Promoting Health and Wellness Through Nursing Interventions, Exams of Nursing

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NUR 163 Exam 1Questions and Answers Graded

A +

1. Health - Correct Answer A complex phenomenon that involves physical, mental, and spiritual aspects
2. Wellness - Correct Answer A way of life oriented toward optimal health and well-being.
3. Nourishment - Correct Answer Life and wellness require nourishment. Nourishment comes in the form of food, exercise, sleep, relationships, meaningful work, the environment, and memories.
4. A person with an illness rarely describes the illness in terms of their diagnosis. Instead, they describe the illness as: - Correct Answer The way it makes them feel. (Pain, sadness, loss, fatigue, overwhelmed)
5. Normalcy - Correct Answer One aspect of persevering in illness and life disruption is maintaining as much normalcy as possible. Normalcy helps clients cope with illness.
6. People who are suffering experience: - Correct Answer Loneliness. Part of aloneness can be related to the actual physical separation, part of it from a sense of the world going on without them, and part of it from a sense of no one really being in their world.
7. What factors can influence a person's response to disruptions? - Correct Answer Age Family patterns Culture Hardiness Support Access to healthcare resources The stage and nature of the illness and the intensity, duration, and multiplicity of the disruption.
8. What is a large and growing healthcare concern, especially among older adults?

• Correct Answer Chronic illness

9. Name the top three risks for functional decline. - Correct Answer 1. Cognitive impairment
10. Depression
11. Disease burden

10. What are some ways we can ease patients' disruptions as a result of admission, transfers, and discharge from a healthcare setting? - Correct Answer Discharge planning, communication, coordination, and teaching.
11. How does the World Health Organization define health? - Correct Answer >The World Health Organization (WHO) initially defined health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (WHO, 1948).

12. In 1986 WHO redefined health as "a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities".

13. How does Traditional Chinese medicine define health? - Correct Answer A balance between yin and yang.
14. How does Ayurveda describe health? - Correct Answer Describes health as the trinity of body, mind, and spiritual awareness.
15. How did Florence Nightingale (1859) define health? - Correct Answer She believed that health was the prevention of disease through the use of fresh air, pure water, efficient drainage, cleanliness, and light.
16. How did nursing theorist Jean Watson (1979) describe health? - Correct Answer She believed that health implies at least three elements: (1) a high level of overall physical, mental, and social functioning; (2) a general adaptive- maintenance level of daily functioning; and (3) the absence of illness (or the presence of efforts that lead to its absence).
17. Explain how full-spectrum nurses define health and illness. - Correct Answer Nurses understand health and illness as individual experiences, emerging from each patient's unique responses.
18. Identify factors that disrupt health. - Correct Answer Factors that disrupt health include physical disease, injury, mental illness, pain, loss, impending death, competing demands, the unknown, imbalance, and isolation.
19. Define hardiness. - Correct Answer Hardiness has been described as developing a very strong positive force to live—and enjoying the fight. It also involves willingness to draw on resources from within oneself or from others to break out of old patterns of living when life situations change. Hardy people seek information and take initiative in dealing with life situations. They have an "I can deal with this" attitude.
20. Explain how you can promote patient trust during admissions, transfers, and discharges. - Correct Answer Patient trust can be promoted by supporting

patients through transitions such as admission, transfer, and discharge from the institution—in helping them adjust to the new environment. Trust is built on the relationship you begin building with your first patient contact. You need to have plans in place and have supplies and equipment already prepared for each of these transitions. Patient and family teaching are essential. Greet the client and introduce yourself; keep the patient informed about what to expect and what is expected of him or her. Establish a relationship with the client. Take time to get to know your client. Try to set a tone of caring, respect, and understanding. Coordinate and communicate with other department and community services to obtain the care your client needs.

21. Health Belief - Correct Answer Characterized by the relationship between what a person believes and how a person acts
22. Host-agent environment - Correct Answer A causative model seeking a source or cause of illness
23. Holistic - Correct Answer The unique interaction of an individual's mind, body, and spirit within the universe
24. Acute Illness - Correct Answer Develops quickly and lasts a limited amount of time.
25. Chronic Illness - Correct Answer Often develop gradually and can last a person's lifetime.
26. Primary Prevention - Correct Answer The implementation of programs aimed to reduce illness by preventing occurrence.
27. Secondary prevention - Correct Answer Aimed at reducing the incidence of illness through early identification and treatment of illness.
28. Tertiary prevention - Correct Answer The reduction of the residual effects of illness after the development of the illness.
29. It is after visiting hours when the minister from John's church stops by to visit him. By allowing the minister to visit, the nurse demonstrates recognition of the influence of _________ on the healing process. - Correct Answer Spirituality
30. What is the primary reason pediatric units encourage families to stay with young patients? - Correct Answer Increase involvement of the family in the plan of care
31. What is the goal of analyzing client assessment data about nutrition, exercise, leisure activities, spirituality, and home environment? - Correct Answer Provide the information needed to describe related causal factors

