Chapter 17 Test Your Knowledge

1. Which one of the following is an example of the emotional component of wellness?

Your Answer:

A client expresses frustration with her partner’s substance abuse.

  Rationale: Frustration is an example of an emotion. The client who chooses healthy foods (option 1) represents the physical component, taking parenting classes enhances the intellectual component (option 2), and the bowling league (option 4) enhances both the physical and social components.

Cognitive Level: Understanding.Client Need: Health Promotion and Maintenance.Nursing Process: Assessment.

2. Which individual appears to have “taken on” the sick role?

Correct Answer:

A mother is ill and says, “I won’t be able to make your lunch today.”

  Rationale: The mother has taken on the sick role by expecting to be excused from her usual role responsibilities. The sick role states that persons are not answerable for their illness, contrary to the obese client’s perspective (option 1). In the sick role, the client tries to get better as opposed to the man who misses his physical therapy appointments (option 3). The older adult is not following the sick role expectation to rely on competent help (option 4). 

Cognitive Level: Applying.Client Need: Health Promotion/Maintenance and Physiological Adaptation.Nursing Process: Assessment.

3. Because a client recently diagnosed with diabetes mellitus is confident that blood sugar control can be improved with diet and exercise alone, and recently checked out a video on the management of diabetes at the HMO education center, the client’s actions are most representative of which model?

correct Answer:

Health belief model

  Rationale: The behavior is most representative of health promotion, which is the central focus of the health belief model. The clinical model focuses on relieving signs and symptoms of illness (option 2). The role performance model emphasizes social activities such as fulfilling a particular role (option 3). The agent–host– environment model focuses on predicting illness (option 4).

Cognitive Level: Analyzing.Client Need: Health Promotion and Maintenance.Nursing Process: Analysis.

4. Because a client with human immunodeficiency virus (HIV) is scheduled to begin several medications to manage the infection, the nurse will need to provide client education. Which client characteristics are most likely to predict adherence with the treatment program? Select all that apply.

Correct Answers:

A trusting relationship with the health care provider. 

An expectation that the medications will be helpful. 

Being able to take the medications twice daily instead of four times daily.

  Rationale: Significant evidence exists that a trusting relationship with the provider, effectiveness of the medication, and simple dosing regime are important predictors of adherence to a medical regimen. Neither education nor sex has been shown to be a predictive factor (options 1 and 5).

Cognitive Level: Applying.Client Need: Health Promotion and Maintenance.

Nursing Process: Planning. 

Rationale: Significant evidence exists that a trusting relationship with the provider, effectiveness of the medication, and simple dosing regime are important predictors of adherence to a medical regimen. Neither education nor sex has been shown to be a predictive factor (options 1 and 5).

Cognitive Level: Applying.Client Need: Health Promotion and Maintenance.Nursing Process: Planning.

5. Which one of the following might be the BEST way to measure adherence to a prescribed medication regime?

Correct Answer:

Direct observation of medication administration.

  Rationale: Although not always practical, direct observation is the best method to measure adherence (for example, watching heroin addicts actually take their methadone dose). Because lack of adherence may be life threatening or damaging to the client as well as others, waiting until the client displays illness and waiting until laboratory values reflect a lack of adherence are not the best methods (options 2 and 3). Client report or recall is not always accurate, even if the client believes he or she is telling the truth (option 4).

Cognitive Level: Analyzing.Client Need: Health Promotion and Maintenance.Nursing Process: Evaluation.

6. Which of the following is least likely to influence a client’s personal definition of health/wellness?

Your Answer:

The medical diagnostic terminology used to describe the client’s signs and symptoms.

  Rationale: The actual term used to describe the diagnosis is less important because the client may have no frame of reference for it. That is not to say that the diagnosis is unimportant because clients may be familiar with common diagnoses such as heart disease or cancer and ascribe historical meaning to them. Ability to perform usual activities, culture, and availability of health care will all be strong influences on the client’s definition of health or wellness (options 1, 2, and 3).

Cognitive Level: Analyzing.Client Need: Health Promotion and Maintenance.Nursing Process: Assessment.

7. Which of the following is an internal variable affecting health status, beliefs, or practices?

Correct Answer:

Genetics

  Rationale: Genetics is an internal variable affecting health. Options 1, 2, and 3 are all external variables.

Cognitive Level: Remembering.

Client Need: Health Promotion and Maintenance.Nursing Process: Assessment.

8. A client recently diagnosed with a chronic illness asks for help in understanding the term chronic. It would be correct for the nurse to say which of the following?

Correct Answer:

Chronic illnesses are considered incurable.

  Rationale: By definition, a chronic illness has no known cure, the person will always have it to some degree. Although acute illnesses may have severe symptoms, many chronic illnesses also have severe symptoms (option 1). Although signs and symptoms of chronic illnesses may never go completely away, they can get better and worse at different times (option 3). Chronic illnesses can be treated, just not cured (option 4).

Cognitive Level: Understanding.Client Need: Health Promotion and Maintenance.Nursing Process: Planning.

9. Although not every client progresses in order through each stage, what is the usual sequence in Suchman’s stages of illness?

Option Correct Answer

9.1 The client makes contact with medical care.  E. Step 3  

9.2 The client goes into rehabilitation/recovery.  C. Step 5  

9.3 Signs and symptoms appear.  A. Step 1  

9.4 The client takes on the dependent role.  D. Step 4  

9.5 The client takes on the sick role.  B. Step 2  

10.

A married mother of three small children has frequent immobilizing headaches of unknown cause. The nurse anticipates that the woman may have which of the following possible reactions? Select all that apply.

Correct Answers:

She feels guilty when unable to perform her usual

activities. 

She is angry and acting out. 

She shifts some responsibilities to the spouse. 

She has fewer social interactions with her friends.

  Rationale: In the sick role, she would likely feel guilty and some anger but give up usual roles and accept help from others, and decrease social interactions. The only reaction that would be unlikely is that the woman would take on a job to pay expenses. This would be inconsistent with the sick role.

Cognitive Level: Applying.Client Need: Health Promotion and Maintenance.Nursing Process: Planning. 

Rationale: In the sick role, she would likely feel guilty and some anger but give up usual roles and accept help from others, and decrease social interactions. The only reaction that would be unlikely is that the woman would take on a job to pay expenses. This would be inconsistent with the sick role.

Cognitive Level: Applying.Client Need: Health Promotion and Maintenance.Nursing Process: Planning.