Health Promotion Throughout the Life Span 9th Edition Test Bank

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Health Promotion Throughout the Life SpanTestbank/StudyGuideChapter 01: Health DefinedEdelman: Health Promotion Throughout the Life SpanMULTIPLE CHOICE1. Which model of health is most likely used by a person who does not believe inpreventivehealth care?a. Clinical modelb. Role performance modelc. Adaptive modeld. Eudaimonistic modelANS: AThe clinical model of health views the absence of signs and symptoms of disease as indicative ofhealth. People who use this model wait until they are very sick to seek care.2. A person with chronic back pain is cared for by her primary care provider as well as receivesacupuncture. Which model of health does this person likely favor?a. Clinical modelb. Role performance modelc. Adaptive modeld. Eudaimonistic modelANS: DThe eudaimonistic model embodies the interaction and interrelationships among physical, social,psychological, and spiritual aspects of life and the environment in goal attainment and creatingmeaning in life. Practitioners who practice the clinical model may not be enough for someonewho believes in the eudaimonistic model. Those who believe in the eudaimonistic model oftenlook for alternative providers of care.3. A state of physical, mental, spiritual, and social functioning that realizes a persons potentialand is experienced within a developmental context is known as:a. growth and development.b. health.c. functioning.d. high-level wellness.ANS: BHealth is defined as a state of physical, mental, spiritual, and social functioning that realizes apersons potential and is experienced within a developmental context.4. Which of the following best describes a client who has an illness?a. Someone who has well-controlled diabetesb. Someone with hypercholesterolemiac. Someone with a headached. Someone with coronary artery disease without anginaANS: C

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Someone with a headache represents a person with an illness. An illness is made up of thesubjective experience of the individual and the physical manifestation of disease. It can bedescribed as a response characterized by a mismatch between a persons needs and the resourcesavailable to meet those needs. A person can have a disease without feeling ill. The other choicesrepresent disease.5. Which US report is considereda landmark document in creating a global approach to health?a. The 1990 Health Objectives for the Nation: A Midcourse Reviewb. Healthy People 2020c. Healthy People 2000d. The U.S. Surgeon General ReportANS: CHealthy People 2000 and its Midcourse Review and 1995 Revisions were landmark documentsin which a consortium of people representing national organizations worked with US PublicHealth Service officials to create a more global approach to health.6. Which of the following represents a method of primary prevention?a. Informational session about healthy lifestylesb. Blood pressure screeningc. Interventional cardiac catheterizationd. Diagnostic cardiac catheterizationANS: APrimary prevention precedes disease or dysfunction. It includes health promotion and specificprotection and encourages increased awareness; thus, education about healthy lifestyles fits thisdefinition. Blood pressure screening does not prevent disease, but instead identifies it.7. Which of the following represents a methodof secondary prevention?a. Selfbreast examination educationb. Yearly mammogramsc. Chemotherapy for advanced breast cancerd. Complete mastectomy for breast cancerANS: BScreening is secondary prevention because the principal goal of screenings is to identifyindividuals in an early, detectable stage of the disease process. A mammogram is a screeningtool for breast cancer and thus is considered a method of secondary prevention.8. Which of the following represents a method of tertiary prevention?a. Drunk driving campaignb. Road blocks for drunk drivingc. Emergency surgery for head trauma after a motor vehicle accidentd. Physical and occupational therapy after a motor vehicle accident with head traumaANS: DPhysical therapy and occupational therapy are considered tertiary prevention. Tertiary preventionoccurs when a defect or disability is permanent and irreversible. It involves minimizing the effectof disease and disability. The objective of tertiary prevention is to maximize remainingcapacities.

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9. In reviewing a persons medical claims, a nurse realizes that the individual with moderatepersistent asthma has had several emergency department visits and is not on inhaled steroids asrecommended by the NHLBI asthma management guidelines. The nurse discusses this with thepersons primary care provider. In this scenario, the nurse is acting as a(n):a. advocate.b. care manager.c. consultant.d. educator.ANS: BCare managers act to prevent duplication of service and reduce cost. Care managers baserecommendation on reliable data sources such as evidence-based practices and protocols.10. During a home visit, a nurse assists an individual to complete an application for disabilityservices. The nurse is acting as a(n):a. advocate.b. care manager.c. consultant.d. educator.ANS: AThe advocacy role of the nurse helps individuals obtain what they are entitled to receive from thehealth care system, tries to make the system more responsive to individuals community needs,and assists individuals in developing skills to advocate for themselves.11. During a home visit, a nurse discusses the dangers of smoking with an individual. In thisscenario the nurse is acting as a(n):a. advocate.b. care manager.c. consultant.d. educator.ANS: DHealth education isa primary prevention technique available to avoid major causes of disease.Teaching can range from a chance remark to a planned lesson.12. A nurse is asked to provide an expert opinion about the development of an educationprogram for newly diagnosed diabetics. In this scenario, the nurse is acting as a(n):a. advocate.b. care manager.c. consultant.d. educator.ANS: CNurses with a specialized area of expertise provide education about health promotion and diseaseprevention to individuals and groups asconsultants.13. A nurse is planning to deliver an educational program to individuals with diabetes. Which ofthe following should be the initial action taken by the nurse to ensure the success of theprogram?

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a. Assess the motivation level of the individualsb. Assess the knowledge level of the individualsc. Establish teacher-learner goals with the individualsd. Establish multiple teaching sessions with the individualsANS: BSelection of the methods most likely to succeed involves the establishment ofteacher-learnergoals. Thus, the first step by the nurse should be establishment of goals.14. The conscientious, explicit, and judicious use of current best evidence in making decisionsabout the care of individuals is known as:a. health-related qualityof life.b. evidence-based practice.c. a Healthy People 2010 goal.d. the ecological model of health.ANS: BEvidence-based practice is defined as the conscientious, explicit, and judicious use of currentbest evidence in making decisions about the care of individuals.15. Which research methodology should be used to address the question, What is the differencein the infection rates between individuals who receive twice-a-day dressing changes versus once-a-day dressing changes?a. Evidence-based practiceresearchb. Qualitative researchc. Quantitative researchd. Clinical judgment researchANS: CQuantitative research studies describe situations, correlate different variables related to care, ortest causal relationships among variables related to care. Evidence-based practice research andclinical judgment research are not research methodologies; they are used to answer clinicalquestions.16. The question, What is the experience of teenagers who lose a sibling to cancer? can best beanswered by using which research methodology?a. Evidence-based practice researchb. Qualitative researchc. Quantitative researchd. Clinical judgment researchANS: BQualitative research studies describe phenomena or define the historical nature, culturalrelevance, or philosophical basis of aspects of nursing care. Evidence-based practice researchand clinical judgment research are not research methodologies; they are used to answer clinicalquestions.17. A nurse who uses findings from a randomized, controlled trial on thecare of Foley cathetersto change practice at an institution is practicing:a. evidence-based medicine.b. qualitative research.c. quantitative research.