32. A 28-year-old client underwent surgery for testicular cancer. Which factor might increase the client's recovery time? - Correct Answer History of tobacco use
33. (Increases recovery time from illness, injury, and surgery)
34. When do people typically begin to increase awareness of the compelling reality of death? - Correct Answer Middle age
35. Which health conditions would be considered acute illness? - Correct Answer Appendicitis
36. What is the most important reason for a nurse to remain calm, greet the patient by name, and introduce herself to a new patient, even when the nurse is upset by something else that has happened? - Correct Answer These actions help to establish a trusting relationship.
37. A nurse is admitting a 75-year-old patient to the nursing unit, accompanied by his son. Using a life span approach to care, which of the following is essential for the nurse to do? - Correct Answer Ask the patient whether he has had any falls in the past year.
38. The nurse is responsible for setting up special equipment (e.g., oxygen, suction). Aside from that, which of the following procedures can the nurse delegate in its entirety to nursing assistive personnel (NAP)? - Correct Answer Preparing a room for a newly admitted patient
39. In an effort to promote health, the home health nurse opens the client's bedroom windows to let in fresh air and sunlight, washes her hands often, and teaches the patient and family about the importance of hygiene and cleanliness. This most closely illustrates the ideas of which of the following people? - Correct Answer Florence Nightingale
40. Which of the following is known to be a healthy strategy for coping with stress? - Correct Answer Performing meaningful work
41. Which family would most likely be helpful in encouraging the client to experience a high level of wellness? A family who: - Correct Answer Teaches negotiation skills and independence
42. When developing goals, which guideline should the nurse keep in mind? Goals should be: - Correct Answer Realistic so that progress is recognized by the patient
43. Which one of the following important nursing actions is a hospitalized patient likely to experience on an emotional level and remember long after this

hospitalization has ended? - Correct Answer Providing a healing presence by listening and being attentive

44. Which statement best describes the health-illness continuum? - Correct Answer Health and illness are along a continuum that cannot be divided.
45. What are the DRIs? - Correct Answer DRIs are "dietary reference intakes" established by the National Academy of Sciences in a collaborative effort of the United States and Canada to promote the consumption of healthful nutrient levels by all Americans.
46. What is the body's most usable energy source? - Correct Answer Carbohydrates, especially glucose, provide the most usable energy.
47. Which nutrient's primary function is growth and repair of tissue? - Correct Answer The primary function of dietary protein is the growth and repair of body tissues. Secondarily, proteins attract water in the bloodstream and contribute to regulating fluid balance in the body. They function as buffers for regulating acid- base balance. Proteins are a secondary energy source. They are also involved in immune defense.
48. Which type of vitamin requires daily consumption to maintain appropriate levels?
    • Correct Answer Water-soluble vitamins require daily intake because they are eliminated in the urine with little storage in the body.
49. Which age group experiences a growth spurt second only to that of infants? - Correct Answer Adolescents
50. Why are energy (kcal) requirements less for older adults? - Correct Answer For older adults, lean body mass is lost and appetite, physical activity, and BMR decrease, resulting in slightly reduced energy requirements.
51. List nutrients that may be more difficult to supply through a vegetarian diet. - Correct Answer Vitamin B12, protein, calcium, iron, zinc, and vitamin D. Vegans must supplement these nutrients and calcium or consume foods fortified with them.
52. Why is it important to identify the serum albumin level? - Correct Answer Serum albumin levels are useful in identifying chronic nutritional deficiency and malnutrition.
53. Which food provides the only animal source of carbohydrate? - Correct Answer Milk

54. During an admission assessment, the patient reports that he takes vitamin E supplements twice a day. The nurse should explain that taking vitamin E supplements twice a day: - Correct Answer Can lead to toxicity
55. The nurse is preparing an enteral feeding for a patient who will be receiving intermittent feedings via nasogastric tube for the first time. The patient is conscious. Which of the following is the priority intervention before administering this feeding? - Correct Answer Obtain an x-ray of the chest and abdomen.
56. The head of the bed of a patient who is receiving enteral feedings is elevated to 45 degrees. Which complication associated with enteral feedings does this intervention help prevent? - Correct Answer Aspiration
57. During parenteral nutrition administration, a nurse breaks sterile technique. For which complication does this place the patient at risk? - Correct Answer Sepsis
58. An adult patient who is receiving a continuous enteral feeding at 80 ml/hr has a residual volume of 120 ml 6 hours after the last check. How should the nurse proceed? - Correct Answer Hold the feeding for 1 hour, and recheck
59. Which action should the nurse take after administering a dose of medication through a percutaneous endoscopic gastrostomy (PEG) tube? - Correct Answer Flush the tube with 30 mL of water
60. The nurse is caring for a patient who has multiple fractures from a skiing accident. To best promote bone growth, the nurse should encourage the patient to eat foods high in calcium and vitamin D. Which food selection by the client indicates an understanding of foods that are high in calcium? - Correct Answer Tofu
61. A patient has anemia. An appropriate goal for that the patient would be for him to increase his intake of which nutrient? - Correct Answer Iron
62. Patients may be deficient in which vitamin during the winter months? - Correct Answer D
63. Which organ relies almost exclusively on glucose for energy? - Correct Answer Brain
64. Health promotion - Correct Answer Refers to helping clients develop an optimal state of health.
65. Intention - Correct Answer The difference between health promotion and health protection (illness prevention).

