of the following is an element of communication represented by the nurse? a. Decoder b. Enabler c. Encoder d. Messenger ANS: C

PTS: 1

DIF: Moderate

2. The intended recipient of an original message is which one of the following elements of communications? a. Decoder b. Encoder c. Sender d. Sensory channeler ANS: A

PTS: 1

DIF: Moderate

3. Which of the following is a possible result of faulty encoding? a. The intended message is not received by the receiver. b. The content of the message is incomplete. c. The receiver of the message distorts the intent. d. The sender of the message is unable to receive feedback.

ANS: A

PTS: 1

DIF: Challenging

4. In order to validate the message sent to a client, the nurse should elicit feedback by doing which of the following? a. Asking questions that can be answered by a simple “yes” or “no.” b. Repeating the message using visual aids for reinforcement. c. Requesting the client to restate the message that was sent. d. Encouraging the client to write down questions for clarification.

ANS: C

PTS: 1

DIF: Challenging

5. Which one of the following would be considered a contextual variable affecting communication? a. Focusing on what is being said and listening to the entire message b. Common language, vocabulary, or codes used to send a message c. Conveyance of messages without the use of spoken or written words d. Social, cultural, and ethnic expectations for individuals involved in communication ANS: D

PTS: 1

DIF: Challenging

6. A client who identifies as a member of the deaf community culture in the United States usually uses which one of the following for communication? a. American Sign Language b. Invented sign systems c. Paralanguage d. Proxemics

ANS: A

PTS: 1

DIF: Easy

7. Nonverbal communication is what percent of all forms of communication? a. 60% b. 70% c. 80% d. 90% ANS: D

PTS: 1

DIF: Easy

8. Which of the following is an example of paralanguage? a. Arm crossing b. Eye contact c. Grunting sounds d. Twitching ANS: C

PTS: 1

DIF: Moderate

9. A space of 12 feet or more allowing for formal communication between persons is termed: a. intimate distance. b. personal distance. c. public distance. d. social distance.

ANS: C

PTS: 1

DIF: Easy

10. Which of the following nursing theorists believed that conscious awareness of interactions was vital to therapeutic communication? a. King b. Orem c. Peplau d. Travelbee ANS: C

PTS: 1

DIF: Moderate

11. When selecting one topic for exploration from among several possible topics presented by a client, the nurse is using which one of the following therapeutic communication techniques? a. Clarifying b. Focusing c. Interpreting d. Validating ANS: B

PTS: 1

DIF: Moderate

12. A 38-year-old client wants to know what he can do to reduce his risk of heart disease. In which one of the following is an andragogical assumption for learning represented? a. Biological developmental influences on readiness to learn b. Dependency on the teacher for learning c. Immediate application time perspective d. Subject-centered orientation to learning ANS: C

PTS: 1

DIF: Challenging

13. Active listening involves which of the following nursing actions? a. Alternating between verbal and nonverbal communication methods when giving feedback b. Giving orders or advice to motivate the client’s health actions toward goal achievement

c. Periodically interjecting affirmations such as “I see” or I understand” when appropriate as the client speaks d. Reflecting the feelings, meanings, or intent of the client’s words as the nurse perceives them ANS: D

PTS: 1

DIF: Challenging

14. A 40-year-old Asian woman lowers her eyes as the nurse is talking with her. The nurse realizes that this is a nonverbal component of communication that is termed: a. active listening. b. kinesics. c. proxemics. d. visual aphasia.

ANS: B

PTS: 1

DIF: Moderate

15. Which of the following actions would be important for the nurse to remember when communicating with a deaf person through the use of a sign language interpreter? a. Avoid looking at the interpreter and focus eye contact on the deaf person. b. Allow for intervals of rest when communicating for an extended length of time. c. Speak very slowly and face the interpreter at all times. d. Use more animation when speaking to relay emotion or emphasize points.

ANS: B

PTS: 1

DIF: Easy

TRUE/FALSE 1. It is usually sufficient to use only one channel of communication to communicate clearly.

ANS: F

PTS: 1

DIF: Easy

2. Verbal communication includes the use of written words.

ANS: T

PTS: 1

DIF: Easy

3. The inability to communicate is considered a disease.

ANS: T

PTS: 1

DIF: Easy

4. The visually impaired have much more trouble with verbal communication than do the hearing impaired.

ANS: F

PTS: 1

DIF: Moderate

5. How we use the personal space around us is called kinesics.

ANS: F

PTS: 1

DIF: Easy

6. The quality of empathy, or empathetic understanding, means that the nurse maintains unconditional positive regard for the client.

ANS: F

PTS: 1

DIF: Moderate

7. In using active listening, nurses must be aware of verbal and nonverbal messages being conveyed by clients.

ANS: T

PTS: 1

DIF: Easy

8. Giving orders or advice can be a verbal barrier imposed by the nurse.

ANS: T

PTS: 1

DIF: Easy

9. Andragogy focuses on principles of adult education.

ANS: T

PTS: 1

DIF: Easy

10. Although there is great benefit in using technology to facilitate communication for clients and health-care providers, nurses need to be aware of associated legal issues.

ANS: T

PTS: 1

DIF: Easy

MATCHING Match the following descriptive terms with the deficits described below. a. Agraphia b. Aphemesthesia c. Auditory aphasia d. Expressive aphasia e. Global aphasia f. Visual aphasia 1.

2.

3.

4.

5.

Ability to think and hear without the ability to speak Ability to think and hear without the ability to understand the spoken word Ability to think and hear without the ability to produce handwriting A visual receptive deficit in a literate person, the inability to decode the written word Mixed auditory and visual receptive deficit in a literate person resulting in an inability to understand the spoken or the written word 6. Inability to express or receive verbal messages in any form 1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS:

D C A F B E

PTS: PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1 1

DIF: DIF: DIF: DIF: DIF: DIF:

Moderate Moderate Moderate Moderate Moderate Moderate

Chapter 6 Cultural Considerations MULTIPLE CHOICE 1. The culture of a person can be determined by which one of the following actions? a. Knowing and talking to the person b. Determining the family history c. Having the person complete a culture questionnaire d. Identifying the person’s customs ANS: A

PTS: 1

DIF: Easy

2. Of the following groups, which are designations of race according the United States Census form? a. Alaskan Native, White, Black, and Asian b. Black, White, Asian, and American Indian c. Caucasian, Pacific Islander, African-American, and Asian d. Negro, Caucasian, Asian and Hispanic ANS: A

PTS: 1

DIF: Challenging

3. Which of the following is an ethnicity and not a race? a. African American b. Hispanic c. Pacific Islander d. White ANS: B

PTS: 1

DIF: Moderate

4. You overhear a colleague referring to a patient as the “Asian” in the emergency room. Using labels such as this when referring to people tends to reflect which of the following? a. A caste system mentality of the colleague b. Application of cultural competence by the colleague c. Enhancement of social connectedness of the client d. Personalization of the client ANS: A

PTS: 1

DIF: Easy

5. The ability to incorporate cultural knowledge into holistic and culturally congruent care is called: a. cultural awareness. b. cultural competence. c. cultural pride. d. cultural tapestry.

ANS: B

PTS: 1

DIF: Easy

6. An outsider’s viewpoint of a specific culture or culture group is referred to as: a. emic knowledge. b. etic knowledge. c. lay or folk knowledge. d. worldview knowledge.

ANS: A

PTS: 1

DIF: Moderate

7. Which of the following nurse leaders is a recognized theorist on transcultural nursing?

a. b. c. d.

Dorthea Orem Madeleine Leininger Martha Rogers Nola Pender

ANS: B

PTS: 1

DIF: Moderate

8. Of the following assessment elements, which one would be included in a cultural assessment? a. Genogram b. Religion c. Review of body systems d. Substance use ANS: B

PTS: 1

DIF: Easy

9. An elderly man offers prayer every morning in the community church. This would be called a: a. habit. b. rite of passage. c. ritual. d. sacrifice.

ANS: C

PTS: 1

DIF: Moderate

10. Which of the following are overlapping health-care arenas that are important to recognize in order for a health-care system to be holistic? a. Cultural pride, cultural competence, and worldview b. Individual, family, and society c. Lay/popular, folk, and professional d. Values, beliefs, and customs ANS: C

PTS: 1

DIF: Moderate

11. A nurse colleague states that health care in the hospital is superior to the use of herbal medicine by a Native American. The belief this colleague is expressing would be categorized as: a. egoism. b. ethnocentrism. c. humanism. d. medicocentrism.

ANS: D

PTS: 1

DIF: Challenging

12. Which of the following represents an example of the lay/popular health sector? a. Health food store employee b. Registered pharmacist c. Spiritual healer d. Yourself ANS: D

PTS: 1

DIF: Moderate

13. A person who chooses to use meditation and aroma therapy in conjunction with pain medication prescribed by a professional health-care provider is said to be using which of the following approaches to health care? a. Alternative b. Complementary c. Cultural d. Traditional

ANS: B

PTS: 1

DIF: Moderate

14. Which of the following is an example of acculturation in a young Hispanic Cuban man? a. He adopts the Protestant religion of his fiancée. b. He believes in a balance of body, mind, and spirit. c. He maintains the language of his country of origin. d. He supports the use of folk medicine for wellness.

ANS: A

PTS: 1

DIF: Moderate

15. You overhear someone saying that “All Catholics want to see a priest.” This is an example of: a. cultural cataloguing. b. cultural competence. c. cultural ignorance. d. cultural sensitivity.

ANS: A

PTS: 1

DIF: Moderate

TRUE/FALSE 1. People from the same family share the same worldview.

ANS: F

PTS: 1

DIF: Easy

2. The number of particular groups bound by race, ethnicity, religion, and nationality is virtually limitless.

ANS: T

PTS: 1

DIF: Easy

3. Race as a category is concise and provides for specific information about a person.

ANS: F

PTS: 1

DIF: Moderate

4. It is possible for a person to be of the white race and of Mexican ancestry.

ANS: T

PTS: 1

DIF: Moderate

5. People within the same ethnic group manifest the same characteristics and behavior.

ANS: F

PTS: 1

DIF: Easy

6. People can be spiritual without having a specific religion affiliation.

ANS: T

PTS: 1

DIF: Easy

7. A person with culture pride is self-centered and egotistical.

ANS: F

PTS: 1

DIF: Moderate

8. Research shows that people tend to abandon lay/popular health practices when they become involved with treatment from the professional health sector.

ANS: F

PTS: 1

DIF: Easy

9. A registered nurse practices in the lay health-care arena.

ANS: F

PTS: 1

DIF: Easy

10. Some religious practices can be both a ritual and a rite of passage.

ANS: T

PTS: 1

DIF: Easy

MATCHING Match the following terms to the appropriate attributes below: a. Culture b. Custom c. Ethnicity d. Myth e. Superstition 1.

2.

3.

4.

5.

Foods, holidays, clothing, art music Trust in magic or chance Overarching lifeways, worldview, and way of life Historical belief, tradition, or story Common nation, tribe, language, and shared identity

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

B E A D C

PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1

DIF: DIF: DIF: DIF: DIF:

Moderate Easy Moderate Easy Moderate

Chapter 7 Environmental Factors MULTIPLE CHOICE 1. A substance or agent that has the ability to cause any type of adverse health effect is the definition of: a. a biological contaminant. b. a chemical emission. c. an environmental health hazard. d. an environmental risk.

ANS: C

PTS: 1

DIF: Moderate

2. Which of the following is a primary function of epidemiology? a. Identifying the common educational needs of people in communities b. Discovering new advances and treatments for disease in a population c. Researching individual and cultural similarities and differences among groups d. Studying the distribution and determinants of disease in a population ANS: D

PTS: 1

DIF: Moderate

3. Which of the following is an example of a focus area for the Environmental Protection Agency (EPA)? a. Developing safer food handling practices b. Eliminating risks for the use of pesticides c. Monitoring the testing of chemicals sold in the marketplace d. Studying the occurrence of health effects in humans ANS: B

PTS: 1

DIF: Challenging

4. Of the four major steps used by the Environmental Protection Agency (EPA) to assess risk when a disease cluster is identified, which one of the following would be the first? a. Estimation of the exposure b. Delineation of the potential environmental hazards c. Delineation of the dose response process d. Determination of the seriousness of harm and susceptibility of the population ANS: B

PTS: 1

DIF: Challenging

5. Indoor air pollution has been estimated to be how many times higher than outdoor air pollution levels? a. 10 to 20 times higher b. 2.2 to 100 times higher c. 50 to 150 times higher d. 100 to 200 times higher ANS: B

PTS: 1

DIF: Moderate

6. Several employees working in the same building reported burning eyes, irritated throats, and fatigue that disappeared a short time after leaving the building. This could be a situation called: a. building-related illness. b. chronic fatigue syndrome. c. seasonal affective disorder. d. sick building syndrome.

ANS: D

PTS: 1

DIF: Moderate

7. A friend tells you that he has been diagnosed with a building-related illness. You know that he will most likely obtain relief from his symptoms: a. immediately after leaving his building. b. never; symptoms are permanent. c. one to two days after leaving his building. d. weeks to months after leaving his building.

ANS: D

PTS: 1

DIF: Challenging

8. The single most preventable indoor air pollutant is: a. asbestos. b. dust. c. environmental tobacco smoke. d. gas and vapors.