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d. clinical judgment.ANS: AThe practice of evidence-based medicine means integrating individual clinical expertise with thebest available external clinical evidence from systematic research.18. Which of the following is most influenced by the social and economic environment of acommunity?a. Social health policiesb. Quality of carec. Evidence-basedpracticed. Practice guidelinesANS: ASocial policies concerning health are influenced by the social and economic environment of apopulation. Analysis of population trends and projections is necessary to help healthprofessionals determine changing needs.MULTIPLE RESPONSE1. Which of the following investment themes has been identified by the National Institute ofNursing Research? (select all that apply)a. Interprofessional collaborationb. Improving quality of lifec. End-of-life cared.Increasing physical activity among AmericansANS: B, CThe National Institute of Nursing Research has identified five themes that promote health andprevent disease, improve quality of life through symptom management, and support palliativeand end-of-lifecare, innovation, and nurse scientists.2. Which interventions address both the National Institute of Nursing Research themes and theoverall goals of the Healthy People 2020 leading health indicators? (select all that apply)a. Establishing a new park with a well-lit trackb. Establishing a smoking cessation campaignc. Providing reduced-cost transportation passes to senior citizensd. Providing free condoms at all federally funded health clinicsANS: A, B, DEstablishing a new park with a well-lit track,establishing a smoking cessation campaign, andproviding free condoms at all federally funded health clinics all address the National Institute ofNursing Research themes and the Healthy People 2020 leading health indicators. A park,smoking cessation campaign, and free condoms address the themes of promoting health andpreventing disease and the goal of increasing quality and years of healthy life. Providingreduced-cost transportation passes to senior citizens may indirectly affect the health of thispopulation; however, it is not directly related to the themes of the National Institute of Research(promote health and prevent disease, improve quality of life through symptom management, andsupport palliative and end-of-life care, innovation, and nurse scientists) or the overall goals ofHealthy People 2020 (increase quality and years of healthy life and eliminate health disparities).

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Chapter 02: Emerging Populations and HealthEdelman: Health Promotion Throughout the Life SpanMULTIPLE CHOICE1. Whichof the following statements about ethnic minorities in the United States is accurate?a. It is estimated that the percentage of ethnic minorities will decrease during the next 30 years.b. It is estimated that ethnic minorities will increase to one in twoby 2050.c. The increasing population of refugees has been a significant contributor to the increase inethnic minorities.d. The increasing population of ethnic minorities has helped decrease the health disparities facedby this population.ANS: BIt is estimated that the number of ethnic minorities will increase to one in two by 2050. In 2010,it was estimated that 33% of the population was from an ethnic minority. The increasingpopulation of immigrants has been a significant contributor to the increasing populations ofmajor ethnic groups. The increasing populations of ethnic groups is one factor that is producingdisparities in health status and access of the health care system.2. A person states, My grandmother is the decision maker in our family. Which of the followingis being described by the person?a. Cultureb. Racec. Ethnicityd. ValuesANS: ACulture, as an element of ethnicity, refers to integrated patterns of human behavior that includethe language, thoughts, communications, actions, customs, beliefs, values, and institutions ofracial, ethnic, religious, or social groups. The term ethnicity encompasses more than a culturalpractice, which is what is being described by the person; it focuses on differences in meanings,values, and ways of living. Race is associated with power and indexes the history or ongoingimposition of ones groups authority above another. Values are beliefs about the worth ofsomething and serve as standards that influence behavior and thinking.3. The nurse recommendedto a 50-year-old woman that she schedule a routine mammogram.Which of the following would be the most important factor in this womans decision to schedulethis exam?a. Raceb. Ethnicityc. Cultural valuesd. Value orientationANS: CCultural values guide actions and decision-making that facilitates self-worth and self-esteem.

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They shape human behaviors and determine what individuals will do to maintain their healthstatus, how they will care for themselves, and others who become ill, and where and from whomthey will seek health care. Race is associated with power and indexes the history or ongoingimposition of ones groups authority above another. Ethnicity focuses on differences in meanings,values, and ways of living. Value orientations reflect the personality type of a particular society.4. Which of the following actions demonstrates a health care professional providing culturallycompetent care?a. Encouraging the person to take medications as prescribedb. Asking the person to describe his folk healing methodsc. Demonstrating the proper way to administer an insulin injectiond. Assisting the person with discussing his health problems with the familyANS: BIt is very important for health care providers to be aware of how people interpret their healthissues or illnesses to be capable to provide culturally competent care. A culturally competenthealth care professional should be able to consistently and thoroughly recognize and understandthe differences in his or her culture and that of the patient or client, to respect the persons valuesand beliefs, and adjust the approach of delivering care to meet each persons needs andexpectations. Asking the person to describe his folk healing methods is the only action thatdemonstrates the health care professional seeking input from the person into the care that isreceived.5. A person reports that she has been seeking care from an acupuncturist to help relieve thechronic pain that she has been experiencing. Which of the following statements would be themost appropriate response from the nurse?a. You should have told me that the current treatments were helping your pain.b. Tell me more about your treatments from the acupuncturist.c. Tell me why you decided to not to continue with your treatment plan.d. You should not be seeing an acupuncturist while receiving professional care.ANS: BThrough a culturally sensitive assessment process, nurses can determine what specific remediesindividuals are using and whether their continued use would interfere with theprescribedmethod. The nurse asking the person to describe the treatments from the acupuncturist allows thenurse to learn this information. The other responses demonstrate an ethnocentric perspective bythe nurse, viewing the treatments from the acupuncturist as inferior to professional care.6. When providing an educational session about the Arab American population, which of thefollowing information would be included?a. The largest group of Arab Americans was refugees in the 1960s.b. The largest groups of Arab Americans are from Palestine and Iraq.c. Members of the Arab American population are most likely to live in rural communities.d. Members of the Arab American population are more likely to have college degrees thanAmericans at large.ANS: DMembers of the Arab American population are more likely to have college degrees (+45%) thanAmericans at large (28%). About 94% of Arab Americans live in metropolitan areas. The largestgroups of Arab Americans are the Lebanese, Syrians, and Egyptians. ArabAmericans came to