66. Primary intervention - Correct Answer Designed to prevent or slow the onset of disease.
67. Secondary interventions - Correct Answer Designed to detect illnesses in early stages
68. Tertiary interventions - Correct Answer Focus on stopping the disease from progressing and on rehabilitation.
69. Pender's Health Promotion Model (HPM) - Correct Answer Identifies three groups of variables that affect health behavior: (1) individual characteristics and experiences; (2) behavior-specific cognitions and affect; and (3) behavioral outcome.
70. Health promotion activities for all age groups include: - Correct Answer Nutrition, exercise, safety concerns, changing unhealthy lifestyles, immunizations, and screenings.
71. A health promotion assessment involves : - Correct Answer Obtaining a health history, physical examination, fitness assessment, lifestyle and risk appraisal, life stress review, assessment of healthcare beliefs, nutritional assessment, and screening activities
72. Health screening activities are designed to: - Correct Answer Detect disease at an early stage so that treatment can begin before there is an opportunity for disease to spread or reduce the quality of life.
73. Health screening activities vary based on: - Correct Answer Developmental stage and identified risk factors.
74. Nurses promote health through: - Correct Answer Role models, counseling, health education, and providing and facilitating support.
75. How does health promotion differ from health protection? - Correct Answer Health promotion is motivated by the desire to increase well-being. Health promotion is related to individual lifestyle and involves making choices that affect one's health prospects. Examples include physical activity, nutrition, tobacco and alcohol use, and family planning.
76. Health protection is directed at preventing illness. Examples include safety, environmental conditions, exercise, and nutrition.
77. What are the six dimensions of health represented by the spokes on the wellness wheel? - Correct Answer Physical Mental Emotional

Social/family Occupational Spiritual

78. Identify the stages of change identified by Prochaska and DiClemente. - Correct Answer Pre contemplation Contemplation Determination Action stage Maintenance stage Termination
79. Describe the four main types of health promotion programs. - Correct Answer Disseminating information. Programs for changing lifestyle and behavior (stop smoking, etc) Environmental-control programs. (air, water, etc) Wellness assessment and health risk appraisal programs. (promote health and fight disease- found online and in fitness magazines)
80. What role does stress play in health promotion? - Correct Answer Stress triggers physiological responses that may, over time, induce illness. Stress includes life change events and daily hassles. For some people, life events may contribute more to individual hardiness than to vulnerability.
81. Identify strategies to help a client engage in positive lifestyle change. - Correct Answer Role modeling Counseling Providing health education Facilitating support
82. Winona has made the decision to stop smoking; her father was just diagnosed with lung cancer, and she fears that she will also develop this disease. This is an example of which of the following? - Correct Answer Health protection
83. Which of the following statements would indicate a patient is likely to comply with a newly prescribed low-sodium diet? - Correct Answer "I know we are going to have to buy some different foods now, even if they don't taste as good."
84. Which of the following health promotion programs would have the greatest overall effect on the intended participants? - Correct Answer An exercise program started in a county school system
85. A man converts a room in his home into a workout area. He uses the gym on a regular basis to improve his health. As his muscle strength improves, he adds more machines, which, in turn, enable him to work on his cardiovascular health.

This is an example of which of the following? - Correct Answer Pender's Health Promotion Model

86. A tennis professional had surgical repair of a rotator cuff injury and is now participating in physical therapy. This is an example of which of the following? - Correct Answer Tertiary prevention
87. A patient with a 30-year history of tobacco use has decided to quit smoking and is preparing a plan to ensure that she is successful in this endeavor. Which of the change stages identified by Prochaska and DiClemente is this patient experiencing? - Correct Answer Determination
88. When assessing the level of cardiorespiratory fitness in healthy, middle-aged adults without joint restriction or mobility impairment, what screening activity would be most suitable for the nurse to ask the patient to perform? - Correct Answer Step test
89. The nurse would advise which patient to have a fasting lipid panel performed at least once every 5 years? Select all that apply. - Correct Answer 1) Adult with total cholesterol greater than 150 mg/dL

2. All adults 20 years and older
3. Children exceeding 95% for weight

90. The nurse planning a health promotion and wellness screening program considers which factor as the greatest risk for cardiovascular disease? - Correct Answer BMI greater than 30
91. The nurse would try to identify the patient's locus of control when trying to change health promotion behavior because she wanted to determine which of the following? Select all that apply. - Correct Answer 1) Perception of powerlessness

3. Feeling of being in charge of own health

92. In the Leavell and Clark model of health protection, the chief distinction between the levels of prevention is: - Correct Answer The point in the disease process at which they occur.
93. The muscle strength of a woman weighing 132 pounds who is able to lift 72 pounds would be recorded as 0.55. The nurse explains this to the client as the: - Correct Answer Ability of a muscle to perform repeated movements.
94. Which is one of the greatest concerns with heavy and chronic use of alcohol in teens and young adults? - Correct Answer Unintentional Death
95. The World Health Organization's definition of health includes which of the following? Select all that apply. - Correct Answer 2) Physical well-being

3. Mental well-being
4. Social well-being

96. Health promotion programs assist a person to advance toward optimal health. Which of the following activities might such programs include? Select all that apply. - Correct Answer 1) Disseminating information