ANS: C

PTS: 1

DIF: Moderate

9. Which of the following are among the biggest sources of particulate matter in indoor air pollution? a. Carbon monoxide and carbon dioxide b. House dust and tobacco smoke c. Paints and varnishes d. Radon and formaldehyde ANS: B

PTS: 1

DIF: Moderate

10. Which of the following substances is tasteless, colorless, and odorless and is second to cigarette smoking as the leading source of lung cancer? a. Asbestos b. Formaldehyde c. Methane d. Radon ANS: D

PTS: 1

DIF: Moderate

11. The interpretation of danger on a warning label indicates that the product contains a chemical that: a. causes allergic reactions. b. destroys tissue. c. is corrosive, flammable, toxic, or poisonous. d. may cause injury or inflammation on contact.

ANS: C

PTS: 1

DIF: Moderate

12. Which of the following actions would contribute to creation of a safe haven for a chemically sensitized individual? a. Avoiding use of electric appliances b. Hiring exterminators for routine pest control c. Replacing natural wood furniture with particle board d. Using natural-fiber fabrics such as cotton ANS: D

PTS: 1

DIF: Moderate

13. Which of the following would be an appropriate action to take in order to avoid serious injury in an earthquake?

a. b. c. d.

Duck into a doorway if walking on a sidewalk.

Move outdoors if in a high-rise building.

Pull under an overpass if driving.

Rush for the nearest exit if in a stadium or theater.

ANS: A

PTS: 1

DIF: Moderate

14. Which of the following acts is in keeping with a major role of nurses in the case of a bioterrorist attack? a. Create individualized nursing care plans to provide for the best possible outcome for each patient. b. Initiate and coordinate communication with public communication systems, such as radio and television reporters. c. Provide client referrals to physicians for initial evaluation, triage, and medical management. d. Recognize cases and clusters of cases resulting from the attack or from naturally occurring outbreaks.

ANS: D

PTS: 1

DIF: Easy

15. A disaster supply kit for a family of five should contain how much water? a. 5 gallons b. 15 gallons c. 25 gallons d. 30 gallons ANS: B

PTS: 1

DIF: Moderate

TRUE/FALSE 1. Creating an entirely pollution-free environment is virtually impossible.

ANS: T

PTS: 1

DIF: Easy

2. No body system is safe from environmental harm.

ANS: T

PTS: 1

DIF: Easy

3. The sense of taste is noted as an accurate tool for detecting pollutants.

ANS: F

PTS: 1

DIF: Easy

4. Among age groups, the elderly are especially affected by environmental tobacco smoke.

ANS: F

PTS: 1

DIF: Easy

5. Concentrations of many volatile organic chemicals (VOCs) are up to ten times higher indoors than outdoors.

ANS: T

PTS: 1

DIF: Easy

6. Diesel exhaust is less harmful than exhaust from gasoline.

ANS: F

PTS: 1

DIF: Moderate

7. The majority of people with hearing loss are males below the age of retirement.

ANS: T

PTS: 1

DIF: Moderate

8. A hurricane “warning” is issued when there is a threat of hurricane conditions within 24 to 36 hours.

ANS: F

PTS: 1

DIF: Moderate

9. A lesson learned from the 9/11 terrorist attack on the Unites States is that there is very little to do to prepare for the unexpected.

ANS: F

PTS: 1

DIF: Moderate

10. Posttraumatic stress disorder from natural disasters tends to disappear within 2 years of the event.

ANS: T

PTS: 1

DIF: Moderate

MATCHING Match each term with the appropriate definition. a. Decibels b. Mutagens c. Ergonomics d. Teratogens e. Volatile organic chemicals 1.

2.

3.

4.

5.

Can cause birth defects Can improve workplace conditions Gases released from certain solids or liquids from thousands of products Substances that can change genetic material found in chromosomes Measurement of sound loudness

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

D C E B A

PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1

DIF: DIF: DIF: DIF: DIF:

Easy Easy Easy Easy Easy

Chapter 8 The Mind-Body-Spirit Connection MULTIPLE CHOICE 1. Which of the following persons, known as the father of modern medicine, is credited with noting that the beliefs of the patient and physician are more important than what the physician actually does? a. Descartes b. Galen c. Hippocrates d. Osler ANS: D

PTS: 1

DIF: Moderate

2. Which of the following nursing leaders recognized the importance of the role of nursing in producing a state of body and mind that would be conducive to healing? a. Florence Nightingale b. Martha Rogers c. Madeleine Leininger d. Nola Pender ANS: A

PTS: 1

DIF: Easy

3. Which of the following most accurately describes psychoneuroimmunology? a. It centers on cellular research investigating hormone effects on nerve cell function. b. It is a field of study that focuses on the interrelatedness of the mind and body. c. It is an attempt by biologists to show how genetics affect human health. d. It is a technique developed by psychologists to assist in the stress response.

ANS: B

PTS: 1

DIF: Moderate

4. Research in psychoneuroimmunology will be helpful to nurses for what reason? a. To enhance holistic care b. To facilitate collaboration among disciplines c. To foster the client-patient relationship d. To identify the most appropriate medical interventions ANS: A

PTS: 1

DIF: Moderate

5. Which branch of the nervous system is responsible for the stress response known as “fight or flight”? a. Central nervous system b. Parasympathetic nervous system c. Somatic division of the peripheral nervous system d. Sympathetic nervous system ANS: D

PTS: 1

DIF: Difficult

6. What is the importance of the hypothalamic-pituitary-adrenal (HPA) axis? a. It creates a feedback loop to regulate the release of corticotrophin releasing factor. b. It facilitates the production of hormones necessary for growth and reproduction. c. It helps to maintain the electrolyte balance in the hematological system. d. It unites the central nervous system with the peripheral nervous system.

ANS: A

PTS: 1

DIF: Difficult

7. Which of the following is an important neurotransmitter in the hypothalamic-pituitary-adrenal (HPA) axis? a. Acetylcholine b. Adrenocorticotropin c. Glucocorticoid d. T lymphocytes ANS: A

PTS: 1

DIF: Difficult

8. The role of glucocorticoids in the hypothalamic-pituitary-adrenal (HPA) axis is to serve as which of the following? a. To activate T lymphocytes in the immune system b. To diminish phagocytosis in the inflammatory process c. To prevent further release of the corticotrophin releasing factor (CRF) d. To stimulate the further release of serotonin and norepinephrine ANS: C

PTS: 1

DIF: Difficult

9. Natural killer cells in the body have the ability to do which of the following actions? a. Destroy T lymphocytes in an attempt to regulate the immune response b. Kill tumor cells and cells infected with microbes c. Stimulate the production of cytotoxic T cells d. Suppress the formation of B lymphocytes ANS: B

PTS: 1

DIF: Moderate

10. Which of the following is considered to be an immediate response to stress? a. Constriction of pupils and peripheral blood vessels b. Excessive sweating and weakness c. Fatigue and carbon dioxide retention d. Increased glucose production by the liver ANS: D

PTS: 1

DIF: Moderate

11. A student is next to present a paper to an auditorium filled with classmates and teachers. This stressor would be categorized as: a. acute time-limited. b. brief naturalistic. c. chronic. d. stressful event sequence.

ANS: A

PTS: 1

DIF: Moderate

12. Experiencing a major natural disaster would be a stressor categorized as: a. acute time-limited. b. brief naturalistic. c. chronic. d. stressful event sequence.

ANS: D

PTS: 1

DIF: Moderate

13. Which of the following is a tip to ease mental stress? a. Breathe rapidly at frequent intervals to increase oxygen to the brain. b. Drink six to eight glasses of water daily to avoid dehydration.

c. Limit meals to three major meals per day for adequate nutrition. d. Take time out regularly, preferably indoors to avoid exposure to allergens.

ANS: B

PTS: 1

DIF: Easy

14. Research has shown a psychoneuroimmunologic link between stress, the immune system, and cardiac disease through an effect of which of the following two substances? a. B lymphocytes and glucocorticoids b. Corticotropin hormone and norepinephrine c. Interleukin-6 and C-reactive protein d. T cells and plasma cortisol ANS: C

PTS: 1

DIF: Difficult

15. A basic crisis intervention strategy is to do which one of the following? a. Allow sufficient time to pass for a calming effect to occur before intervening. b. Avoid developing a plan for action until the crisis has subsided. c. Strive to understand and empathize, considering the cultural context of the victim. d. Try to provide as many answers as possible until the crisis is under control.

ANS: C

PTS: 1

DIF: Easy

TRUE/FALSE 1. A mind-body dualism philosophy recognizes the interrelatedness between the mind and the body.

ANS: F

PTS: 1

DIF: Easy

2. Genetic predisposition, environment, and the behavioral or psychological component are three factors that influence disease susceptibility.

ANS: T

PTS: 1

DIF: Moderate

3. A major communication pathway between the immune system and the brain is through cytokines such as interleukins, interferons, tumor necrosis factors, and growth-stimulating factors.

ANS: T

PTS: 1

DIF: Moderate

4. Biofeedback, psychotherapy, and hypnosis are examples of adjunctive therapy in addition to traditional medical treatment that have been shown to have a positive effect on the course of psoriasis.

ANS: T

PTS: 1

DIF: Easy

5. The National Cancer Institute has confirmed a direct cause-and-effect relationship between immune system changes and the development of cancer.

ANS: F

PTS: 1

DIF: Moderate

6. Mind-body medicine is one of five major areas of research focus for the National Center for Complementary and Alternative Medicine.

ANS: T

PTS: 1

DIF: Easy

7. A survey by the National Center for Complementary and Alternative Medicine showed that 62% of Americans used prayer within the preceding 12 months for health issues.

ANS: F

PTS: 1

DIF: Easy

8. A recent national survey revealed that massage is the most used of all complementary methods.

ANS: F

PTS: 1

DIF: Easy

9. Psychoneuroimmunology is a bidirectional communication between the brain and the immune system.

ANS: T

PTS: 1

DIF: Moderate

10. The autonomic nervous system helps regulate the internal organs through the sympathetic and parasympathetic nervous systems.

ANS: T

PTS: 1

DIF: Moderate

MATCHING Match each of the following terms with its definition below: a. General adaptation syndrome b. Holistic medicine c. Immune modulation d. Immunoenhancement e. Prospective studies f. Retrospective studies 1. Research that follows subjects without the disease or outcome of interest forward in time 2. A factor, either physical, emotional, or treatment variable that alters the degree of immune functioning 3. A response to stress consisting of three phases, including an alarm reaction, resistance phase, and exhaustion phase 4. Research that identifies subjects with the illness or outcome of interest and evaluates their past experiences for causal factors 5. An approach to health care that uses social, psychological, and spiritual aspects to bring about wellness 6. A factor that can bring about increased immune function, prevention of disease, and recovery from illness in an individual 1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS:

E C A F B D

PTS: PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1 1

DIF: DIF: DIF: DIF: DIF: DIF:

Moderate Moderate Moderate Moderate Moderate Moderate

Chapter 9 Promoting Mother, Infant, and Toddler Health MULTIPLE CHOICE 1. Infant mortality refers to: a. death rate of infants. b. illness rate of infants. c. postpartum depression occurrence in new mothers. d. socio-economic status of parents of the infant.

ANS: A

PTS: 1

DIF: Easy

2. What is the percentage of unintended pregnancies among adult women in the United States? a. 25% b. 35% c. 50% d. 75% ANS: C

PTS: 1

DIF: Moderate

3. Which of the following prenatal nutritional supplements is necessary to prevent neural tube disorders in newborns? a. Calcium b. Folic acid c. Iron d. Vitamin C ANS: B

PTS: 1

DIF: Moderate

4. Nonhormonal contraceptives prevent pregnancy by which of the following actions? a. Interfering with sperm movement and/or creating a difficult environment for sperm to travel b. Preventing the ovary from releasing an egg into a fallopian tube c. Thickening of the cervical mucus, making it difficult for sperm to enter the uterus d. Thinning of the lining of the endometrium to prevent implantation of the fertilized ovum ANS: A

PTS: 1

DIF: Moderate

5. Which of the following are important nutrients for fathers-to-be to improve sperm production? a. Ascorbic acid and iron b. Folic acid and Vitamin B c. Vitamin K and magnesium d. Zinc and selenium ANS: D

PTS: 1

DIF: Challenging

6. Genetic counseling would be recommended for prospective mothers and fathers who have a family history of which one of the following? a. Breast cancer b. Diabetes mellitus c. Cystic fibrosis d. Rubella ANS: C

PTS: 1

DIF: Challenging

7. Dangers to the fetus from environmental tobacco smoke include: a. hearing loss and vision disturbances. b. impaired fetal growth and low birth weight. c. muscular dystrophy and skeletal deformities. d. seizures and neurological deficits.