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the United States in three immigration waves; the last occurred in the 1960s and consisted ofmany professionals, entrepreneurs, and skilled and semiskilled laborers.7. A health care professional is caring for an Arab American individual. Which of the followingcultural practices of this ethnic minority should be considered when planning care?a. This ethnic culture tends to be future oriented.b. Religion plays an important role in this culture.c. Traditional cultural practices are infrequently used during a health crisis.d. Members of this culture tend to have smaller families.ANS: BReligion plays an important part in Arab culture, and there are dietary rules and prescribed ritualsfor praying and washing. Arab Americans are presentoriented and view the future as uncertain.During a health crisis, many Arab Americans seek out their family, community, and traditionalvalues and cultural practices. Arab American families are, on average, larger than nonArabAmerican families.8. A health care professional is providing education to the parents of an Asian American childwho has recently been diagnosed with Type I diabetes. Which of the following actions should betaken by the health care professional?a. Provide instructions to the childs father.b. Encourage the parents to bring other siblings into the clinic for screening.c. Schedule multiple educational sessions for the child and family.d. Watch for nonverbal gestures by the adults to indicate understanding.ANS: AIn Asian Americanculture, the oldest male family member often is the decision maker andspokesperson. Maintaining harmony is an important value in Asian cultures, and it is stronglyemphasized to avoid conflict and direct confrontation. As a result of this, Asian Americansmaynot show their disagreement with the recommendations of health care professionals. Type Idiabetes is not a common health problem experienced by this minority, so it is probably notnecessary to encourage screening for siblings. Additional educationalsessions may be necessary;however, Asian Americans tend to be more highly educated than any other population in theUnited States.9. An Asian American family has recently immigrated to the United States. Which of thefollowing would provide an appropriate rationale when encouraging the family to send theirchild to school?a. The child will get a good education.b. According to law, all children must go to school.c. The child can get health care at school.d. Exposure to different cultures in school will enhance socialization.ANS: DExposure to different cultures in school facilitates the adoption of other cultural beliefs and aidsin the socialization of the child into a new environment.10. Which of the following was the fastest-growing minority groupin the United States between2000 and 2010?a. Asian Americanb. Arab American

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c. Hispanic Americand. Native AmericanANS: CA 43% increase in the Hispanic population between 2000 and 2010 makes Hispanics the fastest-growing minority group in the UnitedStates.11. The interrelationship of poverty and health care dollars spent by Blacks and other minoritiesis affected greatly by:a. lack of access to preventive health care servicesb. low numbers of minority health care providersc. use of emergency rooms for cared. increased infant mortality rates in African American populationsANS: AA decrease in resources for preventive care leads to the use of emergency rooms and other moreexpensive health care services that are often used as resources when severeillness occurs.12. A health care provider is working with an African American woman who has recentlysuffered a stroke and is homebound. She insists that she must get out of the house and attendSunday worship services. What is the most likely explanation for her insisting that sheparticipate in this cultural practice?a. The church is the only place where prayer can be performed.b. The church serves as a social support for its members.c. The church is the place where the family meets on a weekly basis.d. The church serves as a site for folk healing practices.ANS: BThe church is significant support system many African Americans. It serves many purposesbeyond worship and formation, including serving as a place to meet where members could passnews, take care of business, and find strength of purpose; providing direct social welfareservices; acting as a stabilizing force in the community; facilitating citizenship training andcommunity social action; serving as a transmitter of cultural history; and providing the means forcoping and surviving in a hostile world. African Americans often find comfort in the supporttheir religious leader can give them, but it does not have to happen within the church. AfricanAmericans believe in the healing power of prayer, but that can happen outside of the church aswell. Family is the strongest source of support for African Americans, and most meet more oftenthan weekly at church.13. Which of the following ethnic groups has a disproportionately high death rate fromunintentional injuries and suicide?a. American Indian/Alaska Native Americansb. Asian Americansc. Latino/Hispanic Americansd. Black/African AmericansANS: AAmerican Indian/Alaska Native Americans have disproportionately high death rates fromunintentional injuries and suicide. Difficult life situations and stresses of daily life contribute toan array of problems, including feelings of hopelessness, desperation, family dissolution, andsubstance abuse.

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14. A health care professional is offering an educational session about providing culturallycongruent care. Which of the following information would be included the presentation?a. Hispanic Americans value keeping balance and harmony with the earth.b. The oldest male is the decision maker in African American families.c. Native Americans are present oriented, taking one day at a time.d. The hot and cold concept of disease is part of the Asian American culture.ANS: CNative Americans are generally present oriented, emphasizing events that are occurring nowrather than events that will happen later. They take one day at a time and in times of illness theycope by hoping for improvements the next day. Native Americans value keeping balance andharmony with the earth. The oldest male is the decision makerand spokesperson in AsianAmerican families. The hot and cold concept of disease is part of the Hispanic culture.15. A family has recently become homeless. Which of the following factors most likelycontributed to this situation?a. Being from an ethnicminority backgroundb. Declining rates of povertyc. Having multiple chronic illnessesd. Being unable to find affordable housingANS: DThe inability to find affordable housing, decline in public assistance, poverty, and eroding workopportunities all contribute to homelessness. The increasing prevalence of poverty has caused anincrease in the homeless population. Other factors that may affect this situation are lack ofaffordable health care, domestic violence, mental illness, and addiction disorders.16. A health care professional is caring for an individual who is homeless. Which of thefollowing considerations should be made?a. The prevalence of substance abuse is much lower among the homeless population than thegeneral population.b. The prevalenceof HIV/AIDS is much lower among the homeless population than the generalpopulation.c. The percentage of the population who has health insurance is much lower among the homelessthan the general population.d. The percentage of the population who has limited access to medical care is much lower amongthe homeless than the general population.ANS: CMost homeless people do not have health insurance or the ability to pay for needed health care,and many providers refuse to deliver treatments to these people.The prevalence of substanceabuse, HIV/AIDS, and mental health disorders is higher among the homeless population than thegeneral population.17. A health care professional is caring for an individual who is homeless and has recently beendiagnosed with Type II diabetes. Which of the following factors is the most important toconsider when planning care?a. Considering the cost of the purchasing medicationsb. Determining the pharmacy where medications will be obtainedc. Obtaining insurance that will pay for the follow-up cared. Finding supportive housing for the individual