2. Changing lifestyle and behavior
3. Environmental control programs

97. Family - Correct Answer A group of individuals who provide physical, emotional, economic, and/or spiritual support while maintaining involvement in each other's lives.
98. Examples of family structure are: - Correct Answer The traditional nuclear family Dual-earner families Single-parent families Stepfamilies Blended families Married couples with no children Extended family sharing dwelling
99. Family nursing views the family from three perspectives: - Correct Answer As the context for care of an individual, as the unit of care, and as a system.
100. Under general systems theory, the family is viewed as: - Correct Answer A system in interaction with other systems (e.g., other families, groups, communities, and individuals).
101. Under structural-functional theories, families are viewed as: - Correct Answer Social systems with a focus on outcomes.
102. What are some examples of family functions as defined by structural- functional theories? - Correct Answer Socialization of children Meeting the physical and emotional needs of family members Caregivers to older adults Developing productive members of society
103. Developmental theories focus on family stages: - Correct Answer Beginning family, childbearing family, family with preschool children, family with school-age children, family with teenagers and young adults, family launching young adults, postparental family, and aging family.
104. Family interactional theory views the family as: - Correct Answer A unit of interacting personalities with a major emphasis on family roles.

105. The family teaches: - Correct Answer Health beliefs, values, and behaviors to its individual members
106. How families cope with everyday life situations and hospitalization can influence: - Correct Answer The effectiveness of care rendered
107. Nurses can promote family wellness by: - Correct Answer Addressing both individual and family concerns.
108. What are some topics that the nurse can discuss with the family as a unit?

- **Correct Answer** Nutrition 

Physical activity Stress relief Coping behaviors/mechanisms Communication skills Developmental Tasks

109. What concerns are associated with teenage pregnancies? - Correct Answer Pregnant teenagers tend to seek prenatal care later in their pregnancy, which can put the fetus at risk. Teenage mothers are more likely to drop out of school and this increases the probability of living in poverty. They have greater health disparities, and their children are more likely to be involved in the juvenile justice system
110. What gender groups are experiencing the fastest rate of growth in new HIV cases? - Correct Answer African American males and females have the fastest rate of growth in new HIV cases
111. What are some potential causes of homelessness? - Correct Answer Mental illness (e.g., discharging mentally ill persons to the street when their insurance coverage ends) Unemployment or lack of employment opportunities or skills Inability or lack of desire to live within society's norms Explosion of healthcare costs Divorce with loss of income and/or added expenses
112. What are the different types of violence? - Correct Answer Physical violence Domestic (spousal) violence Gang violence Child abuse Sexual assault/rape Emotional abuse Elder abuse

113. Among children, which age group is the most vulnerable to abuse and neglect? - Correct Answer The younger the age of the child, the more vulnerable they are to abuse because of their dependency, small size, and inability to defend themselves. Children aged 2 years and younger were the most frequent victims of fatalities from abuse and neglect.
114. Describe the effects of family violence that generally endure after the physical injury has healed. - Correct Answer Family violence leaves wounds deeper than physical injury. These are wounds of mistrust, betrayal, and anger. Any type of violence is likely to have long-lasting effects on the victims and on the family. It may result in the disintegration of the family structure
115. Why is it important for you to ask about family health beliefs? - Correct Answer Health beliefs influence individual and family health behaviors. By knowing the family's beliefs, the nurse can structure a collaborative plan that will be complementary to the family's health beliefs. In addition, the nurse can correct any misinformation that the family may have regarding health.
116. What factors may impede a family's ability to cope with an individual's illness? - Correct Answer Stress Lack of understanding Poor communication Distrust in healthcare providers/hospitals Inadequate sleep Previous experience with a poor illness outcome Emotional bond with the ill individual
117. What is the significance of a genogram? - Correct Answer A genogram allows you to construct a tool that provides pertinent information about a client's health risks, using his/her family's health history data. The family tree will contain the health status, cause of death, and other health concerns of relatives genetically linked to the client, starting with the parents, grandparents, siblings, and so forth.
118. List four specific areas of family assessment. - Correct Answer Developmental stage Wholeness Communication Support
119. The difference between structural-functional and systems theory is that structural-functional focuses on which of the following? - Correct Answer Outcomes instead of process
120. The nurse is developing a care plan for a patient admitted to the intensive care unit with upper gastrointestinal bleeding. Which intervention by the nurse

may help the family cope with the emergent hospitalization? - Correct Answer Keeping the family informed of the patient's progress

121. Which statement about families is true? - Correct Answer Wellness of each family member is critical to the health of the family unit.
122. Life transitions that young adults experience as they mature are most typically perceived as: - Correct Answer Occurring in a predictable order
123. Among noninstitutionalized persons with a disability, what type of disability is least common in the United States? - Correct Answer Visual impairment
124. For which behavior should the nurse observe when assessing the family's ineffective pattern for coping with stress of illness and hospitalization of a family member? - Correct Answer Avoiding coming to the hospital to visit a family member
125. (indicates those who are not coping well)
126. A 12-year-old patient's mother recently married a man who has a 13-year- old daughter. The nurse recognizes that the patient belongs to which type of family? - Correct Answer Blended
127. A 13-year-old girl is admitted to the adolescent unit with acute leukemia. The patient has a support system that includes her brother, sister, mother, father, and grandmother as well as members of her local community. Which component of her support system is considered a suprasystem? - Correct Answer Her community
128. The nurse is developing a teaching plan for an older adult patient with Alzheimer's disease and her family. Which point should the nurse include in the teaching plan before discharge? - Correct Answer Availability of community resources
129. Which factor is related to the increased risk of acquiring polio in the United States after the disease was thought to be eradicated? - Correct Answer Reduced compliance with vaccinations
130. Which question helps the nurse to assess family structure? - Correct Answer How are family decisions made?
131. The nurse is caring for a patient newly diagnosed with colon cancer. When the physician leaves the room, two of the three siblings begin to argue and the third sibling abruptly but quietly leaves the hospital. What is the nurse's best action? - Correct Answer Ask the patient and family to discuss their understanding of the diagnosis and treatment plan.