ANS: B

PTS: 1

DIF: Moderate

8. Pregnancy (gestation) in humans lasts approximately how long? a. 30 weeks b. 34 weeks c. 36 weeks d. 40 weeks ANS: D

PTS: 1

DIF: Easy

9. Women with a normal body mass index are recommended to have a weight gain of how many pounds during pregnancy? a. 15 to 20 b. 20 to 40 c. 25 to 35 d. 30 to 45 ANS: C

PTS: 1

DIF: Easy

10. Which of the following sweeteners should be avoided by pregnant women? a. Nutrasweet (aspartame) b. Splenda (sucralose) c. Sweet’N Low (saccharin) d. White refined sugar ANS: C

PTS: 1

DIF: Moderate

11. Which of the following is a pregnancy risk factor for chromosomal abnormalities? a. Fetus with ultrasound showing increased neck thickness b. Father with history of alcoholism or substance use c. Mother older than 25 carrying more than one fetus d. Parents younger than 18 years of age ANS: A

PTS: 1

DIF: Moderate

12. Which of the following requires companies with 50 or more employees to allow an employee who is pregnant or the partner of a pregnant woman to take up to 12 weeks of unpaid leave in the year following the birth of their baby? a. Family and Medical Leave Act of 1993 b. Pregnancy Discrimination Act of 1978 c. Medicaid Amendment of 1965 d. Roe versus Wade decision of 1973 ANS: A

PTS: 1

DIF: Easy

13. Infants are physiologically and developmentally ready for solid foods at what age? a. 4 months b. 6 months c. 10 months

d. 12 months ANS: B

PTS: 1

DIF: Moderate

14. Which of the following actions is recommended to prevent sudden infant death syndrome (SIDS) in infants? a. Allowing infants to sleep in the same bed as the parents b. Offering a pacifier at naptime and bedtime for the first year c. Positioning the infant in a side-lying position d. Propping the infant’s head on a small soft pillow ANS: B

PTS: 1

DIF: Moderate

15. What immunization is provided to infants at birth? a. Hepatitis B b. Diphtheria, tetanus, and pertussis (DPT) c. Measles, mumps, and rubella (MMR) d. Pneumococcal (PCV) ANS: A

PTS: 1

DIF: Moderate

TRUE/FALSE 1. The flu vaccine can be administered to infants as young as 6 months.

ANS: T

PTS: 1

DIF: Easy

2. Pregnant women should have a daily intake of 1000 to 1300 mg of calcium, 1 to 4 mg of folic acid, and 30 mg of iron.

ANS: F

PTS: 1

DIF: Moderate

3. Lactation uses about 500 calories a day, making it the best way to lose weight after childbirth.

ANS: F

PTS: 1

DIF: Easy

4. Sex during pregnancy, especially during the last trimester, creates a significant risk for harm to the fetus.

ANS: F

PTS: 1

DIF: Easy

5. A lack of babbling at 6 months of age, coupled with parental reports of lack of response, warrants a hearing evaluation by an audiologist.

ANS: T

PTS: 1

DIF: Easy

6. The most important nutritional health-promotion strategy is to encourage the mother to breast-feed her infant.

ANS: T

PTS: 1

DIF: Easy

7. The United States is among the top 10 countries in the world having the lowest rates of infant deaths.

ANS: F

PTS: 1

DIF: Easy

8. The breast-fed infant does not get fluoride; therefore supplementation is recommended after 6 months of age.

ANS: T

PTS: 1

DIF: Moderate

9. Motor vehicle accidents are the leading cause of death in infants.

ANS: F

PTS: 1

DIF: Easy

10. Trust versus mistrust is the conflict stage for the first stage of development at the infant level.

ANS: T

PTS: 1

DIF: Easy

MATCHING Match the following terms with the description below: a. Couvade b. Dyspepsia c. Edwards’ Syndrome d. Pica e. Toxoplasmosis 1.

2.

3.

4.

5.

Trisomy 18 chromosomal abnormality Virus that can affect the fetus if the mother becomes infected Ingestion of substances with no food value Commonly known as heartburn Sympathetic pregnancy by the father

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

C E D B A

PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1

DIF: DIF: DIF: DIF: DIF:

Moderate Moderate Moderate Easy Moderate

Chapter 10 The Child MULTIPLE CHOICE 1. Body mass index in children is helpful in determining a child’s a. body fat. b. eating habits. c. growth pattern. d. weight status.

ANS: D

PTS: 1

DIF: Challenging

2. Which of the following would be a helpful suggestion for parents of a picky eater? a. Discontinue offering new foods that are rejected. b. Introduce new foods into casseroles and stews. c. Provide one food from the child’s “like list” at each meal. d. Serve vegetables that are well cooked.

ANS: C

PTS: 1

DIF: Moderate

3. Which of the following places a child at risk for developing osteoporosis in adulthood? a. Consuming sodas or carbonated beverages b. Exposure to environmental tobacco smoke c. Growth spurts that occur in adolescence d. Participating in weight-bearing exercises ANS: A

PTS: 1

DIF: Moderate

4. Obesity in children is defined as being at or above what percentile for age/specific BMI? a. 65th percentile b. 75th percentile c. 85th percentile d. 95th percentile ANS: D

PTS: 1

DIF: Moderate

5. Which of the following would be a helpful suggestion for parents of a child whom they say refuses to stay in bed at night? a. Begin a “get out of bed” free pass good for one time each night. b. Offer warm fluids such as hot chocolate before bedtime. c. Place a glass of water and a snack on the child’s bedside table. d. Sit in a chair by the child’s bed until the child falls asleep.

ANS: A

PTS: 1

DIF: Moderate

6. A nursing intervention for parents of a 5-year-old boy who experiences nightmares and sleepwalking would be to: a. advise them to take the child to a child psychologist. b. extend the child’s bedtime at least 1 hour. c. plan for moderate exercise before bedtime to tire him out. d. reassure them that these sleep disturbances tend to be outgrown.

ANS: D

PTS: 1

DIF: Moderate

7. What is the minimum exercise recommendation for school-age children? a. 20 to 30 minutes of vigorous exercise six times per week b. 30 to 45 minutes of vigorous exercise five times per week c. 45 to 60 minutes of moderate to mild exercise seven times per week d. 60 to 120 minutes of moderate to mild exercise seven times per week ANS: A

PTS: 1

DIF: Moderate

8. Preschoolers or school-age children who were immunized in infancy would be required to obtain which of the following immunizations? a. Booster for tetanus-diphtheria and polio b. Hepatitis A and hepatitis B c. Tetanus toxoid and measles-mumps-rubella d. Varicella and pneumococcal vaccine ANS: A

PTS: 1

DIF: Challenging

9. Which of the following characteristics is associated with acanthosis nigricans? a. Accentuated skin markings b. Episodes of bedwetting c. Diarrhea d. Weight loss ANS: A

PTS: 1

DIF: Moderate

10. Which of the following is common to children with attention-deficit hyperactivity disorder? a. Alternating periods of hyperactivity and withdrawal. b. Difficulty with schoolwork in the absence of learning disabilities. c. Multiple learning disabilities interfering with concentration. d. Three- to five-year developmental delay compared to peers.

ANS: B

PTS: 1

DIF: Moderate

11. Which of the following would be a helpful strategy for a 10-year-old child with attention-deficit hyperactivity disorder? a. Allow the child to leave the room for a few minutes if the child is frustrated. b. Arrange for the child to be with a class of older children periodically. c. Keep the child in the front of the class near the teacher’s desk. d. Seat the child away from task-focused children.

ANS: A

PTS: 1

DIF: Challenging

12. The State Children’s Health Insurance Program (SCHIP) was enacted to: a. expand public health insurance coverage to children in low-income families making too much to qualify for Medicaid. b. supplement medical coverage of children on Medicaid to cover hospital and office visits. c. offer all families with children an opportunity for health insurance regardless of their income. d. provide health insurance for children of immigrant families who are unable to qualify for Medicaid.

ANS: A

PTS: 1

DIF: Challenging

13. Which of the following acts of legislation provides funding that guarantees free and appropriate education in the least restrictive environment without bias and discrimination? a. Americans with Disabilities Act

b. Individuals with Disabilities Education Act c. Section 504 of the Rehabilitation Act d. Special Education Act ANS: B

PTS: 1

DIF: Challenging

14. How much more likely are children to own and use helmets while bicycling if their parents use them too? a. 25 times b. 50 times c. 75 times d. 100 times ANS: D

PTS: 1

DIF: Moderate

TRUE/FALSE 1. Acanthosis nigricans is common among female children ages 9 to 12 years.

ANS: F

PTS: 1

DIF: Easy

2. Obesity treatment programs for children do not have weight loss as a goal.

ANS: T

PTS: 1

DIF: Challenging

3. The State Children’s Health Insurance Program (SCHIP) is designed for all children regardless of economic status.

ANS: F

PTS: 1

DIF: Easy

4. Night terrors are more common than nightmares among preschoolers.

ANS: F

PTS: 1

DIF: Moderate

5. There is no decrease in the effectiveness of vaccines in a child with a mild infection at the time of vaccination.

ANS: T

PTS: 1

DIF: Moderate

6. ADHD is found in approximately 3–17% of children and adolescents.

ANS: T

PTS: 1

DIF: Moderate

7. Varying routines is a helpful classroom strategy for a child with attention-deficit hyperactivity disorder.

ANS: F

PTS: 1

DIF: Easy

8. Middle ear infections have been linked to exposure to environmental tobacco smoke.

ANS: T

PTS: 1

DIF: Easy

9. Automobile safety requires children over 70 pounds to use a booster seat.

ANS: F

PTS: 1

DIF: Easy

10. Gun safety requires that ammunition and the gun be stored separately in a locked location.

ANS: T

PTS: 1

DIF: Easy

MATCHING Match each term with the appropriate definition. a. Acanthosis nigricans b. Egocentric c. Encopresis d. Enuresis e. Scoliosis 1.

2.

3.

4.

5.

Involuntary urinary incontinence in a child 5 years or older in the absence of physical abnormality A lateral curvature of the spine Fecal incontinence in a child 4 years or older in the absence of physical abnormality A skin condition associated with insulin resistance Concentration on self with little or no regard to others or the external world

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

D E C A B

PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1

DIF: DIF: DIF: DIF: DIF:

Moderate Easy Easy Easy Easy

Chapter 11 The Adolescent and the Young Adult MULTIPLE CHOICE 1. Which of the following is an accurate demographic of the adolescent and young adult age groups? a. Their morbidity rates for chronic medical conditions are the highest of the entire population. b. Their morbidity rates for chronic medical conditions are equal to that of the middle adult population. c. Their mortality rates are among the lowest of all age groups. d. Their mortality rates are among the highest of all age groups.

ANS: C

PTS: 1

DIF: Challenging

2. Control over the dynamic biological process of puberty is primarily the responsibility of the: a. adrenal glands. b. anterior pituitary. c. hypothalamus. d. gonads.

ANS: C

PTS: 1

DIF: Easy

3. Which of the following would be appropriate for treating moderate acne? a. Oil-based moisturizers to lubricate skin b. Oral retinoids to decrease sebum production c. Systemic antibiotics to reduce inflammation d. Topical benzoyl peroxide to dry lesions ANS: D

PTS: 1

DIF: Challenging

4. An important health-promotion strategy for parents of adolescents is to help them understand that: a. chronological age and social and emotional development should be considered in determining autonomy for adolescents. b. chronological age is the best indicator of adolescent maturity and the ability to make decisions. c. physical maturation takes precedence over emotional development in determining maturity. d. social and emotional development are more important than chronological age in determining adolescent maturity.

ANS: D

PTS: 1

DIF: Difficult

5. Which of the following is an eating disorder characterized by voluntary refusal to eat? a. Anorexia nervosa b. Bulimia nervosa c. Malnutrition d. Pica ANS: A

PTS: 1

6. Symptoms specific to bulimia include: a. acne and dry skin. b. enlarged parotid gland. c. refusal to eat.

DIF: Easy

d. eating only small amounts of food.

ANS: B

PTS: 1

DIF: Challenging

7. Which of the following would be an early sign of an eating disorder in an adolescent? a. Eating late at night b. Excessive chewing of ice or gum c. Desire to eat only at fast-food restaurants d. Preference for eating with specific peer group ANS: A

PTS: 1

DIF: Moderate

8. Taking a blood pressure reading immediately after an adolescent has ingested a caffeinated beverage will result in: a. a falsely high reading. b. a falsely low reading. c. an average reading. d. an unaffected reading.

ANS: A

PTS: 1

DIF: Challenging

9. A direct physiologic effect of carbonated beverages on teeth that is conducive to dental caries is that they: a. increase sugar on teeth surfaces. b. increase bacteria in the mouth. c. decrease the pH of the mouth. d. decrease tooth enamel.

ANS: C

PTS: 1

DIF: Challenging

10. What is the average age at which smokers first try a cigarette? a. 14 b. 15 c. 17 d. 18 ANS: B

PTS: 1

DIF: Moderate

11. According to the Centers for Disease Control and Prevention (CDC) which of the following is an accurate statement regarding sexual practices of high school students? a. Slightly less than half have engaged in sexual intercourse. b. Most reported having sex before the age of 13. c. Multiple sex partners is a rarity among teens. d. Thirteen is the average age of having sex.

ANS: A

PTS: 1

DIF: Moderate

12. Which of the following theorists is known for research on moral development in females? a. Erik Erikson b. Carol Gilligan c. Lawrence Kohlberg d. Jean Piaget ANS: B

PTS: 1

DIF: Challenging

13. Which of the following characteristics is accurate concerning moral development and gender?

a. b. c. d.

Men define moral problems by relationships with others.

Men view moral dilemmas from a justice perspective.

Women tend to emphasize rules, rights, and principles in moral dilemmas.

Women and men alike emphasize caring and concern in moral dilemmas.

ANS: B

PTS: 1

DIF: Challenging

14. Which of the following development conflicts is applicable to adolescents? a. Autonomy versus self-control b. Identity versus role confusion c. Integrity versus despair d. Intimacy versus isolation ANS: B

PTS: 1

DIF: Challenging

15. In which of the following age ranges is testicular cancer most commonly found? a. 15 to 35 b. 18 to 30 c. 25 to 40 d. 30 to 60 ANS: A

PTS: 1

DIF: Easy

16. When is the best time to perform breast self-examination? a. One week after the last day of the menstrual period b. One week after the first day of the menstrual period c. One week before the first day of the menstrual period d. One week before the last day of the menstrual period ANS: B

PTS: 1

DIF: Challenging

17. Papanicolaou (Pap) tests for detection of cervical cancer are recommended for: a. women who are or have been sexually active and under the age of 60. b. women who are or have been sexually active, or have reached the age of 20. c. women who have given birth or who have reached the age of 18. d. women who are sexually active and have reached the age of 30.