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ANS: DResearch and practice have shown that permanent supportive housing works because housing isan essential part of treatment; thus, this is the most important factor that should be considered. Ifsupportive housing is found, the stability will help the homeless individual to follow theprescribed medical regimen.18. A health care professional is leading a community action coalition to address the problem ofhomelessness within the neighborhood. Which of the following statements would most likely bemade by health care professional?a. Homelessness should be addressed by improving financial assistance programs.b. Homelessness should be of concern to everyone in theneighborhood.c. Homelessness should be addressed by encouraging job growth in the area.d. Homelessness should be of concern to the mental health providers in the area.ANS: BHomelessness is everyones problem, and people can ultimately affect the establishment ofpriorities to facilitate an improved quality of life. As more people understand homelessness, thiswill serve as an excellent guide in providing input, taking necessary action, and making the finaldecision as to what will make a healthy nation.19. What is the main focus of the National Institutes of Health (NIH)?a. Addressing and reducing health disparitiesb. Outlining nationwide health promotion and disease preventionc. Protecting minority populations through development of health policiesd. Supporting communities in addressing health disparitiesANS: AThe main concern of the National Institutes of Health is addressing and reducing healthdisparities involving cancer, diabetes, infant mortality, AIDS, cardiovascular illnesses, and manyother diseases. Healthy People 2020 outlines a comprehensive, nationwide health promotion anddisease prevention agenda. The Office of Minority Health improves and protects the health ofracial and ethnic minority populations through the development of healthpolicies and programsthat concentrate on eliminating health disparities. The Centers for Disease Control andPreventions Racial and Ethnic Health Disparities Action Institute supports communities to takeaction in addressing health disparities.MULTIPLERESPONSE1. Which of the following individuals will most likely experience a disparity in health and healthcare? (select all that apply)a. African American manb. Unemployed womanc. White middle-aged mand. Single white womanANS: A, B, DHealth disparities adversely affect groups of people who have systematically experienced greaterobstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender;age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender

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identity; geographic location; or other characteristics historically linked to discrimination orexclusion. A white middle-aged man is the only individual who does not meet that definition.2. A health care professional is providing culturally competent care. Which of the followingactions is being performed by the professional? (select all that apply)a. Recognizing and accepting cultural diversityb. Respecting the patients values, beliefs, and expectationsc. Understanding the pathophysiology of disease processesd. Providing health care services that are respectful of the individuals cultural beliefsANS: B, DA culturally competent health care professional should be able to consistently and thoroughlyrecognize and understand the differences in his or her culture and that of the patient or client;respect the individuals values and beliefs; and adjust the approach of delivering care to meeteach individuals needs and expectations. Simply recognizing and accepting cultural diversity andunderstanding the pathophysiology of disease processes are insufficient measures to reachcultural competency in health care.3. A health care provider is discussing the importance of receiving routine preventive care with aHispanic family who has recently immigrated to the United States. Which of the followingwould best describe why they may be disinterested in receiving professional care? (select all thatapply)a. Lack of folk remediesb. Lack of interpreter servicesc. Lack of health insuranced. Lack of family supportANS: B, CBarriers experienced by Hispanic Americans in receiving appropriate health care servicesinclude lack of racial and ethnic diversity in the leadership and workforce of the health caresystem, lack of interpreter services for Spanish-speaking people, lack of health insurance, andlack of or inadequate culturally appropriate health care resources. They may not readily seek carebecause of their continued reliance on their folk system of healing. The family is the mostimportant source of support for Hispanic Americans.4. A nurse is developing a continuing education program about strategies to work with culturallydiverse populations for health care professionals in the community. Which of the followingorganizations would provideinformation that could be included in this presentation? (select allthat apply)a. The American Nurses Associationb. Sigma Theta Tau Internationalc. The National League for Nursingd. The American Association of Colleges of NursingANS: A, C, DMajor organizations, such as the American Nurses Association (ANA),AACN.Chapter 03: Health Policy and the Delivery SystemEdelman: Health Promotion Throughout the Life Span

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MULTIPLE CHOICE1. Which addition to a community best demonstrates the concept ofthe Healthy People 2020report?a. New cardiothoracic intensive care unit at a major hospitalb. New rehabilitation centerc. New recreational health centerd. New childrens hospitalANS: CThe Healthy People 2020 report promotes health care, not illness care. A hospital, ICU, andrehabilitation center emphasize episodic care after an illness. The recreation health center servesto preserve health in the community and helps meet the goals of the Healthy People 2020 report.2. Which nurse is at risk of making a medical error?a. Working overtimeb. Works in a hospital that advocates multidisciplinary carec. Caring for four clients during the shiftd. Attends regular continuing education programsANS: AHealth care systems are the basic cause of medical errors. Organizational and workforcemanagement, work design, and organizational culture are problem areas that contribute tomedical errors. Poor management leads to increased nurse turnover, the need for increasedclient-to-nurse ratios, increased need for overtime, and decreased number of nurses, all of whichcan lead to medical errors. A nurse working overtime is at risk of making a medical error.3. What is the most effective policy a staff nurse can implement to help decrease medical errorson the unit?a.Forgo opportunities for continuing education so the unit is never understaffed.b. Foster a collaborative working environment on the unit.c. Check all medications a minimum of three times before administering them.d. Develop a policy that mandates the firing of any nurse who commits an error.ANS: BHealth care systems are the basic cause of medical errors. Organizational and workforcemanagement, work design, and organizational culture are problem areas that contribute tomedical errors. Creating a collaborative working environment helps improve organizationalculture, thereby reducing the chance of medical errors.4. The person known as the father of British and American public health is:a. Lillian Wald.b. Edwin Chadwick.c. Lemuel Shattuck.d. Paul Ehrlich.ANS: BEdwin Chadwick is known as the father of British and American public health.5. A community health nurse most effectively preserves the health of a person with tuberculosis(TB) and the community by:a. administering and reading the purifiedprotein derivative (PPD) of all close contacts