132. What are primary risk factors that newly married childless families encounter? Select all that apply. - Correct Answer 3) Adapting to the continuous presence of another person
133. 4. Use of maladaptive coping mechanisms
134. Culture includes: - Correct Answer Shared values, beliefs, norms, and practices that guide a particular group's thinking, decision making, and actions in a patterned way.
135. Culture universals (commonalities): - Correct Answer Are the values, beliefs, and practices that people from all cultures share.
136. Culture specifics (diversities): - Correct Answer Are those values, beliefs, and practices that are unique to a culture.
137. Cultural archetype - Correct Answer Similar to a model, is an example of something that is recurrent and has its basis in facts.
138. Cultural stereotype - Correct Answer A widely held but oversimplified and unsubstantiated belief that all people of a certain racial or ethnic group are alike in certain respects.
139. Six organizing phenomena of culture that influence health include: - Correct Answer Communication patterns, space, social organization, time, environmental control, and biological variations.
140. An understanding of _____________, _____________, and __________ can help you develop cultural competence. - Correct Answer cultural concepts, theories, and models
141. List the barriers to culturally competent care. - Correct Answer Ethnocentrism, stereotyping, prejudice, and racism
142. Culturally competent care requires: - Correct Answer A nonjudgmental attitude, self-awareness, sensitivity, respect for differences, theoretical knowledge, and the desire to be culturally competent.
143. When assessing a client and making nursing diagnoses, you must consider: - Correct Answer The client's cultural values, beliefs, and practices related to health and healthcare.
144. What do recent demographic trends in North America indicate? - Correct Answer Demographic trends in North America (particularly in the United States and Canada) indicate that recent immigration patterns have led to a multicultural society.

145. List types of alternative healthcare that are delivered by formally trained practitioners as a part of the professional healthcare system. - Correct Answer Types of alternative healthcare include diet therapy, mind-body control methods, therapeutic touch, acupressure, reflexology, naturopathy, kinesiology, and chiropractic therapy.
146. As a nurse, in which of the following cultural health practices would you support your client: efficacious, neutral, dysfunctional, uncertain? Why? - Correct Answer A nurse should allow and even promote efficacious health practices because they are beneficial. Dysfunctional practices are harmful and should be discouraged. Neutral or uncertain practices can be allowed to continue if they are important to the client until a time they are considered to be harmful.
147. How do the cultural norms of the North American healthcare system differ from those of other cultural groups? - Correct Answer Although there may be some similarities, the major difference between the norms of the healthcare system and those of other cultural groups is that the professional healthcare system is run by a set of professionals who have been formally educated and trained for their roles and responsibilities.
148. Define cultural competence. - Correct Answer Cultural competence is what we are attempting to achieve in providing care to clients that is appropriate, congruent, and nonbiased. Cultural competence can be defined as a set of congruent behaviors, attitudes, and practices that enables us to provide such care appropriate to a group's cultural values and beliefs. It includes developing an awareness of our own beliefs and those of others, accepting and respecting cultural differences, engaging in cultural encounters, and adapting care so that it is congruent to those of other cultures. This attribute is conscious and nonlinear. Although cultural competence is a developmental process, healthcare providers must continue to work toward its achievement.
149. How do the barriers of ethnocentrism and language impede nursing care of diverse populations? - Correct Answer Such barriers can impede the nurse's ability to provide culturally competent care by failing to incorporate and view as important the client and family values, beliefs and practices. Language barriers prevent an adequate and comprehensive assessment upon which to plan, implement, and evaluate care.
150. Describe, in general, how the nursing process can help you provide culturally competent care. - Correct Answer With every client, the nursing process is essential to the performance of a cultural assessment, the formulation of appropriate nursing diagnoses, the identification of expected client outcomes, the planning of nursing interventions, and the evaluation of the plan of care.

151. How can nursing diagnoses cause bias in the planning of care for clients from different cultures? - Correct Answer The use of some nursing diagnoses and diagnostic labels can be biased because the implied assumption may be that the client is at fault (e.g., language barrier, knowledge deficit) rather than acknowledging that the healthcare provider has an inability to meet the needs of the client and/or family. The nurse may perceive a problem when the patient does not, and vice versa.
152. What does the acronym "BALI" stand for? - Correct Answer Be aware of your cultural heritage. Appreciate that the client is unique: influenced, but not defined by his culture. Learn about the client's cultural group. Incorporate the client's cultural values/behaviors into the plan of care.
153. List the six cultural specifics affecting health. - Correct Answer Communication Space Social organization Time orientation Environmental control Biological variations
154. The process a person goes through to adapt to a new culture is referred to as which of the following? - Correct Answer Acculturation
155. Stereotyping in nursing may result in which of the following? - Correct Answer Inaccurate assessments and inappropriate interventions
156. A patient is prescribed a low-sodium, low-fat diet. How can the nurse best ensure that the patient follows the prescribed diet during hospitalization? - Correct Answer Arrange for meals that accommodate his cultural dietary practices and specified diet.
157. The nurse preparing a Latino patient for a diagnostic procedure states, "After the cardiac catherization, you will need to be supine. We will also assess you for a thrombus." Which statement below is true? - Correct Answer The nurse is using healthcare jargon in her explanation to the patient. She should better explain the procedures.
158. Which intervention by the nurse best indicates that she values a Native American patient's beliefs and indigenous healthcare system? - Correct Answer Planning how to incorporate traditional practices and beliefs through discussion with the patient
159. A long-term care facility has started a program to increase the cultural competence of its employees. When notified of this, a nurse thinks to himself, "I