ANS: B

PTS: 1

DIF: Challenging

18. Which of the following groupings of assessment findings would place a woman at risk for breast cancer? a. Early menarche, high school education level, and lower socioeconomic status b. Early menopause, early menarche, and recent use of estrogens c. Late menarche, never had children, and higher socioeconomic status d. Young adult age, sexually active, and lower socioeconomic status ANS: A

PTS: 1

DIF: Challenging

19. Which of the following is accurate concerning intimate partner violence (IPV)? a. The incidence of IPV is equal among socioeconomic groups. b. There is a higher rate of all health problems in women with histories of IPV. c. There is less IPV during pregnancy in abusive relationships. d. There are well over 1000 deaths each year from IPV. ANS: B

PTS: 1

DIF: Challenging

20. Which of the following is a characteristic of young adulthood? a. Health concerns remain the same as those of the adolescent. b. It is a period of repression of intimacy. c. It is a time of balance between autonomy and attachment. d. There is instability in careers and relationships.

ANS: C

PTS: 1

DIF: Challenging

TRUE/FALSE 1. Breast development in girls is one of the most observable signs of female puberty.

ANS: T

PTS: 1

DIF: Easy

2. Bulimia nervosa is an eating disorder in which the individual refuses to eat because of excessive concern over body shape or weight.

ANS: F

PTS: 1

DIF: Moderate

3. Violence is a major contributor to deaths and disabilities in adolescents.

ANS: T

PTS: 1

DIF: Easy

4. Young adults have accomplished the developmental tasks of establishing their sexual identity.

ANS: T

PTS: 1

DIF: Easy

5. Individuals in the adolescent and young adult period of their lifespan are generally the healthiest they have ever been or will be.

ANS: T

PTS: 1

DIF: Easy

6. Unless there is a pathologic condition, the boy who gets his height early will fall into the same average adult height range as the boy who gets his height later.

ANS: T

PTS: 1

DIF: Easy

7. Adolescents from higher socioeconomic status levels are more prone to use tobacco products than those from lower levels.

ANS: F

PTS: 1

DIF: Easy

8. Smokeless tobacco can be more addictive than tobacco smoking.

ANS: T

PTS: 1

DIF: Moderate

9. Children of alcoholics have a 75% chance of becoming alcoholics themselves.

ANS: F

PTS: 1

DIF: Moderate

10. According to Jean Piaget, as adolescents mature, they move beyond using concrete, actual experience as the only basis for their thought processes to using abstract, logical, and hypothetical processes.

ANS: T

PTS: 1

DIF: Moderate

MATCHING Match the following to the related definition. a. Androgenic activity b. Estrogenic activity c. Gynecomastia d. Melanoma e. Menarche 1.

2.

3.

4.

5.

Causes growth and development of the female genitalia Causes growth and development of the male genitalia Skin cancer Breast development in males Initiation of menstruation

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

B A D C E

PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1

DIF: DIF: DIF: DIF: DIF:

Moderate Moderate Moderate Moderate Moderate

Chapter 12 The Middle-Aged Adult MULTIPLE CHOICE 1. Which of the following age ranges is generally accepted as being middle age for adults? a. 30 to 45 b. 35 to 55 c. 40 to 65 d. 45 to 55 ANS: C

PTS: 1

DIF: Easy

2. According to the 2010 Census, what percentage of the Unites States population is considered to be middle-aged? a. 8% b. 12% c. 15% d. 26% ANS: D

PTS: 1

DIF: Easy

3. Middle-aged adults experience the most sweeping changes in which one of the following domains? a. Biological b. Psychological c. Sociological d. Spiritual ANS: B

PTS: 1

DIF: Moderate

4. In adults of any age, regular tetanus-diphtheria-toxoid immunization boosters should be obtained at a recommended interval of: a. 2 years. b. 5 years. c. 10 years. d. 12 years.

ANS: C

PTS: 1

DIF: Easy

5. Menopause refers to which one of the following descriptions? a. An irregular pattern of menstruation with diminished pre-menstrual symptoms b. Gynecological changes associated with increased amounts of circulating estrogen c. The age at which women cease to bear children d. The cessation of menses after one year of amenorrhea ANS: D

PTS: 1

DIF: Moderate

6. Which of the following characteristics is an indicator for bone density testing in women? a. Age over 30 b. Family history of osteoporosis c. Obesity d. Surgical sterilization with hormone replacement therapy ANS: B

PTS: 1

DIF: Challenging

7. A new trend affecting men and women in the middle adult years is: a. career stability and consistency. b. completion of childbearing before age 40. c. grandparents raising grandchildren. d. pressure for risk-taking by peer group.

ANS: C

PTS: 1

DIF: Moderate

8. Which of the following would be an appropriate recommendation for exercise in creating a health-promotion plan for a 42-year-old male? a. Exercise twice per week for 60 minutes of aerobic exercises. b. Exercise three to four times per week for 30 minutes of brisk walking. c. Exercise four to five times per week for 20 minutes of weight lifting. d. Exercise five times per week for 15 minutes of jogging.

ANS: D

PTS: 1

DIF: Challenging

9. A nutrition assessment for a 51-year-old female revealed a diet low in fiber at 10 grams per day.

What changes would be important to include in dietary counseling to promote health in this middle-aged adult? a. Increase dietary fiber to 15 gm. b. Increase dietary fiber to 20 gm. c. Increase dietary fiber to 40 gm. d. Increase dietary fiber to 25 gm.

ANS: D

PTS: 1

DIF: Challenging

10. A nutrition assessment for a 55-year-old male revealed a diet with a high percentage (40%) of calories from fat. What changes would be important to include in dietary counseling to promote health in this middle-aged adult? a. Decrease calories from fat to less than 15%. b. Decrease calories from fat to less than 25%. c. Decrease calories from fat to less than 30%. d. Decrease calories from fat to less than 35%.

ANS: C

PTS: 1

DIF: Challenging

11. Although individuals vary in the amount of sleep they require, the recommended number of hours of sleep for the middle-aged adult is which of the following? a. 5 to 6 hours b. 6 to 8 hours c. 7 to 9 hours d. 8 to 9 hours ANS: B

PTS: 1

DIF: Easy

12. In counseling middle-aged adults, an adult learning principle that should be kept in mind is that adults are motivated to learn when: a. at least 1 week is allowed between learning a skill and practicing the skill. b. dependence on others to problem-solve is facilitated. c. information can be stored and retrieved for future use. d. information is congruent with life experiences.

ANS: D

PTS: 1

DIF: Challenging

13. According to the U.S. Preventive Services Task Force, at what age should a woman begin having yearly mammograms? a. 35 b. 40 c. 45 d. 50 ANS: D

PTS: 1

DIF: Moderate

14. At what age is it recommended for men to begin screening for prostate cancer? a. 20 b. 30 c. 40 d. 50 ANS: D

PTS: 1

DIF: Moderate

15. Which of the following groups of women have been identified as being at high risk for endometrial cancer? a. Postmenopausal Caucasian women, over 50, obese, and with a history of abnormal bleeding b. Postmenopausal Hispanic women, over 40, obese, and with a history of large babies over 9 pounds c. Premenopausal African American women, under age 40, with a history of hypertension d. Premenopausal Native American women, over 50, thin, and with a history of multiple miscarriages ANS: A

PTS: 1

DIF: Challenging

TRUE/FALSE 1. Physical changes during middle adulthood are relatively gradual.

ANS: T

PTS: 1

DIF: Easy

2. Hormone replacement therapy is recommended for all women during and after menopause.

ANS: F

PTS: 1

DIF: Easy

3. The climacteric, or change of life, for men occurs at a much more rapid rate than for their female counterparts.

ANS: F

PTS: 1

DIF: Easy

4. Annual influenza immunization is recommended for all middle-aged adults.

ANS: T

PTS: 1

DIF: Easy

5. When assessing for occupational exposure to carcinogens, it is important to consider the family members of the worker even though they are not physically present in the work environment.

ANS: T

PTS: 1

DIF: Easy

6. The specificity of a screening test refers to the ability of the test to correctly give a positive result when the person has the condition.

ANS: F

PTS: 1

DIF: Challenging

7. If a screening test has low sensitivity, persons with the disease will be missed by the screening procedure.

ANS: T

PTS: 1

DIF: Challenging

8. Women can discontinue monthly self-breast exams after the age of 50 or after the completion of menopause.

ANS: F

PTS: 1

DIF: Moderate

9. Adults with a history of upper body (head and neck) radiation in childhood should be screened for thyroid cancer.

ANS: T

PTS: 1

DIF: Moderate

10. The U.S. Preventive Services Task Force has suggested that blood cholesterol screening for women begin at age 45, 10 years after that recommended for men at age 35.

ANS: T

PTS: 1

DIF: Moderate

MATCHING Match the following variables from Pender’s Health Promotion Model to the related risk behavior or health-promotion activity. a. Individual characteristics and experience b. Behavior-specific cognitions and affect c. Outcomes 1.

2.

3.

4.

5.

6.

Alcohol abuse Excessive daily caloric intake Lack of commitment to a smoking cessation program Nonsupportive spouse Signature on a weight-reduction contract with nurse Self-efficacy

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS:

A B C B C B

PTS: PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1 1

DIF: DIF: DIF: DIF: DIF: DIF:

Challenging Challenging Challenging Challenging Challenging Challenging

Chapter 13 The Older Adult MULTIPLE CHOICE 1. Projections of life expectancy 1999 to 2100 indicate which of the following trends? a. Men will have a decreasingly shorter life span. b. Men’s life expectancy will equal that of women. c. Women will have a decreasingly shorter life span. d. Women will continue to have a longer life span than men.

ANS: D

PTS: 1

DIF: Moderate

2. Health-promotion planning for nutrition of an elderly person is based on the understanding that: a. most older persons believe that nutrition is important, but few act on that belief. b. nutrition requirements decline with age, due to decreased activity levels. c. poverty forces older people to rely more on fresh produce than canned or frozen foods. d. older persons rarely skip meals, preferring to keep an organized eating schedule.

ANS: A

PTS: 1

DIF: Moderate

3. Which of the following accurately reflects the presence of HIV/AIDS in the elderly? a. There is a low incidence of occurrence in the elderly population. b. The signs and symptoms mimic those of normal aging. c. There are more elderly women than men affected by this disease. d. Less than 5% of all new cases are in people over the age of 50.

ANS: B

PTS: 1

DIF: Challenging

4. Which of the following is an accurate estimation of the incidence of depression in the elderly? a. 7% b. 17% c. 27% d. 47% ANS: B

PTS: 1

DIF: Moderate

5. Reasons for lack of identification and treatment of depression in the elderly include: a. atypical symptoms and stigma among older adults. b. lack of screening tools and inaccurate screening tools. c. indifference among caregivers and health-care providers. d. self-neglect and poor quality of life.

ANS: A

PTS: 1

DIF: Challenging

6. The incidence of elder abuse from domestic violence can only be estimated, because the authorities believe that they receive reports on only one in: a. 4 cases b. 8 cases c. 1 in 14 cases d. 1 in 28 cases ANS: C

PTS: 1

DIF: Moderate

7. Which of the following is a health-promotion driving tip for older adults?

a. b. c. d.

Avoid driving for a few days after the start of a new medication.

Keep the radio on for increased stimulation.

Refrain from using the rear-view mirror and turn the head instead.

Wait to drive in the evening and night to avoid daytime traffic.

ANS: A

PTS: 1

DIF: Easy

8. Which of the following would be in the highest risk group for hip fractures in postmenopausal females? a. African American and over 5 ft. 8 in. tall b. Asian and under 5 ft. 2in. tall c. Hispanic and under 5 ft. 2 in tall d. White and over 5 ft. 8 in. tall ANS: D

PTS: 1

DIF: Moderate

9. An elderly person taking five medications has what percent chance of a drug interaction to occur? a. 20% b. 30% c. 40% d. 50% ANS: D

PTS: 1

DIF: Moderate

10. Although types of services vary, which of the following would be an expected function of an assisted living facility (ALF)? a. Caring for bedridden residents b. Managing specialized long-term care c. Monitoring medications and dietary intake d. Providing 24-hour professional nursing care ANS: C

PTS: 1

DIF: Moderate

11. Which of the following is an appropriate health-promotion recommendation for an older adult male who has moderate activity and is in generally good health with a good metabolism? a. Avoid foods fortified with vitamin B12 and vitamin D. b. Consume less than 30% of total calories from fat. c. Include five to six servings of red meat, poultry, eggs, and dairy products per day. d. Intake of 1600 calories per day.

ANS: B

PTS: 1

DIF: Challenging

12. Which of the following is an appropriate exercise recommendation for an older person in good health? a. Add weight lifting of no more than 15 pounds to daily exercise. b. Bicycle in a safe location for 1 hour three times per week. c. Use a treadmill at a moderate pace in the home for 20 to 30 minutes daily. d. Walk or swim for 30 minutes at least three to five times per week.

ANS: D

PTS: 1

DIF: Challenging

13. In addition to an annual flu immunization, health promotion of elderly persons would be to assess for or recommend the following immunizations: a. hepatitis B, pneumonia, and tetanus-diphtheria. b. mumps-measles-rubella, hepatitis B, and tetanus-diphtheria. c. Pneumonia, polio, and varicella zoster.

d. varicella zoster, pneumonia, and tetanus-diphtheria.

