Chapter 17 Promoting Healthful Living in the Primary Care Setting

Chapter 17  Promoting Healthful Living in the Primary Care Setting

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A patient admitted with chest pain who is a one pack-a-day smoker tells the nurse, “I am just not ready to quit smoking yet.” The most appropriate response by the nurse is:
a.
“This would be a really good time to quit.”
b.
“Are you familiar with the nicotine patch?”
c.
“Your smoking is the cause of your chest pain.”
d.
“What do you think keeps you from quitting?”

ANS: D
Pender and Pender discuss the relationship of situational influences with regard to health promotion. The nurse’s role is to assist the patient in identifying motivators to quitting. In addition, the nurse may also ask the patient about roadblocks to quitting. The responses about this being a good time to quit and naming smoking as the cause of the chest pain express judgmental feelings by the nurse and are not likely to motivate the patient. Suggesting the use of medication would be appropriate for the patient only if the patient expressed a desire to quit smoking.

DIF: Cognitive Level: Application REF: Page 270
OBJ: Analyze the RN’s role in health promotion. TOP: Health Promotion
MSC: NCLEX: Health Promotion and Maintenance

2. A nurse is caring for a non–English-speaking Asian patient whose cultural practices are not familiar to the nurse. The nurse is curious about practices regarding communication and eye contact. The nurse should:
a.
tell the patient that it is cultural practice in the United States to maintain good eye contact when communicating with someone.
b.
observe the behaviors and interactions between the patient and other members of the culture.
c.
avoid all eye contact unless the patient establishes eye contact.
d.
use eye contact and communication techniques that are most comfortable for the nurse.

ANS: B
Telling the patient what U.S. practices are will not be helpful in assessing the patient’s cultural values regarding eye contact. Avoiding eye contact may not be appropriate for interactions with some patients. The nurse should attempt to adapt communication to the patient’s communication style.

DIF: Cognitive Level: Application REF: Page 271
OBJ: Describe the theoretical basis of self-care. TOP: Self-Care
MSC: NCLEX: Health Promotion and Maintenance

3. After the nurse implements diet instruction with a patient with heart disease, the patient can explain the information but fails to make the recommended dietary changes. The nurse’s evaluation is that:
a.
learning did not occur because the patient’s behavior did not change.
b.
the nursing responsibility for helping the patient make dietary changes has been fulfilled.
c.
choosing not to follow the diet is the behavior that resulted from the learning.
d.
the teaching methods were ineffective in helping the patient learn the dietary information.

ANS: C
Orem assumes that the responsibility of primary health promotion lies with the individual. Although the patient’s behavior has not changed, the patient’s ability to explain the information indicates that learning has occurred and the patient is choosing at this time to continue with the previous diet. The patient may be contemplating or preparing to transition his behavior. The nurse should reinforce the need for change and continue to provide information and assistance with planning for change.

DIF: Cognitive Level: Application REF: Page 271
OBJ: Describe the theoretical basis of self-care. TOP: Self-Care
MSC: NCLEX: Health Promotion and Maintenance

4. A patient is admitted to the hospital with a new diagnosis of diabetes mellitus type 1 and is scheduled for discharge on the second day after admission. In view of the patient’s 2-day inpatient stay, the nurse should set realistic goals by planning to:
a.
teach the patient how to monitor glucose and self-administer insulin.
b.
include detailed information about diet and medication use in patient teaching.
c.
use every interaction to teach the patient about the details of glucose control.
d.
focus on teaching the family instead of the patient about diabetic management.

ANS: A
When time is limited, the nurse should set realistic goals with the patient that will meet immediate needs. The patient and family will need further teaching about the role of diet, exercise, medications, and so forth, in controlling glucose, but these topics can be addressed through planning for appropriate referrals.

DIF: Cognitive Level: Application REF: Page 271
OBJ: Describe the theoretical basis of self-care. TOP: Self-Care
MSC: NCLEX: Health Promotion and Maintenance

5. A nurse recognizes that a homeless patient must walk great distances to obtain food. What kind of need does this patient demonstrate?
a.
Health-deviation need
b.
Developmental need
c.
Universal need
d.
Health continuum need

ANS: C
A universal need is an essential requirement for everyone: food, shelter, air, water, and other basic needs. A developmental need, such as trust, love, and belonging, changes as a person moves through each life-cycle period. A health-deviation need is based on an individual’s genetic or constitutional deviations from normal. A health continuum need is not a true term.

DIF: Cognitive Level: Application REF: Page 273
OBJ: Describe the theoretical basis of self-care. TOP: Self-Care
MSC: NCLEX: Health Promotion and Maintenance