don't have time for this nonsense. I already know all I need to about culture, and I don't really like taking care of so many different kinds of people anyway." This most clearly illustrates the nurse's lack of cultural: - Correct Answer Desire Cultural desire is the wish to be culturally competent.

160. While admitting a patient with a particular religious heritage, the nurse comments to another nurse, "This is going to be a pain. This kind of patient always has a million family members in and out, and they're always so noisy and demanding." This illustrates: - Correct Answer Prejudice
161. When taking a cultural history, all of the following are important. Which one is most important to later plan for patient safety? - Correct Answer Ask about use of alternative medicine and folk remedies.
162. North American healthcare culture typically reflects which culture? - Correct Answer European American
163. The nurse is caring for a 42-year-old, Chinese American patient who underwent emergency coronary artery bypass graft surgery. He is self-employed and has no health insurance. Each day members of his family spend hours at his bedside. Which is the most important factor for the nurse to focus on when planning the patient's discharge? - Correct Answer Family Support
164. A patient who came from Central America is admitted with diabetes mellitus. The nurse is collecting biographical information. Which information provided by the patient represents his ethnicity? - Correct Answer Latino
165. A patient who moved to the United States from Italy comes to the clinic for medical care. The patient has been in this country for several years and has adopted some elements of her new country. Yet, she still retains some customs from her homeland. This patient is experiencing: - Correct Answer Acculturation
166. A patient reports experiencing gas, abdominal bloating, and diarrhea after consuming milk or cheese. Lactose intolerance might immediately be suspected if the patient is of which heritage? - Correct Answer African American
167. A patient of Scandinavian heritage is admitted for observation after sustaining injuries in a motor vehicle accident. The nurse expects that he may endure pain stoically, without grimacing or vocalizing. The nurse's thinking is an example of a/an: - Correct Answer Prejudice
168. A Hispanic patient is frustrated because the healthcare team does not understand the importance of hot and cold therapies. Which nursing diagnosis is most appropriate for this patient? - Correct Answer Powerlessness

169. Development - Correct Answer Refers to the process of adapting to one's body and environment over time, which is enabled by increasing complexity of function and skill progression.
170. What are some examples of development? - Correct Answer •A child who comes to know right from wrong •An adolescent who decides on a vocation •An older adult who recognizes the nearness of death.
171. Growth - Correct Answer Refers to physical changes that occur over time
172. What are some examples of growth? - Correct Answer •Increases in height •Sexual maturation •Gains in weight and muscle tone
173. Growth - Correct Answer ________ is the physical aspect of development. The rest is behavioral.
174. Change - Correct Answer ______ is constant throughout the lifespan.
175. Nature - Correct Answer Refers to genetic endowment.
176. Nurture - Correct Answer The influence of the environment on the individual.
177. Cephalocaudal Pattern of Growth - Correct Answer Begins at the head and progresses down to the chest, trunk, and lower extremities.
178. Proximodistal Pattern of Growth - Correct Answer Begins at the center of the body and moves outward.
179. Simple skills - Correct Answer Develop separately and independently, and are later integrated into more complex skills
180. Each body system: - Correct Answer Grows at its own rate. Think of puberty
181. Body system functions become: - Correct Answer Increasingly differentiated over time
182. Theories of Development - Correct Answer Describe and explain patterns of development common to all people. These theories provide a basis for nursing interventions and clinical decision making.

183. Understanding the tasks associated with a person's developmental stage:

- **Correct Answer** • Provides a basis for assessing whether behaviors are as expected or if they need further assessment - Suggests specific ways in which to support and encourage the person's progress through the developmental stage 

184. Stage - Correct Answer Represents a period of time that shares common characteristics
185. Robert Havighurst - Correct Answer Theorized that learning is a lifelong process. Believed that a person moves through 6 life stages, each associated with a # of tasks that must be learned.
186. Havighurst characterizes developmental task as: - Correct Answer Midway between individual need and societal demand. It assumes an active learner interacting with an active social environment.
187. Developmental Task Theory states that failing to master a task leads to: - Correct Answer • Imbalance within the individual
     • Unhappiness
     • Difficulty mastering future tasks and interacting with others
188. (DTT) Infants and toddlers: - Correct Answer • Walking

- Talking - Taking solid food - Controlling bowel and bladder elimination - Learning sex differences and sexual modesty - Acquiring physiological stability - Forming concepts; learning language - Getting ready to read 