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b. providing direct observed therapy (DOT) for the individual with TBc. isolating the person because it is likely drug resistantd. telling the person to wear a mask when leaving the homeANS: BCommunity health nursing practice promotes, preserves, and maintains the health of populationsand the effect of their health status on that of the community as a whole through care provided toindividuals, families, and groups. Thus, the most effective strategy of treating the individual andpreventing the spread of TB is to provide DOT.6. A community planning committee is working on the development of a community nursingcenter. Which of the following essential components should be included in this center?a. Physician as medical directorb. Interdisciplinary staffc. Nurse as chief managerd. Partnership with an academic institutionANS: CThe essential components of a community nursing center include a nurse as chief manager, anursing staff that is accountable and responsible for care and professional practice, and nurses asthe primary providers of care.7. Considering the provider and client perspective, which of the following is the mostautonomous form of insurance?a. Fee-for-service planb. Health maintenance organization (HMO)c. Preferred provider organization (PPO)d. Independent practice association (IPA)ANS: AIn the fee-for-service plan, a provider provides a service and bills the individuals insurancecompany. The individual is also allowed to choosehis or her provider.8. Which could result in a change in a nurse practitioners practice?a. Holding a masters degree or higherb. Moving to another state when she gets marriedc. Caring for Medicare clientsd. Changing to another office within the same practiceANS: BNurse practitioners generally hold masters degrees or higher. The nurse practice act within theirstates may be more comprehensive than the institutions for which they work. Legislation existsfor reimbursement of nurse practitioners by Medicare. However, practice acts and prescriptiveauthority vary from state to state and thus influence practice patterns.9. Which health care provider represents a primary care provider?a. Psychiatric advanced practice nurseb. Clinical nurse specialistc. Pediatric nurse practitionerd. Acute care nurse practitioner

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ANS: CA primary care provider serves as a gatekeeper, coordinating care of individuals by determiningthe need for referrals and procedures. A primary care provider can be a physician, physiciansassistant, or advanced practice nurse in a primary care setting. The primary care providerprovides basic and routine care usually in an office or a clinic. A pediatric nurse practitioner is anexample of a primary care provider.10. Which form of managed care restricts providers to caring for individuals who are members oftheir organization?a. Fee-for-service planb. Health maintenance organization (HMO)c. Preferred provider organization (PPO)d. Independent practice association (IPA)ANS: BThe traditional HMO was a group or staff model in which a group of physicians and somespecialty services provided care to its members. Providers generally spent all their time servingmembers of the HMO. Fee-for-service, IPAs, and PPOs are not restricted to serving clients forany one organization.11. A Medicare client reports to the home care nurse that he is receiving care through anaccountable care organization (ACO). Which of the following considerations should be madewhen delivering care to this individual?a. The individual must see a primary care provider before being referred to a specialist.b. The focus of care is prevention and management of individuals with chronic disease.c. The individual has paid a membership fee to be part of this organization.d. The focus of care is to conserve money in a health savings account.ANS: BThe focus of care of accountable care organizations (ACOs) is to focus on prevention andmanagement of individuals with chronic disease out of the hospital. In an ACO, physiciansaccept the responsibility for the quality of care provided and overall costs of delivering care to adefined population of patients. Accountable care organizations are composed of physicians,specialists, and hospitals, so a specialist will be able to be seen within the ACO. Individuals whoare part of concierge care pay a membership fee in return for enhanced health care services oramenities. Health savings accounts are used in conjunction with high deductible health insuranceplans and are not related tothe use of ACOs.12. An individual states that his family has insurance, but that paying for routine medical costs isvery expensive because most routine services are paid for out of pocket. Which type of insuranceplan does this individual mostlikely have?a. High deductible health insurance plan (HDHP)b. Point-of-service plan (POS)c. Health maintenance organization (HMO)d. Preferred provider organization (PPO)ANS: AHigh deductible health insurance plans (HDHPs) are structured in a way similar to traditionalmanaged care plans and fee-for-service plans but have a very high annual out-of-pocketdeductible. Thus, a family with this type of insurance will pay out-of-pocket until they reach thedeductible, which may make receiving health services expensive for them. Point-of-service plans

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allow members, for an additional fee and higher copayment, to use providers outside of theHMO network. Health maintenance organizations (HMOs) deliver comprehensive healthmaintenance and treatment services fora group of enrolled individuals who prepay a fixed fee.Preferred provider organizations (PPOs) have a preselected list of providers who have agreed toprovide health services for those enrolled in the plan.13. Which of the following is a health plan consisting of hospitals and physician providersproviding health care services to plan members (usually at discounted rates) in return forexpedited claims payment?a. Health maintenance organization (HMO)b. Health savings account (HSA)c. Preferred providerorganization (PPO)d. Independent practice association (IPA)ANS: CA health plan consisting of hospitals and physician providers providing health care services toplan members (usually at discounted rates) in return for expedited claims payment is knownas apreferred provider organization (PPO).14. Two working adults do not have access to health insurance for their family from theiremployers and do not meet the financial criteria for Medicaid. For which of the following federalprograms may the children in this family be eligible?a. Medicareb. Civilian Health Medical Program for Uniformed Services (CHAMPUS)c. State Childrens Health Insurance Program (SCHIP)d. Veterans Administration ProgramANS: CThe State Childrens Health Insurance Program is a public state insurance program established toprovide insurance to uninsured children whose family is typically described as the working poorand do not meet Medicaid requirements. In this case, both parents work but do not have access toinsurance through their employers. Additionally, they do not meet the financial Medicaidrequirement.15. A nurse complies with the Patient Self-Determination Act when asking:a. a person upon admission to the hospital if he or she has an advanced directiveb. the family inthe recovery room if the client has an advanced directivec. a person before discharge from the hospital if he or she has an advance directived. the family about an advanced directive after the person has been intubatedANS: AThe Patient Self-Determination Act is designed to increase individual involvement in decisionsabout life-sustaining treatments. The nurse must ensure that advanced directives are available tophysicians at the time the medical decision is being made. Therefore, the nurse complies with theact when she asks a person upon admission to the hospital if he or she has an advanced directive.16. A nurse discussing the care of a person on the surgical unit following gastric bypass surgerywith a friend is in violation of the:a. Patient Self-Determination Actb. Health Insurance Portability and Accountability Act of 1996c. Americans with Disabilities Act