ANS: A

PTS: 1

DIF: Challenging

14. An 85-year-old male who lives with his daughter and her family has become withdrawn, with a decreasing appetite and lack of interest in his usual hobbies. For health-promotion planning, the nurse should recognize that focus should be placed on moving him toward the positive aspect of which one of Erikson’s developmental stages? a. Autonomy versus doubt b. Body transcendence versus body preoccupation c. Ego integrity versus despair d. Generativity versus stagnation ANS: C

PTS: 1

DIF: Challenging

TRUE/FALSE 1. Complaints of sleep disturbances are rare among problems reported by the elderly.

ANS: F

PTS: 1

DIF: Easy

2. There is evidence that exercise may reverse the syndrome of physical frailty in the elderly.

ANS: T

PTS: 1

DIF: Easy

3. Statistics have shown that elderly people living in central cities have a higher than average poverty rate than those living in more rural areas.

ANS: T

PTS: 1

DIF: Moderate

4. Eustress refers to negative stress that is created from learned helplessness in the elderly.

ANS: F

PTS: 1

DIF: Moderate

5. Twenty-five percent of those with hip fractures make a full recovery, while about the same percent in those over 50 will die within 12 months due to complications.

ANS: T

PTS: 1

DIF: Moderate

6. Increased risk factors of adverse outcome for hip replacement surgery include advanced age, male gender, black race, existing health problems, and a low income.

ANS: T

PTS: 1

DIF: Moderate

7. There are strict regulations for assisted living facilities that ensure resident safety.

ANS: F

PTS: 1

DIF: Easy

8. A safety tip for caregivers of elderly persons living at home would be to keep the kitchen floor polished and waxed, avoid rugs, and clean spills immediately.

ANS: F

PTS: 1

DIF: Easy

9. Drinking milk or chamomile tea and eating a light snack prior to bedtime may promote healthier sleep in older adults.

ANS: T

PTS: 1

DIF: Easy

10. Asian ginseng and Ginkgo biloba are two herbal supplements used as alternative treatments for erectile dysfunction.

ANS: T

PTS: 1

DIF: Moderate

MATCHING Match each term with the appropriate definition. a. Continuity Theory b. Free Radical Theory c. Disengagement Theory d. Genetic Theory e. Wear and Tear Theory 1.

2.

3.

4.

5.

Aging is according to a predetermined clock.

Older people desire to retire and younger people assume their roles.

How a person ages depends on how they adjusted to changes throughout their life.

Cell damage begins at birth and continues until death.

Overuse and abuse ages the body and its organs.

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

D C A B E

PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1

DIF: DIF: DIF: DIF: DIF:

Moderate Moderate Moderate Moderate Easy

Chapter 14 Health Promotion through the End of Life MULTIPLE CHOICE 1. The state of being deprived of something or someone is known as: a. loss. b. grief. c. bereavement. d. mourning.

ANS: C

PTS: 1

DIF: Moderate

2. Which of the following statements is NOT one of the twelve principles of a “good death”? a. To have choice and control over where death occurs b. To free oneself from deciding who can or cannot be present at the end c. To be able to issue advance directives that ensure wishes are respected d. To know when death is coming and to understand what can be expected ANS: B

PTS: 1

DIF: Moderate

3. Candace’s husband, Theo, is dying of cancer. Although she knows he is suffering and he welcomes the relief of death, Candace worries. How will she get along without him? Candace is experiencing: a. psychological loss. b. ambiguous loss. c. perceived loss. d. anticipatory loss.

ANS: D

PTS: 1

DIF: Moderate

4. Losing flexibility as one ages is considered what kind of loss? a. Physical loss b. Actual loss c. Loss of aspect of self d. Both a and c ANS: D

PTS: 1

DIF: Moderate

5. To be of most help to patients who are dying and their families, nurses must: a. keep abreast of the latest trends and findings associated with end-of-life issues. b. examine their own feelings, thoughts, and beliefs about death and dying. c. incorporate all aspects of best practices in promoting health. d. all of the above ANS: D

PTS: 1

DIF: Moderate

6. After months of chemotherapy for breast cancer with no significant results, Mrs. Selbinco has decided that she can no longer cope with the nausea and other unpleasant side effects of the treatment. Knowing her prognosis, she has none-the-less declined any further treatment. Mrs. Selbinco: a. is moving from the early palliative phase to the late palliative phase of the illness trajectory. b. is exiting from the late palliative phase of her illness. c. is moving from the early palliative phase to the middle palliative phase of the illness

trajectory. d. is exiting the curative phase and entering the early palliative phase of the illness trajectory.

ANS: A

PTS: 1

DIF: Difficult

7. Mr. Tybeck has learned that his wife has a fast-growing brain tumor. Faced with very little hope for a positive outcome, all he can think is, “Please God, I will never be angry at my wife again if you’ll just let her live.” My Tybeck’s thinking is an example of: a. the first task of grieving described by Worden. b. bargaining, as described by Kubler-Ross. c. bargaining, as described by Bowlby. d. shock and numbness, as described by Bowlby.

ANS: B

PTS: 1

DIF: Difficult

8. Which of the following statements is a myth surrounding hospice? a. The patient’s personal physician frequently works with an interdisciplinary hospice team of professionals. b. The expense of hospice is rarely covered by private insurers, Medicare, or Medicaid. c. Hospice services are available to patients with any terminal illness, regardless of their religion or spirituality. d. The major focus of hospice is caring, not curing.

ANS: B

PTS: 1

DIF: Moderate

9. Living Wills and Durable Power of Attorney are: a. examples of advance directives. b. best not spoken of in front of patients, for fear of upsetting or offending them. c. legal documents initiated by next-of-kin after the death of a loved one. d. usually shared by most patients with their health-care providers.

ANS: A

PTS: 1

DIF: Moderate

10. Which of the following statements reflects an abnormal experience of grief? a. Panic attacks b. Fatigue, nausea, and lowered immunity c. Guilt d. None of the above ANS: D

PTS: 1

DIF: Moderate

TRUE/FALSE 1. The major cause of death in the 21st century was acute infections.

ANS: F

PTS: 1

DIF: Moderate

2. Due to advances in pain treatment, almost 98% of all pain problems can be relieved or reduced.

ANS: T

PTS: 1

DIF: Easy

3. Palliative care is usually considered in three stages: early, middle, and late.

ANS: F

PTS: 1

DIF: Moderate

4. The modern hospice movement began in the early 1900s with the establishment of St. Christopher’s Hospice near London.

ANS: F

PTS: 1

DIF: Easy

5. Eighty percent of hospice care occurs outside of a hospital setting.

ANS: T

PTS: 1

DIF: Easy

6. Because death happens to everyone, the definition of “good death” is universally accepted, regardless of culture.

ANS: F

PTS: 1

DIF: Easy

7. Palliative care seeks to improve the quality of life of patients with life-threatening illness through early identification, impeccable assessment, and treatment of pain and other problems.

ANS: T

PTS: 1

DIF: Easy

8. National guidelines recommend advance care planning for patients with terminal illness and life expectancy of less than 6 months.

ANS: F

PTS: 1

DIF: Easy

9. Taking only sips of fluids and no longer being able to swallow pills have been found to be predictive factors for life expectancy.

ANS: T

PTS: 1

DIF: Easy

10. All terminal illnesses, regardless of length, follow the same illness trajectory.

ANS: F

PTS: 1

DIF: Easy

MATCHING Match each theorist with the correct theory or model of grief: a. Worden b. Engel c. Kubler-Ross d. Rando e. Bowlby 1. Six Rs of grieving 2. Biopsychosocial model of three major stages: shock and disbelief; developing awareness of the loss; and restitution and recover 3. Draws from attachment theory to describe the cycle of grief 4. Four tasks of grieving 5. Five stages of grief: denial, anger, bargaining, depression, and acceptance 1. ANS: 2. ANS: 3. ANS: 4. ANS:

D B E A

PTS: PTS: PTS: PTS:

1 1 1 1

DIF: DIF: DIF: DIF:

Easy Easy Easy Easy

5. ANS: C

PTS: 1

DIF: Easy

Chapter 15 Embracing Proper Nutrition MULTIPLE CHOICE 1. Which of the following statements about obesity in the United States is true? a. Sixty-five percent of U.S. men are overweight or obese. b. Obesity rates have slightly lowered over the past decades. c. The United States spent over $147 billion in medical care costs associated with obesity in 2008. d. Sixty-four percent of U.S. women are overweight or obese.

ANS: D

PTS: 1

DIF: Easy

2. An essential nutrient is: a. manufactured by the body in sufficient amounts to meet basic body needs. b. never supplied by foods in the diet. c. not required by the body for effective bodily function. d. required for body growth but not manufactured by the body in sufficient amounts.

ANS: D

PTS: 1

DIF: Moderate

3. Dietary reference intakes (DRI) have been established as a reference for the amount of dietary intake that is: a. acceptable in a restricted dietary plan. b. usually requested for body requirements. c. sufficient to meet the nutritional requirements of the body. d. supposed to be eaten in certain dietary conditions.

ANS: C

PTS: 1

DIF: Difficult

4. Mary is pregnant and receiving prenatal instruction regarding her need for folic acid. Folic acid is recommended for Mary because it: a. helps in absorption of dietary calcium. b. is essential for collagen and bone formation. c. neutralizes substances harmful to the baby. d. prevents spinal cord birth defects during pregnancy.

ANS: D

PTS: 1

DIF: Easy

5. Vitamin A: a. affects vision and hair growth. b. maintains fluid and acid-base balance. c. prevents tissue and cell damage. d. provides sustained energy to the body.

ANS: A

PTS: 1

DIF: Easy

6. Mr. Abrego has been complaining of frequent muscle cramps. The nurse knows that Mr. Abrego’s potassium levels are slightly low and advises him to eat foods rich in potassium. Which of the following are rich in potassium foods that the nurse would recommend? a. Brewer’s yeast and organ meats b. Dairy products, fruits, and vegetables c. Salted foods and beef d. Processed foods and whole grains

ANS: B

PTS: 1

DIF: Difficult

7. Marie is 8 years old and has mottling of the teeth. The school nurse suspects that her stained teeth are the result of drinking water high in: a. calcium. b. chloride. c. fluoride. d. zinc.

ANS: C

PTS: 1

DIF: Easy

8. Which of the following is a Healthy People 2020 Nutrition and Weight Status objective? a. Decrease the number of persons aged 2 and older who consume three daily servings of vegetables. b. Increase the proportion of persons aged 2 and older who consume over 2400 mg of sodium. c. Reduce the proportion of adults, children, and adolescents who eat 30% of calories from fat. d. Prevent inappropriate weight gain in youths and adults.

ANS: D

PTS: 1

DIF: Moderate

9. Which of the following is a Healthy People 2020 focus area? a. Medication compliance b. Nursing safety c. Sleep health d. Spirituality ANS: C

PTS: 1

DIF: Moderate

10. Which of the following statements regarding nutrient intake is true? a. Complex carbohydrates should be increased for all age groups. b. Dietary fiber intake is not essential. c. Saturated fat intake should be reduced in the adult diet. d. Sodium intake should be increased in the elderly.

ANS: C

PTS: 1

DIF: Moderate

11. Mr. Cantu wants to know how much food he should consume in an average day. You inform Mr. Cantu that average intake is based on his energy requirements. Energy requirements are dependent on Mr. Cantu’s: a. body size. b. dietary intake. c. lifestyle behaviors. d. nutrient intake.

ANS: A

PTS: 1

DIF: Difficult

12. Anorexia nervosa and bulimia are two eating disorders that are thought to originate from: a. loss of sociological control. b. early nutritional excesses. c. poor parental monitoring. d. unresolved psychological issues.

ANS: D

PTS: 1

DIF: Difficult

13. Jenny is 22 and slightly overweight, and is attempting to lose weight by following the grapefruit diet. As her nurse, you would tell her that: a. a balanced diet and activity are more important in losing weight. b. fad diets and supplements usually work. c. quick dietary results from diets such as hers are good. d. the grapefruit diet will give her a jumpstart to a healthful diet.

ANS: A

PTS: 1

DIF: Moderate

14. Which of the following is a true statement according to the Dietary Guidelines for Americans? a. Avoid all fats in foods. b. Calories consumed should be balanced with those expended. c. Consume no more than 2 cups of whole milk daily. d. Raw eggs can be consumed in moderation.

ANS: B

PTS: 1

DIF: Moderate

15. In reading food labels to determine caloric content, it is important to note: a. cooking methods used in food preparation. b. entire nutrient and fiber content. c. individual serving size. d. trademark versus the generic labeling.

ANS: C

PTS: 1

DIF: Difficult

16. Mrs. Johnson is a 65-year-old postmenopausal woman in good health. Because of her age and postmenopausal status, Mrs. Johnson is more prone to have: a. anorexia. b. calcium deficit. c. cancer. d. diabetes.

ANS: B

PTS: 1

DIF: Moderate

17. The next step of the nursing process following determination of an appropriate nursing diagnosis is the: a. assessment phase. b. planning phase. c. implementation phase. d. evaluation phase.

ANS: B

PTS: 1

DIF: Easy

TRUE/FALSE 1. Obesity in the United States is both a health and a social problem.