189. (DTT) Preschool and School Age - Correct Answer • Learning physical tasks necessary to play games
     • Building wholesome attitudes towards oneself as a growing organism
     • Learning to get along with age-mates
     • Learning masculine or feminine social role
     • Acquiring fundamental skills in reading, writing, and calculating
     • Developing concepts necessary for everyday living
     • Developing a conscience, morality, and a scale of values
     • Achieving personal independence
     • Acquiring attitudes towards social groups and institutions
190. Adolescents - Correct Answer • Accepting one's physique and using body effectively
     • Achieving new and more mature relations with age-mates of both sexes
     • Developing emotional independence from parents and other adults

• Preparing for future marriage and family life
• Preparing for a career
• Acquiring a set of values and an ethical system to guide behavior; developing an ideology
• Aspiring to achieve socially responsible behavior

191. (DTT) Young Adults - Correct Answer • Choosing a mate

• Achieving masculine or feminine social role
• Learning to live with partner
• Rearing children
• Managing a home
• Establishing an occupation
• Taking on community responsibilities
• Finding a compatible social group

192. Middle Adults - Correct Answer • Adjusting to physiological changes of middle age

• Assisting teenage children to become responsible, happy adults
• Achieving adult civic and social responsibility
• Reaching and maintaining satisfactory performance in one's occupational career
• Developing adult leisure-time activities
• Relating oneself to one's spouse as a person

193. Sigmund Freud - Correct Answer A pioneer of science and human development. Psychoanalytic theory
194. Psychoanalytic Theory - Correct Answer Freud's theory which focuses on the motivation for human behavior and personality development. He believed human development is maintained by instinctual drives such as libido, aggression, and survival.
195. In Psychoanalytic Theory, different drives predominate depending on: - Correct Answer The age of the indiviual
196. Many social scientists question whether Freud's theory should be used today because: - Correct Answer It was developed during the Victorian era, when societal norms were very strict. Sexual repression and male dominance over female behavior was the cultural standard. This does not apply today.
197. In Psychoanalytic Theory, the personality consist of: - Correct Answer • id

• ego
• superego
• unconscious mind

198. Id - Correct Answer Represents instinctual urges, pleasure, and gratification (hunger, procreation, pleasure, and aggression)
199. Ego - Correct Answer Begins to develop around 4-6 months of age. Thought to represent reality. It strives to balance what is wanted (id) and what is possible to attain and achieve.
200. Superego - Correct Answer Sometimes referred to as conscience. Develops in early childhood (age 5 or 6) as a result of the internalization of primary caregiver responses to environmental events.
201. Unconscious Mind - Correct Answer Composed of thoughts and memories that are not readily recalled but unconsciously influence our behavior.
202. Anna Freud - Correct Answer Freud's daughter. Identified a number of defense mechanisms in the 1950s.
203. Defense Mechanisms - Correct Answer Thought patterns or behaviors that the ego makes use of in the face of a threat to biological or psychological integrity.
204. Defense mechanisms protect us from: - Correct Answer Excess anxiety
205. Freud's Stages of Sexual Development: - Correct Answer • Oral

- Anal - Phallic - Latency - Genital 

206. Oral Stage of Sexual Decelopment - Correct Answer Birth- 18 months Primary needs are centered on the oral zone. Need for hunger and pleasure are satisfied orally. Trust is developed through meeting of needs. When needs are not met, aggression can manifest.
207. Anal Stage of Sexual Development - Correct Answer 18 mo- 3 yrs Neuromuscular control over anal sphincter allows the child to have control over expulsion and retention of feces. This coincides with the child's struggle for separation and independence from caregivers. Successful completion of this stage yields a child who is self-directed, cooperative, and without shame. Conversely, the anal child will exhibit willfulness, stubbornness, and need for orderliness.
208. Phallic Stage of Sexual Development - Correct Answer 3-6 yrs The focus is on genital organs. This coincides with development of gender identity. Unconscious sexual feelings towards parent of opposite sex are common.

Children emerge from this stage with a sense of sexual curiosity and a mastery for their instinctual impulses.

209. Latency Stage of Sexual Development - Correct Answer 6-12 yrs Ego functioning matures and sexual urges diminish.
210. The child focuses energy on same-sex relationships and mastery of his world, including relationships with significant others (teachers, coaches) Genital Stage of Sexual Development - Correct Answer 13-20 yrs Puberty causes an intensification of instinctual drives, particularly sexual. The focus in this stage is the resolution of previous conflicts and the development of a mature identity and the ability to form adult relationships.
211. Jean Piaget - Correct Answer Swiss psychologist. Studied his own children to understand how humans gain cognitive abilities.
212. According to Piaget, cognitive development requires three core competencies: - Correct Answer • Adaptation

• Assimilation
• Accomodation

213. Adaptation - Correct Answer Ability to adjust to and interact with one's environment.
214. Assimilate, Accommodate - Correct Answer To be able to adapt, one must be able to __________ and __________.
215. Assimilation - Correct Answer Integration of new experiences with one's own system of knowledge.
216. Accommodation - Correct Answer The change in one's own system of knowledge that results from processing new information
217. According to Piaget, development occurs from: - Correct Answer Birth through adolescence in 4 stages.
218. Piaget's 4 Stages of Growth and Development - Correct Answer • Sensorimotor

• Preoperational thought
• Concrete operations
• Formal operations

219. According to Piaget, the rate at which a child moves through the stages is determined by: - Correct Answer Inherited intellect and the influence of the environment

220. Sensorimotor Stage - Correct Answer • Birth- 2 yrs

- Learns the world through the senses - Displays curiosity - Shows intentional behavior - Begins to see that objects exist apart from self - Begins to see objects as separate from self. 