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d. Civil Rights ActANS: BThe Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal privacystandard that requires safeguards to protect the security and confidentiality of health information.Disclosures without individual authorization are allowed only to public health authoritiesauthorized by law to collect and receive information for the purpose of preventingor controllingdisease, injury, or disability.17. Which is a violation of the Health Insurance Portability and Accountability Act of 1996?a. Nurse reporting a case of TB to the health departmentb. Nurse reporting a case of child abuse to the Departmentof Human Servicesc. Nurse discussing the persons case with his or her physiciand. Nurse discussing the persons case with his or her school nurseANS: DThe Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal privacystandardthat requires safeguards to protect the security and confidentiality of health information.Disclosures without individual authorization are allowed only to public health authoritiesauthorized by law to collect and receive information for the purpose of preventing or controllingdisease, injury, or disability. Before speaking to the school nurse, the nurse must obtainauthorization from the clients parents.18. Which nurse is functioning as a care manager?a. Nurse working with a family to coordinate careafter their child experiences a secondhospitalization for an asthma exacerbationb. Nurse providing asthma education in the office setting to a child with moderate, persistentasthmac. Nurse administering the appropriate antiinflammatory medication to achild admitted to thehospital with an asthma exacerbationd. Nurse making a home visit for a respiratory assessment to a child following an admission foran asthma exacerbationANS: ACare managers help determine what medical care is necessary, monitor care, and arrange forindividuals to receive the most cost-effective care in the most appropriate settings. They mustcollaborate with providers and with the client/family. Care managers are especially helpfulfollowing a client after discharge and clients with complex needs. A nurse working with a familyto coordinate service after a hospitalization is a good example of services provided by a caremanager.19. A pregnant woman with two toddlers living at less than 135% of the federal poverty levelwould be eligible for:a. Medicare Part Ab. Medicare Part Bc. Medicaidd. State Childrens Health Insurance Program (SCHIP)ANS: CState Medicaid programs must cover all pregnant women and children up to 6 years of age with afamily income of less than 133% of thefederal poverty level. States Childrens Health InsuranceProgram provides insurance coverage to children whose family income is below 200% of the

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federal poverty level or whose income is 50% higher than the states Medicaid eligibilitythreshold. In this case, the woman is pregnant, her children are under the age of 6, and they meetthe financial criteria for Medicaid but not SCHIP.20. Which of the following is a major factor limiting health care services in the United States?a. Lack of nursesb. Lack of health care facilitiesc. Lack of fundingd. Lack of client interest in health promotionANS: CThe lack of nurses may prevent health care providers from offering health promotional educationactivities. The cost of health care and prescription drugs is a major limitation to health careservices. The United States has the highest proportion of population with no health insurance,thereby limiting health care services available to Americans.MULTIPLE RESPONSE1. A community health nurse is presenting information about the current health of the nation to alocal political action group in 2011. Which of the following information would be included inthis presentation? (select all that apply)a. Funding of public health programs has improved the health of the nation.b. Provision of health care has improved the health of the nation.c. Advances in technology have improved the health of the nation.d. Consumer education has improved the health of the nation.ANS: A, B, DAccording to the 2010 Report of Health, thehealth of the nation has improved in many areas as aresult of substantial funding of public health programs, research, provision of health care, andinitiatives to support consumer education.2. Which of the following statements about the financing of health care in the United States isaccurate? (select all that apply)a. Employee-sponsored health insurance premiums experienced minimal increases from 2001 to2011.b. State tax dollars must fund at least 50% of a states Medicaid cost.c. The largest percentage of health care dollars is spent on hospital care.d. Most workers who have an employer-sponsored health insurance plan are enrolled in preferredprovider organizations (PPOs).ANS: C, DIn 2010, almost one third (31%) of health care dollars was spenton hospital care. The majorityof employee-covered workers were enrolled in PPOs (55%). Employee-sponsored healthinsurance premiums rose dramatically from 2001 to 2011 by 113%. Federal dollars must fund aminimum of 50% of a states Medicaid cost; the state is responsible for contributing whateverpercentage is not funded by the federal government.3. Which of the following would be considered part of a vulnerable population? (select all thatapply)a. Deaf man

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b. Cocaine-addicted teenage girlc. Handicapped childd. College graduateANS: A, B, CThose who are physically disabled or handicapped, substance abusers, and those withcommunication difficulties are considered part of the vulnerable population in the United States.Chapter 04: The Therapeutic RelationshipEdelman: Health Promotion Throughout the Life SpanMULTIPLE CHOICE1. Which of the following statements about values is true?a. It is impossible for someone to understand his or her values.

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b. Values evolve over time; they are not static.c. Values assimilated in childhood are those held for a lifetime.d. Values clarification tells a person how to act.ANS: BValues take time to develop, and they may change with education, experience, exposure, or acombination ofthese.2. A nurse is providing education about improving self-awareness to a small group of womenwho have been victims of domestic violence. Which of the following should the nurserecommend the clients do first to improve their self-awareness?a. Use self-disclosure to share aspects of self.b. Listen to and learn from others.c. Listen to oneself and pay attention to emotions, thoughts, and reactions.d. Use others to bounce back your own thoughts and recollections.ANS: CTo achieve a high self-awareness, three steps must be taken. The first step is listening to oneselfand paying attention to emotions, thoughts, memories, reactions, and impulses. The second stepis listening to and learning from others. The third step is using self-disclosure to share aspects ofself.3. The nurse shares with her client the news that she, the nurse, is going to be married soon andtells the client about her wedding plans. Which of the following best describes the nursesactions?a. The nurse is sharing inappropriate personal information with her client.b. The nurse is exhibiting a communication technique called self-disclosure.c. The nurse is attempting to show empathy with her client.d. The nurse is violating client confidentiality rights of the Health Insurance Portability andAccountability Act (HIPAA).ANS: BSharing aspects of the self enriches interpersonal life and is a use of the technique labeled self-disclosure.4. A nurse has started admitting a new person on home care and is beginning to establish arelationship. Which of the following would be the most important thing for the nurse to do?a. Complete the paperwork in a timely fashionb. Establish open communicationc. Conduct a complete physical health assessmentd. Provide feedback to the persons questionsANS: BCommunication is the foundation for any professional relationship. It is the cornerstone of apositive nurse-person relationship. It refers to a set of strategies and actions to enhancereciprocity, mutual understanding, and decision making.5. Which of the following best describes person-centered communication?a. The nurse says to the person seeking care, Why do you continue to drink when you know it isnot good for you?