ANS: T

PTS: 1

DIF: Easy

2. Healthy People 2020 is a government initiative that focuses strictly on obesity.

ANS: F

PTS: 1

DIF: Easy

3. Lifestyle behavior changes do not influence the biological domain.

ANS: F

PTS: 1

DIF: Easy

4. Adequate nutritional status adds to the quality of life.

ANS: T

PTS: 1

DIF: Easy

5. According to Ayurveda, all foods have their own heating or cooling energy and postdigestive effect.

ANS: T

PTS: 1

DIF: Moderate

6. Bulimia is rarely seen in adolescence.

ANS: F

PTS: 1

DIF: Easy

7. Nutrient needs should be met primarily through consumption of foods.

ANS: T

PTS: 1

DIF: Easy

8. The Food Guide Pyramid’s approach to nutrition is to develop standardized dietary plans for all age groups.

ANS: F

PTS: 1

DIF: Moderate

9. Religion and spiritual beliefs are synonymous.

ANS: F

PTS: 1

DIF: Moderate

10. Food safety is one of the focus areas of Healthy People 2020.

ANS: T

PTS: 1

DIF: Easy

MATCHING Match each nutrient with its function: a. Protein b. Vitamin D c. Sodium d. Potassium e. Vitamin E f. Iodine 1.

2.

3.

4.

5.

6.

Calcium and phosphorous absorption Nerve and muscle function Growth and repair of tissues Antioxidant; prevents cell damage Body fluid balance Part of thyroid hormones

1. ANS: B 2. ANS: D 3. ANS: A

PTS: 1 PTS: 1 PTS: 1

DIF: DIF: DIF:

Easy Easy Easy

4. ANS: E 5. ANS: C 6. ANS: F

PTS: 1 PTS: 1 PTS: 1

DIF: DIF: DIF:

Easy Easy Easy

Chapter 16 Engaging in Physical Fitness MULTIPLE CHOICE 1. What percentage of adults does not exercise enough to achieve health benefits? a. 10% b. 15% c. 25% d. 60% ANS: D

PTS: 1

DIF: Easy

2. Which of the following is a goal of Healthy People 2020? a. Improve health, fitness, and quality of life through daily physical activity b. Improve flexibility of joints through stretching c. Influence sociocultural domain and self-confidence d. Provide cultural competence to individuals ANS: A

PTS: 1

DIF: Easy

3. Marty, a 45-year-old female, wants to improve her physical fitness. You recommend that she engage in: a. moderate physical activity most days of the week for 15 minutes. b. moderate physical activity most days of the week for 45 minutes. c. moderate physical activity most days of the week for 30 minutes. d. 150 minutes of moderate physical activity per week.

ANS: D

PTS: 1

DIF: Moderate

4. Which of the following is a general definition for the term physical fitness? a. Ability to exercise for 30 minutes without respiratory distress b. Attainment of cardiovascular health c. Flexibility of the joints and back muscles d. Performance-related and health-related attributes associated with healthy lifestyle ANS: D

PTS: 1

DIF: Difficult

5. Another term for aerobic fitness is: a. body composition fitness. b. cardiovascular fitness. c. muscular endurance. d. oxygenation cell transport.

ANS: B

PTS: 1

DIF: Moderate

6. An extreme lack of flexibility is demonstrated by which of the following? a. Displacement of the hip and pelvis b. Knee and joint hyperextension c. Knee of a person with osteoarthritis d. Range of motion restriction ANS: C

PTS: 1

DIF: Moderate

7. Which of the following causes of death can be linked to obesity?

a. b. c. d.

Accidents Cancer Pneumonia Tuberculosis

ANS: B

PTS: 1

DIF: Easy

8. Ballistic stretching for improving flexibility involves: a. gradual static stretching. b. range of motion stretching. c. repeated bouncing stretching. d. slow and deliberate stretching.

ANS: C

PTS: 1

DIF: Moderate

9. Body mass index (BMI) is used for assessing: a. bioelectric impedance. b. hydrostatic weighing. c. overweight and obesity status. d. skinfold thickness.

ANS: C

PTS: 1

DIF: Easy

10. For a muscle to get stronger, which of the following principles must be applied? a. Principle of fitness b. Principle of overload c. Principle of progression d. Principle of specificity ANS: B

PTS: 1

DIF: Easy

11. Alma Reyna is interested in starting an exercise program. She asks you to suggest what type of exercise she should engage in and how hard she should work at exercising. Your best response to Ms. Reyna is: a. Can you exercise for a minimum of 30 minutes daily? b. Have you exercised recently? c. How much time can you devote to exercise? d. What is your goal for engaging in a fitness program?

ANS: D

PTS: 1

DIF: Moderate

12. Which of the following factors is most important when establishing a fitness program for a person? a. Current lifestyle b. Past exercise experiences c. Personal motivation d. Social status ANS: C

PTS: 1

DIF: Difficult

13. Which of the following factors impacts the decision to exercise? a. Diet b. Family c. Hobbies d. Psychological outlook ANS: D

PTS: 1

DIF: Difficult

14. Rosie moved from South Texas to Colorado during the winter. She wants to begin an exercise program right away. You caution Rosie that: a. cold weather may have adverse effects initially on her exercise regimen. b. exercising in Colorado will probably be too hard for her. c. muscle soreness will likely result when she exercises. d. plantar fasciitis or arch pain will likely develop when exercising.

ANS: A

PTS: 1

DIF: Moderate

15. Which of the following nursing diagnoses would be appropriate for an individual recovering from a cerebral stroke? a. Activity noncompliance related to obesity b. Activity intolerance related to generalized weakness c. Decreased cardiac output related to altered heart contractility d. Sedentary lifestyle related to deficient knowledge ANS: B

PTS: 1

DIF: Difficult

TRUE/FALSE 1. Physical activity decreases with age.

ANS: T

PTS: 1

DIF: Easy

2. Health can be defined merely as the absence of disease.

ANS: F

PTS: 1

DIF: Easy

3. Health-related fitness is the same as performance-related fitness.

ANS: F

PTS: 1

DIF: Moderate

4. To successfully compete in sports, individuals must possess both performance-related and health-related fitness.

ANS: T

PTS: 1

DIF: Easy

5. Psychological variables do not influence a person’s decision to exercise.

ANS: F

PTS: 1

DIF: Moderate

6. Individual culture should be considered when planning an exercise program.

ANS: T

PTS: 1

DIF: Easy

7. The RICE method is a good modality to use with muscle sprains, strains, or other minor discomforts.

ANS: T

PTS: 1

DIF: Easy

8. If an athlete stops exercising for long periods of time, all of his muscles will become fatty tissue.

ANS: F

PTS: 1

DIF: Moderate

9. The spiritual domain does not influence the decision to exercise.

ANS: F

PTS: 1

DIF: Moderate

10. The Health Promotion Model is essential to establishing an exercise and fitness plan.

ANS: T

PTS: 1

DIF: Easy

MATCHING Match each term with the appropriate definition: a. Side stitch b. Sprain c. Strain d. Progression principle e. Specificity principle 1.

2.

3.

4.

5.

States that one must overload the body systems to achieve a specific outcome Sharp pain that occurs during exercise Involve injuries to a muscle Gradual overload stimulus increase Involves injuries to a ligament

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

E A C D B

PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1

DIF: DIF: DIF: DIF: DIF:

Moderate Easy Easy Easy Easy

Chapter 17 Controlling Weight MULTIPLE CHOICE 1. Obesity can be defined as being: a. above ideal body weight by 20% or more. b. 20 pounds over ideal body weight. c. 100 pounds over normal body weight. d. 10 pounds over normal body weight.

ANS: A

PTS: 1

DIF: Easy

2. Which of the following physical conditions is attributable to obesity? a. Bulimia b. Eczema c. Goiter d. Sleep apnea ANS: D

PTS: 1

DIF: Moderate

3. Which of the following is NOT one of the six categories presented in Healthy People 2020? a. Iron Deficiency b. Healthier Food Access c. Physical Fitness and Food d. Weight Status ANS: C

PTS: 1

DIF: Moderate

4. Olga, a 45-year-old, tells you that she has been gaining weight gradually since she became menopausal. In educating Olga about weight control issues, you inform her that: a. exercise and a balanced diet are essential for effective weight control. b. genetic predispositions frequently occur in women. c. weight control is easy once you put your mind to it. d. weight gain is part of the normal aging process.

ANS: A

PTS: 1

DIF: Easy

5. Human body mass and structure are primarily determined by: a. environmental influences. b. equilibrium set-point. c. eating behaviors. d. genetic make-up.

ANS: D

PTS: 1

DIF: Moderate

6. An underlying assumption of the biological theory of weight control is: a. genetic predisposition to obesity will result regardless of dietary modifications. b. people resemble their biological parents. c. some people are born to be fat. d. weight control is not influenced by genetics.

ANS: B

PTS: 1

DIF: Moderate

7. According to the theory of thermogenesis, weight control is the result of:

a. b. c. d.

a balance between caloric intake and energy expenditure. decrease in caloric intake and energy expenditure. increase in caloric intake and energy expenditure. storage of fat for energy.

ANS: A

PTS: 1

DIF: Challenging

8. Positive energy balance means that the individual is: a. balancing calories and energy expenditure. b. consuming less food than the body needs. c. gaining weight. d. losing weight.

ANS: B

PTS: 1

DIF: Challenging

9. Angela tells you that after losing 50 pounds on a diet modification plan, she has been unable to lose more weight for the last 2 months even though she has done nothing differently. Which theory of weight control explains Angela’s current situation? a. Theory of biochemical influences b. Theory of environmental influences c. Theory of equilibrium set-point of weight control d. Theory of thermogenesis and weight control ANS: C

PTS: 1

DIF: Challenging

10. Energy expenditure is dependent on: a. basal metabolism. b. dietary patterns. c. high set-point value. d. out-of-control eating patterns.

ANS: A

PTS: 1

DIF: Easy

11. One important psychological consequence of obesity is what? a. Apathy b. Body image disturbance c. Insomnia d. Sleep apnea ANS: B

PTS: 1

DIF: Difficult

12. Aaron is 5 ft. 9 in. tall and weighs 350 pounds. He has tried dieting to no avail. In talking to Aaron, you recommend: a. avoidance of carbohydrates. b. a low glycemic index diet. c. that he consider bariatric surgery. d. the Atkins diet.

ANS: C

PTS: 1

DIF: Difficult

13. Which of the following is an appropriate weight control and maintenance recommendation? a. Always eat breakfast. b. Don’t sit down when you eat. c. Eat foods from only one or two food groups. d. Measure progress in large increments.

ANS: A

PTS: 1

DIF: Moderate

14. Which of the following is part of the dietary guidelines for reducing chronic disease? a. Consume 3 cups of whole grain products per day. b. Include unlimited fruits and vegetables in the daily diet. c. Increase fat intake to 40 % or more of total calories per day. d. Limit alcohol and salt consumption.

ANS: D

PTS: 1

DIF: Difficult

TRUE/FALSE 1. The percentage rate of obesity in children and adolescents has tripled from just one generation ago.

ANS: T

PTS: 1

DIF: Easy

2. Cardiovascular problems may be a consequence of obesity.

ANS: T

PTS: 1

DIF: Moderate

3. Overweight and obesity are always the result of poor adherence to dietary modifications.

ANS: F

PTS: 1

DIF: Moderate

4. Regardless of genetic predisposition to obesity, the environment influences eating behaviors.

ANS: T

PTS: 1

DIF: Easy

5. Anorectics are a safe alternative to dieting.

ANS: F

PTS: 1

DIF: Moderate

6. Feelings of euphoria and happiness are common responses among the severely obese.

ANS: F

PTS: 1

DIF: Challenging

7. The use of bariatric surgery is considered the only permanent treatment for morbid obesity.

ANS: T

PTS: 1

DIF: Easy

8. Use of Pender’s Health Promotion Model is an effective approach to weight control.

ANS: T

PTS: 1

DIF: Moderate

9. An effective approach to weight control is to weigh yourself daily.

ANS: F

PTS: 1

DIF: Moderate

10. Individual characteristics and behaviors impact the likelihood of behavioral changes related to weight control.

ANS: T

PTS: 1

DIF: Easy

MATCHING Match each term with the appropriate definition: a. Basal metabolic rate b. Central obesity c. Ideal body weight d. Obesity e. Weight cycling 1.

2.

3.

4.

5.

High proportion of body fat localized around the abdomen and upper body Being above ideal body weight by 20% or more Losing and regaining weight as seen in yo-yo dieting Amount of energy required to carry out involuntary activities Reasonable weight for height

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

B D E A C

PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1

DIF: DIF: DIF: DIF: DIF:

Easy Easy Easy Easy Easy

Chapter 18 Avoiding Tobacco, Alcohol, and Substance Abuse MULTIPLE CHOICE 1. How many smoking-related deaths occur in the United States each year? a. Fewer than 200,000 b. Less than 300,000 c. Over 400,000 d. Over 1,000,000 ANS: C

PTS: 1

DIF: Easy

2. Lisa drinks alcohol on a daily basis. She mentions to you that she is okay with that because she does not use drugs. You explain to Lisa that: a. alcohol is a drug, since a drug is any substance that modifies bodily functions. b. alcohol is not a drug, and it is socially acceptable to drink. c. she is right, since alcohol is by definition not a drug. d. technically, she is right because alcohol is only taken orally.

ANS: A

PTS: 1

DIF: Moderate

3. Which of the following is a basic source from which drugs are derived? a. Animals b. Fats c. Gelatin d. Oils ANS: A

PTS: 1

DIF: Moderate

4. Which of the following agencies regulates drugs in the United States? a. Agency for Health Research and Quality b. Centers for Substance Abuse Prevention c. National Institute on Drug Abuse d. The Food and Drug Administration ANS: D

PTS: 1

DIF: Easy

5. A psychotropic drug is prescribed for: a. insomnia. b. mental disorders. c. eating disorders. d. tobacco addiction.

ANS: B

PTS: 1

DIF: Challenging

6. Drug half-life refers to: a. drugs that are similar and produce similar effects on the body. b. drug detoxification. c. half the time it takes for the drug to be metabolized out of the system. d. the time that it takes for the drug to be effective.