221. Preoperational Stage - Correct Answer • 2-7 yrs

- Uses symbols and language - Sees self as the center of the universe: egocentric - Thought based on perception rather than logic 

222. Concrete Operations Stage - Correct Answer • 7-11 yrs

- Operates and reacts to concrete: What is perceived in actual. - Egocentricity diminishes, can see others' viewpoints. - Able to use logic and reason in thinking - Able to converse: to see objects that may change but recognizes them as the same. (Water to ice, tower of blocks is the same as long fence of blocks) 

223. Formal Operations Stage - Correct Answer • 11- adolescence

- Develops ability to think abstractly: to reason, deduce, and define concepts in a logical manner - Some individuals do not develop the ability to think abstractly 

224. Psychosocial Development Theory - Correct Answer • Erik Erikson introduced in the 1950s
     • Strongly influenced by Freud, but believed personality continues to evolve throughout lifespan as the person interacts with social world.
     • Individuals must negotiate 8 stages as they progress through the lifespan.
     • People can regress in times of stress to earlier stages or be forced to face tasks of later stages because of unforeseen life events
     • Failure to move through stages leads to maladjustment.
     • This is the theory most used in nursing.
225. Stage 1: Trust vs Mistrust - Correct Answer • Birth-18 months

- Child develops sense of trust in himself and the external wold as a result of having needs consistently met. - Beginning of self-confidence - Infant who doesn't have needs met develops a sense of mistrust and suspicion of others that will affect future interpersonal relationships. 

226. Stage 2: Autonomy vs Shame and Doubt - Correct Answer • 18 months- 3 years
     • Goal is for child to develop self-control and independence while maintaining self-esteem

• Requires ability to cooperate and express feelings
• Failure will lead to an adult who lacks self-confidence and feels controlled by others and who may exhibit extreme compliance (self-restraint) or defiance.

227. Stage 3: Initiative vs Guilt - Correct Answer • 3-5 yrs

• Focus is to develop initiative by gradually assuming responsibility and developing self-discipline
• Superego and conscience develops
• Child learns to manage impulses
• Failure leads to guilt, limited creativity, lack of self-confidence, and pessimism

228. Stage 4: Industry vs Inferiority - Correct Answer • 6-11 years

• Child learns that recognition comes through achievement and completion of tasks
• This success occurs primarily in school
• Failure will lead to feelings of inadequacy in all areas of life

229. Stage 5: Identity vs Role Confusion - Correct Answer • 11-21 yrs

• Coincides with puberty
• Adolescents develop sense of self and begin to make decisions about future
• Social groups serve as a place to test out ideas and behaviors
• Healthy role models facilitate development of identity
• Person who fails to recognize his abilities and sense of self is unable to experience a solid place in the world.
• Failure is manifested by dysfunctional interpersonal relationships and occupational performance.
• Delinquent and rebellious behavior may be prominent when the task of identity formation is not met.

230. Stage 6: Intimacy vs Isolation - Correct Answer • 21- 40 years

• Task at this stage is to develop a commitment to work and relationships
• Failure will result in impersonal relationships and difficulty with maintaining a job

231. Intimacy - Correct Answer Erikson defines as the ability to commit to concrete affiliations and partnerships and to develop the ethical strength to abide by such commitments
232. Isolation - Correct Answer The avoidance of intimacy
233. Stage 7: Generativity vs Stagnation - Correct Answer • 40-65 yrs

• Goal of this stage is to be creative and productive

• Often accomplished through work or relationships (raising healthy, functional children, developing a distinguished career)
• Failure may manifest in the form of stagnation in the form of superficial relationships and self-absorption

234. Generativity - Correct Answer The desire and motivation to guide the next generation
235. Stage 8: Ego Integrity vs Despair - Correct Answer • Over 65 yrs

• The task of this stage is the acceptance of one's life, worth, and eventual death
• Ego integrity reflects satisfaction with life and understanding of one's place in the life cycle
• In despair, a sense of loss, discomfort with life and aging, and fear of death are seen

236. Moral Development Theory - Correct Answer • Lawrence Kohlberg

• Developed theory by studying a group of 84 boys for 20 years
• 3 levels, each has 2 stages

237. Kohlberg hypothesized: - Correct Answer A person's level of moral development can be identified by analyzing the rationale he gives for action in a moral dilemma.
238. Kohlberg Level I: Preconventional - Correct Answer Person conforms to cultural norms and labels of good and bad but interprets them in terms of punishment and reward or in terms of physical power of those who enforce the rules. Children ages 4 to 10 are usually at this level some adults are, as well.
239. Kohlberg, Level I, Stage 1 - Correct Answer • Punishment-obedience orientation

• The right action is that which avoids punishment

240. Kohlberg, Level I, Stage 2 - Correct Answer • Personal interest orientation

• Right action is that which satisfies personal need

241. Kohlberg Level II. Conventional - Correct Answer • The person perceives that meeting the expectations of the family, group, or society is valuable and it's own right, regardless of the consequences of the actions.

• More than just conforming, the person is loyal to the social order and identifies with those involved in it.
• Others set standards, but motivation to follow them is internal