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b. The nurse responds to person seeking cares request for pain medicine by saying, It is not timefor your pain medicine. You had it hours ago.c. The client says to the nurse, I think my husband is cheating on me. The nurse responds bysaying, You think your husband is cheating on you?d. The client says to the nurse, I cant believe I have cancer. The nurse responds by saying, Oneof my closest friends had cancer and had to have chemotherapy.ANS: CThe nurse recognizes that the person seeking care has some concerns that she would like todiscuss and paraphrases her statement to give the person an opportunity to elaborate on thoughtsthat are important to him or her.6. A nurse is counseling someone who has recently been diagnosed with diabetes. The nursesays, Tell me more about how this diagnosis has affected your daily activities. Which of thefollowing best describes the type of communication the nurse is using?a. Verbal communicationb. Nonverbal communicationc. Metacommunicationd. Functional communicationANS: AVerbal communication is the transmission of messages using words, spoken or written.Nonverbal communication encompasses all messages that are not spoken or written.Metacommunication refers to a message about the message, the relationship aspect ofcommunication.7. Which of the following statements about nonverbalcommunication is true?a. Nonverbal behavior is not usually contextual.b. Nonverbal behavior is culturally and situationally bound.c. Nonverbal communication is the most important type of communication.d. Nonverbal communication is easy to interpret.ANS: BCultural exposure and situational impact are essential components of interpreting nonverbalcommunication and must be taken into consideration in attempts to interpret nonverbalcommunication.8. Which of the following scenarios best describes a nurseusing metacommunication?a. Using both touch and silence when counseling an individualb. Practicing reflection when interaction with an individualc. Discussing with an individual how to solve a problemd. Understanding that an individual needs a break before proceedingANS: DMetacommunication refers to a message about the message. It is the relationship aspect ofcommunication. In a sense, it involves reading between the lines or going past the surfacecontent of the message to glean nuances of meaning.9. Which of the following statements can be identified as a method for clarifying a message?a. I get very upset when you talk to me in that tone.

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b. You make me very angry when you drink alcohol.c. I can make you happy. I know I can.d. What I want fromyou is to be left alone!ANS: AUse of I statements is one technique that can be used for clarifying and qualifying messages.10. A nurse and a man are involved in a conversation. When the person folds his arms across hischest, the nurse almost simultaneously folds her arms across her chest. This behavior isrecognized as:a. empathy.b. reciprocity.c. flexibility.d. spacing.ANS: BThe patterning of similar activities within the same interval by two people can facilitatecommunication. This patterningis known as reciprocity.11. A nurse and her client are engaged in meaningful conversation when suddenly there issilence between the two. To facilitate effective client-centered communication, the nurse should:a. ask the person what he is thinking, so they can understand each other.b. restate what the person said before silence ensued, to get clarification.c. change the subject to one that is more pleasant for the person to discuss.d. wait quietly to give the person time to reflect where he wants to lead the conversation.ANS: DSilence allows the person to reflect on what is being discussed or experienced and lets him or herknow that the nurse is willing to wait until he or she is ready to say more.12. A person has just been admitted to the hospital.In talking with the person, the nurse is able toelicit from her that the reason for her hospitalization is that her husband beat her up. Whichcharacteristic of the therapeutic relationship is being demonstrated?a. Empathyb. Trustc. Rapportd. Purposeful communicationANS: DThe nurse focuses communication for a particular aim: to obtain information to be used in care ofthe person.13. An individual reveals to the nurse that he is having an affair with his wifes best friend. Whichof the following statements will enhance effective therapeutic communication between him andthe nurse?a. You know that what you are doing is wrong.b. Why would you want do something like that?c. How could you do that to your wife and children?d. This affair seems to be troubling you.ANS: DThe nurse is seeking to determine the clients own feelings about his affair. By seeking feedback,the nurse helps explain the meaning further. The nurse suspends judgment and responds in such a

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way as to encourage him to keep talking rather than make judgments about his behavior, whichwould shut down communication.14. A nurse is working with a person to increase his daily exercise and activity. Which of thefollowing statements by the nurse best demonstrates the use ofreflection?a. I have also struggled with finding time to exercise on a regular basis.b. Regular exercise plays an important role in preventing many health problems.c. You said that you have difficulty making time in your day for exercise.d. It may be helpful if we developed a goal related to daily exercise.ANS: CReflection is the restatement of what the individual has said in the same or different words. Thistechnique can involve paraphrasing or summarizing the persons main point to indicate interestand to focus the discussion. It is the selective paraphrasing or literal repetition of the personswords to underscore the importance of what has been said, summarize a main concern or theme,or elicit elaborated information.15. A woman tells the nursethat she is very nervous about their meeting today. Which of thefollowing relationship stages are the nurse and woman most likely experiencing?a. Orientation phaseb. Working phasec. Therapeutic phased. Termination phaseANS: AThe orientation phase begins when the nurse and individual meet. This meeting typicallyinvolves some feeling of anxiety because neither party knows what to expect.16. Which of the following is the first step in the valuing process?a. Acting out the choiceb. Selecting from alternativesc. Being happy with personal beliefs and actionsd. Choosing freelyANS: DThe seven-step valuing process involves (1) choosing freely, (2) choosing from alternatives, (3)choosing after careful consideration of potential outcomes of each alternative, (4) cherishing andbeing happy with personal beliefs and actions, (5) affirming the choice in public, whenappropriate, (6) acting out the choice, and (7) repeatedly acting in some type of pattern.17. The nurse makes sure that the distance between himself and the client is at least 6 feet beforehe begins to ask questions related to the clients health history. Which of the following statementsis true?a. This is the ideal space for intimate communication.b. This distance is too far for the nurse tobuild a therapeutic relationship while obtaining theinformation.c. This is the recommended distance between client and nurse for effective therapeuticcommunication.d. The nurse should position himself an additional foot away to facilitate the conversation.

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ANS: BPersonal space of 18 inches to 4 feet is appropriate for close relationships in which touching maybe involved and good visualization is desired.MULTIPLE RESPONSE1. A nurse is working on values clarification with a person who has chosen to smoke during herpregnancy. Which of the following statements would be the most appropriate for the nurse toassist in this process? (select all that apply)a. Why do you smoke cigarettes?b. What do you value most in life?c. Who has influenced your decision to smoke?d. Is your decision to smoke consistent with your values?ANS: B, DTechniques to clarify values include assisting the person to identify her own values (What isimportant to you?), identify values conflicts or conflicts between values and actions (Are youractions consistent with your values?), and using reflection to restate the value and make itexplicit.2. A nurse is in the process of establishing a therapeutic relationship with a person. Which of thefollowing techniques should be used bythe nurse? (select all that apply)a. Learn about the persons interests.b. Sit close to the person.c. Show interest in the persons concerns.d. Define the parameters of the relationship with the person.ANS: C, DPurposeful communication should be an aim of the therapeutic relationship. Social chitchat,communication without a goal, should not make up the bulk of the therapeutic interaction. Theamount of space between communicators varies from culture to culture, so sitting close to theperson may not be culturally appropriate. Building rapport by showing the person that his or herconcerns interest the nurse is important. Also, trust can be built with the person by clearlydefining the relationship parameters and expectations.3. Which of the followingis an essential question that nurses should encourage individuals to askat every health visit? (select all that apply)a. What is my main problem?b. What health information do I not understand?c. What do I need to do?d. What is the plan for the next visit?ANS: A, CHealth literacy is the capacity to read, comprehend, and follow through on health information; itis a critical component of health promotion. To combat low health literacy, nurses can encourageindividuals to ask three essential questions at every health visit: What is my main problem? Whatdo I need to do? Why is it important for me to do this?