ANS: C

PTS: 1

DIF: Easy

7. Which of the following produces visual, auditory, and sensory behavior changes after ingestion?

a. b. c. d.

Hallucinogens Opiates Stimulants Antipsychotics

ANS: A

PTS: 1

DIF: Moderate

8. Cocaine is considered to be a (an): a. hallucinogen. b. opiate. c. stimulant. d. antipsychotic.

ANS: C

PTS: 1

DIF: Moderate

9. Carcinogens found in tobacco cause: a. a sedative effect throughout the body. b. cell activity in the body to cease. c. insensitivity to tobacco and tobacco smoke. d. mutation and cellular changes in body cells.

ANS: D

PTS: 1

DIF: Challenging

10. Tobacco addiction occurs in much the same way as drug addiction because tobacco: a. acts on the brain centers to activate pleasure. b. increases perceptions of anxiety and fatigue. c. reduces the pain receptors in the body. d. slows the metabolic rate and produces a sedative state.

ANS: A

PTS: 1

DIF: Challenging

11. Which of the following conditions is directly linked to smoking? a. Chest muscle atrophy b. Coronary heart disease c. Diabetes d. Respiratory tuberculosis ANS: B

PTS: 1

DIF: Moderate

12. Billy, a 4-year-old child, has been diagnosed with chronic bronchitis of undetermined origin. An important question to ask Billy’s mother in order to ascertain what provokes his asthma episodes is: a. Does Billy exercise frequently? b. Does Billy eat a lot of junk food? c. Is Billy exposed to second-hand smoke regularly? d. Is Billy up to date with his immunizations?

ANS: C

PTS: 1

DIF: Moderate

13. Which of the following factors correlates with the development of alcoholism in later years? a. Reduction in amount of alcohol consumed over the years b. Amount of alcohol consumed at one time c. Number of years in sobriety d. Onset of drinking age ANS: D

PTS: 1

DIF: Moderate

14. John is hospitalized due to depression and drug addiction. He is examined by a psychiatrist who plans to hospitalize John, who more than likely is diagnosed as having a: a. discrete diagnosis. b. dual diagnosis. c. tertiary diagnosis. d. triad diagnosis.

ANS: B

PTS: 1

DIF: Easy

15. The school nurse provides education to 2nd-grade students on the dangers of drug abuse and cigarette smoking. In doing this, the school nurse is providing a: a. dual diagnosis prevention strategy. b. primary prevention strategy. c. secondary prevention strategy. d. tertiary prevention strategy.

ANS: B

PTS: 1

DIF: Moderate

TRUE/FALSE 1. Death is the primary measure for the devastating effects of drug use and abuse.

ANS: F

PTS: 1

DIF: Challenging

2. Drugs such as nicotine can be administered through the transdermal route.

ANS: T

PTS: 1

DIF: Moderate

3. Only a physician can prescribe drugs.

ANS: F

PTS: 1

DIF: Moderate

4. Prescription drugs cannot cause drug abuse.

ANS: F

PTS: 1

DIF: Easy

5. Drug abuse occurs when use of the drug is inconsistent with social norms.

ANS: T

PTS: 1

DIF: Challenging

6. Physical dependence is not the same as addiction.

ANS: T

PTS: 1

DIF: Moderate

7. Alcohol is a well-known antidepressant.

ANS: F

PTS: 1

DIF: Moderate

8. In small amounts, alcohol consumption has some benefits.

ANS: T

PTS: 1

DIF: Moderate

9. Males and females differ in alcohol consumption patterns.

ANS: T

PTS: 1

DIF: Easy

MATCHING Match each term with the appropriate definition: a. Addiction b. Triad diagnosis c. Cross tolerance d. Polypharmacy e. Protective factor 1.

2.

3.

4.

5.

Mental health, physical health, and substance abuse diagnosis Drugs that are similar and produce similar effect on body and brain Both a biological and psychosocial dependence on the substance of use Factors that build resiliency against substance abuse Multiple medication use

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

B C A E D

PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1

DIF: DIF: DIF: DIF: DIF:

Easy Easy Easy Easy Easy

Chapter 19 Enhancing Holistic Care MULTIPLE CHOICE 1. Which of the following best defines the meaning of holistic healing? a. It considers all body systems as an integrated whole functioning together for optimum health. b. It considers all aspects of a person’s internal and external environments that may contribute to health and well-being. c. It incorporates lay/folk and Eastern medical practices in conjunction with Western medicine treatments and practices. d. It incorporates caring into nursing practice using eye contact, smiles, touch, time, and presence along with medical interventions to create a healing environment.

ANS: B

PTS: 1

DIF: Easy

2. Which of the following reflects a holistic concept of healing? a. Being conscious of one’s total being, including the spirit, body, thoughts, and feelings b. Using prescription drugs, prayer, massage, play, exercise, and other modalities c. Enhancing the body’s abundant energy to move beyond pain and illness d. Removing resistances that are self-inflicted and replacing them with positive energy ANS: A

PTS: 1

DIF: Moderate

3. Central to the holistic philosophy is that: a. cultural diversity is recognized but insignificant when blended with the whole. b. disease, illness, or imbalances are deterrents to individual positive growth. c. health promotion and disease prevention are a greater focus than symptom treatment. d. empowerment and capacity-building for decision-making are vital components.

ANS: C

PTS: 1

DIF: Moderate

4. What is the role of a nurse healer? a. Directing patients to make health-promoting decisions b. Helping clients discover what they need to heal and ways to meet those needs c. Incorporating complementary modalities into medical management of client illnesses d. Prioritizing client needs and facilitating treatment options ANS: B

PTS: 1

DIF: Easy

5. America was on its way to creating a holistic health-care system until which of the following events marked the beginning of a change of focus for health care? a. Discovery of sulfa in the 1930s b. Introduction of health-care insurance in the 1940s c. Immigration of Europeans in the 1920s d. Rural to urban migration of people in the 1950s ANS: A

PTS: 1

DIF: Challenging

6. A United States national survey of adults has revealed that the percentage of adults over 18 years of age that use some form of complementary and alternative medicine, exclusive of prayer, is: a. 26%. b. 38%. c. 42%.

d. 62%.

ANS: B

PTS: 1

DIF: Moderate

7. Which of the following accurately describes the relationship among complementary, alternative, and conventional medicine? a. Alternative modalities are those that are used instead of conventional medicine. b. Complementary modalities are used only when conventional medicine is not used. c. Conventional medicine incorporates complementary modalities solely in psychiatry. d. Conventional, complementary, and alternative medicine are one and the same.

ANS: A

PTS: 1

DIF: Moderate

8. Which of the following feelings experienced by a nurse should be recognized as a red flag for reflection? a. Eagerness b. Hopefulness c. Peacefulness d. Sadness ANS: D

PTS: 1

DIF: Easy

9. Which of the following is an example of an energy-based modality recognized by the National Center for Complementary and Alternative Medicine? a. Biofeedback b. Pilates exercise c. Phytotherapy d. Reiki ANS: D

PTS: 1

DIF: Moderate

10. Which of the following is a good example of psychoneuroimmunology? a. Capacity-building b. Client empowerment c. Herbal medicine d. Learned helplessness ANS: D

PTS: 1

DIF: Challenging

11. The two steps involved in the relaxation response are to: a. focus on a desired image and apply the image to a desired outcome. b. focus on taking slow, deep abdominal breaths and exhale in reverse. c. focus on repetition of a word or phrase, and return to focus if distracted by thoughts. d. tense and relax the body from toes to head, then reverse the process.

ANS: C

PTS: 1

DIF: Challenging

12. Which of the following mechanisms is accurate in describing the effect of sunlight on seasonal affective disorder (SAD)? a. Sunlight is conveyed via the retina to the pineal gland that blocks conversion of serotonin to melatonin. b. Sunlight stimulates the hypothalamus, which causes melatonin to be released into the blood stream. c. Sunlight is directly connected to the cerebrum via neuro pathways resulting in suppression of serotonin. d. Sunlight is blocked by the retina from entering the neuro pathways resulting in activation

of melatonin production.

ANS: A

PTS: 1

DIF: Challenging

13. Which of the following colors and sounds would have a healing effect on a client suffering from sinus congestion? a. The color red and the sound “ha” b. The color yellow and the sound “ya” c. The color green and the sound “hum” d. The color blue and the sound “ah” ANS: C

PTS: 1

DIF: Challenging

14. Which of the following aromas would be beneficial in promoting calmness, digestion, and ease an upset stomach? a. Black cohosh b. Garlic c. Peppermint d. Saw palmetto ANS: C

PTS: 1

DIF: Moderate

TRUE/FALSE 1. Fabiola is known as a patron saint of nursing after establishing the first free Christian hospital in Rome.

ANS: T

PTS: 1

DIF: Easy

2. The American Holistic Nurses Association is in dire need of support from nurses and is suffering declining membership.

ANS: F

PTS: 1

DIF: Easy

3. According to the National Center for Complementary and Alternative Medicine, the category of manipulative and body-based practices is based on energy fields, subcategorized as veritable, which have yet to be measured.

ANS: F

PTS: 1

DIF: Challenging

4. The etheric or vital layer of the human energy field is the closest to the body.

ANS: T

PTS: 1

DIF: Easy

5. “Disturbed Energy Field” is recognized as a diagnostic domain by the North American Nursing Diagnosis Association (NANDA).

ANS: T

PTS: 1

DIF: Moderate

6. A product labeled as being “natural” has been found to cause no harm.

ANS: F

PTS: 1

DIF: Easy

7. Chakras are natural substances used to produce botanical products in herbal medicine.

ANS: F

PTS: 1

DIF: Easy

8. T’ai Chi and Yoga are two forms of moving meditations.

ANS: T

PTS: 1

DIF: Easy

9. Heliotherapy is the use of sunlight for healing.

ANS: T

PTS: 1

DIF: Easy

10. Using the color blue is known to stimulate the appetite, while the color red can be used as an appetite suppressant.

ANS: F

PTS: 1

DIF: Easy

MATCHING Match the following names to the correct description below: a. Ayerveda b. Dolores Krieger c. Eunice Ingram d. Helen Erickson e. Hippocrates f. Janet Mentgen g. Martha Rogers 1.

2.

3.

4.

5.

6.

7.

Established the holistic form of healing in India Developed Theory of Modeling and Role Modeling Founded Therapeutic Touch as a healing modality Coined the term “biofield” as a force of energy flowing from people Introduced concept of interconnectedness and interaction between client and environment Founded the practice of reflexology as a healing modality Founded the practice of Healing Touch as a healing modality

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS: 6. ANS: 7. ANS:

A D B E G C F

PTS: PTS: PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1 1 1

DIF: DIF: DIF: DIF: DIF: DIF: DIF:

Moderate Moderate Moderate Moderate Moderate Moderate Moderate

Chapter 20 Concerns of the Health Professional MULTIPLE CHOICE 1. A nurse is said to experience burnout when: a. adaptive energy sources are at their peak. b. material and technological resources are scarce. c. physical and emotional exhaustion occur. d. tension and anxiety occur.

ANS: C

PTS: 1

DIF: Moderate

2. Which of the following behaviors might be most indicative that Layne, a nurse, is experiencing burnout? a. Excessive alcohol consumption b. Experiencing role stress c. Inability to fall asleep as usual d. Overeating frequently ANS: A

PTS: 1

DIF: Moderate

3. Role stress refers to: a. adjustment period for all registered nurses. b. anxiety from unrealistic patient expectations. c. lack of clarity in terms of client nursing care. d. stress associated with assuming a new position.

ANS: D

PTS: 1

DIF: Moderate

4. Which of the following issues is of chief concern to the future of the nursing profession? a. Adequate technology b. Aging workforce c. Perceived image of nurses d. Salary pay scales ANS: B

PTS: 1

DIF: Moderate

5. What percentage of all nurses has a baccalaureate degree in the United States? a. 10 percent b. 15 percent c. 28 percent d. 36.8 percent ANS: D

PTS: 1

DIF: Easy

6. James, a 20-year-old nursing student, tells his instructor that he is experiencing much stress during his clinical experiences and that he is not doing as well as he would like. He tells the instructor that he belongs to a fraternity, works part-time, and has a steady girlfriend. As James’ nursing instructor, you recognize that James is probably experiencing stress as a result of: a. difficulty in setting priorities. b. his demanding work schedule. c. heavy clinical workload. d. preconceived ideas about nursing.

ANS: A

PTS: 1

DIF: Moderate

7. Males have not entered the nursing profession in the same numbers as females due to a lack of: a. career opportunities. b. caring abilities. c. job security. d. role models and mentors.

ANS: D

PTS: 1

DIF: Moderate

8. The average age of the registered nurse in the United States is: a. mid-twenties. b. mid-thirties. c. mid-forties. d. mid-fifties.

ANS: C

PTS: 1

DIF: Easy

9. Which of the following is a relevant issue in addressing nursing care? a. A poorly prepared nursing workforce b. Assumption of excessive tasks c. Emphasis on quality health care d. Narrow curriculum spectrum ANS: A

PTS: 1

DIF: Challenging

10. Drawing your own genogram is helpful for: a. containing health-care costs. b. evaluating and changing health patterns. c. identifying stress and anxiety. d. preventing illness and disease.

ANS: B

PTS: 1

DIF: Moderate

11. Which of the following is a primary work-related nursing concern? a. Musculoskeletal injuries b. Workplace advocacy c. Environmental temperature monitoring d. Psychological and emotional security ANS: A

PTS: 1

DIF: Moderate

12. Of the following educational preparations, what nurse would most likely be more satisfied with his or her job, according to Peter Buerhaus? a. Associate degree prepared nurse b. Baccalaureate prepared nurse c. Diploma prepared nurse d. Vocationally prepared nurse ANS: B

PTS: 1

DIF: Moderate

13. James is hospitalized due to depression and chronic pain. In doing your nursing assessment, you are concerned over James’ spiritual health. Which of the following questions to James might help in your assessment of James’ spiritual health? a. Are you sleeping and eating well? b. Do you get along well with your family?

c. Do you have a sense of purpose in your life? d. What do you do for entertainment?

ANS: C

PTS: 1

DIF: Challenging

14. Agnes informs you that she has been having respiratory problems and skin irritation since she started working on your unit. What question should you pose to Agnes in order to assess why she is experiencing these symptoms? a. Are you allergic to latex gloves? b. Have you been very anxious lately? c. Have you been using alcohol swabs? d. Where did you work before coming here?

ANS: A

PTS: 1

DIF: Moderate

TRUE/FALSE 1. Emotional exhaustion occurs in burnout.

ANS: T

PTS: 1

DIF: Easy

2. Health-care professionals are the only professionals at risk for burnout.

ANS: F

PTS: 1

DIF: Easy

3. The first 6 months have been shown to be the most stressful adjustment period for nurses.

ANS: T

PTS: 1

DIF: Moderate

4. Nursing students are immune to stress associated with clinical practice.

ANS: F

PTS: 1

DIF: Easy

5. Nursing students primarily enroll in technical-level nursing programs.

ANS: T

PTS: 1

DIF: Easy

6. The demand for professional nurses is market driven.

ANS: T

PTS: 1

DIF: Moderate

7. Ethnic diversity is well represented in the nursing profession.

ANS: F

PTS: 1

DIF: Moderate

8. Risk for Spiritual Distress is a NANDA identified diagnosis.

ANS: T

PTS: 1

DIF: Easy

MATCHING Match each term with the appropriate definition: a. Burnout

b. c. d. e.

1.

2.

3.

4.

5.

Genogram Hardiness Occupational stress Stressors

Resilience to stress Stress-provoking factors Depicts family health patterns Depletion of health-care giver’s adaptive resources Tension and anxiety that is job-related

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

C E B A D

PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1

DIF: DIF: DIF: DIF: DIF:

Easy Easy Easy Easy Easy

Chapter 21 Economic and Quality Concerns MULTIPLE CHOICE 1. Which of the following entities does not reimburse health-care costs to providers of health-care services? a. Indemnity insurance plans b. Medicaid c. Medicare d. State Health Department ANS: D

PTS: 1

DIF: Moderate

2. Which of the following is the greatest factor contributing to the rise in health-care costs? a. Changing economic conditions b. Health insurance premiums c. Latest technological services d. Unemployment rates ANS: C

PTS: 1

DIF: Challenging

3. Which of the following is a factor affecting health-care costs? a. Consumer knowledge of health-care options b. Hospital availability in rural areas c. In-network provider services d. Lack of options for health-care services ANS: A

PTS: 1

DIF: Challenging

4. The government’s Medicare and Medicaid programs were created to assist: a. children and the elderly. b. health insurance companies. c. managed care plans. d. migrant populations.

ANS: A

PTS: 1

DIF: Moderate

5. Mary, a 76-year-old female receiving Medicare benefits, was recently diagnosed with diabetes and hypertension. She is taking medications by mouth for her diabetes and hypertension and is also receiving insulin injections for her diabetes. Which of the following affects Mary’s access to health care? a. Disease diagnosis b. Health-care services co-payment c. Immigration status d. Prescription drug affordability ANS: D

PTS: 1

DIF: Challenging

6. The Child Health Insurance Program (CHIP) is part of which program/plan? a. Indemnity insurance b. Managed care c. Medicaid d. Medicare

ANS: C

PTS: 1

DIF: Moderate

7. The prospective payment system (PPS) is based on the concept that: a. reimbursement to hospitals is not a major problem. b. similar medical diagnoses result in the same hospitalization costs. c. standards of practice can be set. d. total patient care can be delivered in a safe and holistic manner.

ANS: B

PTS: 1

DIF: Moderate

8. In order to control health-care costs, the consumer can: a. decide never to file a medical lawsuit. b. make sure that his or her provider is within close proximity. c. shop around for lower cost quality health care. d. work with managed care companies supplying health-care services.

ANS: C

PTS: 1

DIF: Moderate

9. Which of the following emphasizes health promotion and disease prevention? a. Indemnity health insurance plans b. Managed care organizations c. Medicaid d. Medicare ANS: B

PTS: 1

DIF: Moderate

10. The Joint Commission: a. determines accreditation policies for not-for-profit organizations. b. determines rights and responsibilities of health-care consumers and providers. c. selects standards by which educational institutions are evaluated. d. sets standards by which health-care quality is measured.

ANS: D

PTS: 1

DIF: Challenging

11. Of the following, select one of the principles to which the American Nurses Association (ANA) is committed: a. Acute care services are preferable to community-based services. b. Health care is a basic right. c. Health policies should be focused on the health-care institutions. d. Multi-payer health-care services are desirable health-care reform options.

ANS: B

PTS: 1

DIF: Moderate

12. Marissa, a 42-year-old female, has been experiencing chronic back pain. She sees her health-care provider, who tells her that she needs to have expensive diagnostic tests done to determine the cause. Because Marissa has no health insurance and does not qualify for Medicaid, her health-care provider gives her a prescription for pain control and sends her home. Which of the following roles should the nurse assume in Marissa’s case to assure the best outcome for her? a. Advocate b. Coordinator of care c. Emotional support coach d. Professional consultant ANS: A

PTS: 1

DIF: Moderate

13. An exclusive provider organization (EPO) requires that members:

a. b. c. d.

accept responsibility for health-care cost containment. identify their preferred provider coverage.

Obtain health-care services within a particular network.

Pay a fixed monthly fee without employer compensation.

ANS: C

PTS: 1

DIF: Moderate

14. Factors contributing to an increase in health-care costs include: a. health-care professional surplus. b. health insurance company losses. c. in-network health-care organizations. d. uninsured consumers of health-care services.

ANS: D

PTS: 1

DIF: Challenging

15. By 2019, national health-care costs are expected to reach: a. $2 billion. b. $20 billion. c. $4.5 trillion. d. $40 trillion.

ANS: C

PTS: 1

DIF: Easy

TRUE/FALSE 1. Reimbursement for delivery of health-care services has not changed in the last 10 years.

ANS: F

PTS: 1

DIF: Easy

2. Lawsuits related to health-care services have had a dramatic effect on health-care costs.

ANS: T

PTS: 1

DIF: Easy

3. Medicare and Medicaid cover all prescription costs for the very young and the elderly.

ANS: F

PTS: 1

DIF: Moderate

4. Managed care organizations provide access to quality health care at a reasonable cost.

ANS: T

PTS: 1

DIF: Moderate

5. In a capitation health-care plan, the hospital’s goal is to provide care for less than what the set fee is.

ANS: T

PTS: 1

DIF: Challenging

6. The American Nurses Association (ANA) is committed to providing managed care plans.

ANS: F

PTS: 1

DIF: Moderate

7. Texas is the only state in the nation that has CHIP. ANS: F

PTS: 1

DIF: Moderate

8. Children are eligible for Medicare coverage.

ANS: F

PTS: 1

DIF: Easy

MATCHING Match each term with the appropriate definition: a. Diagnosis-related groups (DRG) b. Health maintenance organization (HMO) c. Managed care d. Preferred provider organization (PPO) e. Primary care provider 1.

2.

3.

4.

5.

Health-care delivery coordinated with cost of services Provider seen first by consumer of health-care services A diagnosis classification system Type of managed care that uses provider networks to deliver care Type of managed care provided for a fixed payment

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

C E A D B

PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1

DIF: DIF: DIF: DIF: DIF:

Easy Easy Easy Easy Easy

Chapter 22 Ethical, Legal, and Political Concerns MULTIPLE CHOICE 1. A nurse caring for a known child molester is expected to provide care that abides by the standards of practice. Which of the following provides the legal basis for this? a. Beneficence guarantee b. Deontology guarantee c. Equal protection guarantee d. Teleology guarantee ANS: C

PTS: 1

DIF: Easy

2. Which of the following organizations is responsible for establishing a bill of rights for patients? a. American Hospital Association b. American Nurses Association c. Commission for Collegiate Nursing Education d. The Joint Commission ANS: A

PTS: 1

DIF: Moderate

3. Samuel is in the last stages of Acquired Immune Deficiency Syndrome (AIDS). He has decided to become a part of a research study using experimental drugs that might cure him or hasten his death. Which of the following is an ethical theory guiding the use of experimental drugs that might be harmful? a. Deontology b. Maleficence c. Teleology d. Veracity ANS: C

PTS: 1

DIF: Moderate

4. Which of the following is a theory of moral or professional obligation? a. Deontology b. Maleficence c. Teleology d. Veracity ANS: A

PTS: 1

DIF: Moderate

5. The right to self-determination is also called the principle of: a. autonomy. b. beneficence. c. justice. d. standard of best interest.

ANS: A

PTS: 1

DIF: Easy

6. The primary goal of the principle of beneficence is to: a. always be faithful. b. be fair and equitable always. c. do good for a client. d. provide for client privacy.

ANS: C

PTS: 1

DIF: Moderate

7. The Federal Health Insurance Portability and Accountability Act (HIPAA) is associated with which of the following principles? a. Autonomy b. Confidentiality c. Justice d. Respect for others ANS: B

PTS: 1

DIF: Moderate

8. The principle of Respect for Others: a. determines who makes decisions for the client. b. incorporates concepts found in all other principles. c. is the least-recognized principle related to client care. d. is related to the concept of faithfulness.

ANS: B

PTS: 1

DIF: Moderate

9. Roberto is scheduled for a hernia repair tomorrow morning. The nurse is aware that she must obtain an informed consent. An informed consent is a (an): a. explanation of the surgical procedure to the client. b. clear explanation to the client of procedure and its risks and benefits. c. description for the client of the physician’s qualifications. d. description for the client of what constitutes standard of care.

ANS: B

PTS: 1

DIF: Moderate

10. Standards of care: a. allow professional nurses to practice without boundaries. b. determine a professional nurse’s rights in delivering nursing care. c. serve as safety guidelines established by the profession for nursing practice. d. serve as laws that must be abided by in providing nursing care.

ANS: C

PTS: 1

DIF: Moderate

11. Mary dismisses a client from her care without providing instructions on required care at home. The client suffers an injury because of Mary’s omission. Mary’s omission of care is considered to be a a. breach of duty. b. case of battery. c. crime. d. tort.

ANS: A

PTS: 1

DIF: Moderate

12. A nurse who injects a client against his wishes is guilty of: a. battery. b. breach of duty. c. poor judgment. d. professional misconduct.

ANS: A

PTS: 1

DIF: Moderate

13. People have problems accessing health care primarily because of: a. lack of community support. b. lack of resources.

c. poor intellectual ability. d. state government rules and regulations.

ANS: B

PTS: 1

DIF: Moderate

14. In addition to abiding by the profession’s standards of care, a nurse is also expected to abide by the profession’s: a. academic requirements. b. bylaws and mission statement. c. code of ethics. d. standards of care for all health-care professionals.

ANS: C

PTS: 1

DIF: Challenging

15. Janet knows that as a nurse she will be expected to guide clients through personal decisions regarding their care. An activity to help Janet with difficult ethical decisions is: a. to engage in personal meditation. b. to enroll in an ethico-legal class. c. to engage in personal mediation daily. d. values clarification.

ANS: D

PTS: 1

DIF: Moderate

TRUE/FALSE 1. Nurses must develop an awareness of the ethical and legal considerations pertaining to nursing practice.

ANS: T

PTS: 1

DIF: Easy

2. Ethical dilemmas can be resolved, since there are clearly right or wrong courses of action.

ANS: F

PTS: 1

DIF: Moderate

3. Teleology ethical theory can be summed up as “the end justifies the means.”

ANS: T

PTS: 1

DIF: Moderate

4. The right to autonomy gives a client absolute rights.

ANS: F

PTS: 1

DIF: Moderate

5. Nurses must always function with knowledge of the beneficence principle.

ANS: T

PTS: 1

DIF: Easy

6. Only one set of standards of practice exists in the nursing profession.

ANS: F

PTS: 1

DIF: Moderate

7. A tort differs from a crime in that it is settled in civil court.

ANS: T

PTS: 1

DIF: Moderate

8. Nursing students are held liable for their own acts of negligence committed in the course of clinical experiences.

ANS: T

PTS: 1

DIF: Easy

9. Battery can occur without assault.

ANS: F

PTS: 1

DIF: Moderate

MATCHING Match each term with the appropriate definition: a. Assault b. Advance directives c. Breach of duty d. Law e. Nonmaleficence 1.

2.

3.

4.

5.

Written instruction on procedures to be followed if a client becomes incapacitated Infringement upon the mental security and/or tranquility of another Sum total of rules and regulations by which a society is governed Principle requiring nurses to act in such a way as to avoid causing harm Deviation in some manner from the standard of care

1. ANS: 2. ANS: 3. ANS: 4. ANS: 5. ANS:

B A D E C

PTS: PTS: PTS: PTS: PTS:

1 1 1 1 1

DIF: DIF: DIF: DIF: DIF:

Easy Easy Easy Easy Easy