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Chapter 05: Ethical Issues Related to Health PromotionEdelman: Health Promotion Throughout the Life SpanMULTIPLE CHOICE1. Which of the following statements is true with regard to health promotion?a. Health promotion efforts are not concerned with addressing environmental obstacles to health.b. Advocates of health promotion are not involved in political campaigns against harmfulproducts.c.The business of eliminating health disparities is a unique function of Healthy People 2010goals.d. Health promotion involves collaboration of many professional groups.ANS: DHealth promotion is not the province of a single discipline but involves individuals, health careproviders, and institutions working together to create a positive environment for health and toachieve health goals.2. Which of the following types of ethical theories tells us how people act toward each other andtheir environments and what they believe are good or moral actions?a. Descriptive value theoriesb. Normative theoriesc. Consequentialism theoryd. Duty-based theoriesANS: ADescriptive theories do not tell us what actions we ought to take. They are not directive; they tellus how people act toward each other and their environments and what they seem to believe aregood or moral actions.3. A nurse includes the statement, Treat others the way you would like to be treated. whenteaching a group of adolescents about bullying.Which type of ethical theory is being used in thisexample?a. Descriptive value theoryb. Normative theoryc. Consequentialism theoryd. Duty-based theoryANS: BNormative theories are concerned with ensuring good actions. They are reasoned explanations ofthe moral purpose of human interactions, or they are divinely revealed truths about good action(religious ethics).4. A nurse believes that it is his responsibility to ensure the safety of the public by administeringflu shots to everyone in the community. Which ethical theory is being used by the nurse?a. Descriptive value theory

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b. Normative theoryc. Consequentialism theoryd. Duty-based theoryANS: CConsequentialism theory proposes that actions are good insofar as they are aimed at yielding thegreatest amount of happiness or pleasure or cause the least amount of harm or pain to individualsand overall in society. Administration of flu vaccines proposes the best result for individuals anddecreased risk for others in the community.5. Which of the following statements best describes the application of moral or ethical theory tothe practices involved in health promotion?a. One can be assured of morally correct action in a given situation if one adheres to a theory ofmoral principles.b. There are no identifiable criteria that can be used effectively to determine correct actions in agiven situation.c. The good of the larger population always takes precedence over the good of one individual.d. Making ethical decisions regarding human health involves the consideration of multiplefactors.ANS: DMaking moral or ethical decisions about human health is not an easy task and requires assessingvarious criteria or theories.6. An emergency department provides care for all individuals regardless of circumstances andability to pay. This is an example of:a. ethic of justice.b. ethic of care.c. applied ethics.d. metaethics.ANS: AThe ethic of justice is impartial and nondiscriminatory. An ethic of care, however, requires anunderstanding of situational particularities, ensuring that we try to understand a given individualsneeds in the context of his or her life.7. A nurse uses ethical reasoning to solve an ethical dilemma. Why would the nurse use thisprocess?a. Assists in predicting all of the possible consequences of future actionsb. Facilitates gathering of the most important information to solve the problemc. Considers the importance of caring when solving the problemd. Highlights salient aspects of future actionsANS: BThe purpose of ethical inquiry is to gain clarity on actual or potential moral issues arising in thecontext of health-promotion endeavors and to understand what is expected of the health-promotion agent viewed as a moral agent. Ethical reasoning can facilitate appropriate and in-depth data gathering, permit the uncovering of hidden agendas and interests, and focus on themost salient aspects of a particular problem.8. A nurse whose religious beliefs prohibit abortion has been asked to participate in a terminationof the pregnancyof a 16-year-old victim of date rape. According to the revised American Nurses

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Associations (ANAs) Code of Ethics for Nurses, which of the following actions should the nursetake next?a. Suspend her religious beliefs and provide comfort and support for the client.b. Quit her job and find another source of employment.c. Notify her supervisor about her beliefs and request a change in assignment.d. Refuse to participate in the abortion.ANS: CIn the immediacy of the situation, the ANA Code of Ethics provides for the right of nurses torefuse to participate in procedures that violate their own values, but the nurses ethical behaviormust ensure that arrangements for the care of the client are provided.9. A liver for which two people are tissue-typed has become available after the death of a donorin a car accident. Client A is a 45-year-old substance abuser whose liver is damaged as a result ofhis use of alcohol. Client B is a 16-year-old adolescent in need of a liver transplant because of abirth abnormality. Which of the following would be useful for a nurse in giving input as to whichof the two should receive the liver?a. Advocate for Client B because he is the younger of the two and will live longer.b. Use feminist moral theory to advocate for Client A in spite of his alcohol use.c. Use a guided set of moral principles in decision-making before advocating for either.d. Advocate for Client A because he has 15 to 20 years of productive life left.ANS: CSystematically using a set of moral principlesin making ethical decisions assists the nurse inresolving ethical dilemmas such as that described.10. Which concept is aimed at interrupting potential ethical problems before they develop?a. Feminist ethicsb. Preventive ethicsc. Metaethicsd. Normative ethicsANS: BPreventive ethics is a requirement of health promotion in which practitioners envision potentialproblems and institute actions that stop their development.11. When providing preoperative teaching for a client who will beundergoing total kneearthroplasty, the nurse asks the client questions to assess his understanding of the surgery. Whichtype of ethics is the nurse implementing?a. Duty-based ethicsb. Normative ethicsc. Metaethicsd. Preventive ethicsANS: DPreventive ethics aims to forestall ethical problems before they develop. Preventive ethics is animportant requirement of health-promotion endeavors that includes individual action by thenurse, as well as social and political activism with other nurses or professional nursingorganizations. Assessing the clients understanding of what is going to happen during a surgical

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procedure before the client signs the consent for the procedure makes sure the client understandsthe information and should help prevent ethicalproblems.12. A 24-year-old man with severe cognitive impairment, and no relatives participating in hiscare, needs to make a decision about removal of a brain tumor that will render him totallydependent for completion of all activities of daily living.The nurse participates in ethicaldecision making on his behalf, knowing that the client is unable to benefit from which of thefollowing ethical concepts?a. Autonomyb. Justicec. Beneficenced. AdvocacyANS: ABecause the client is cognitively delayed and is unable to understand explanations of treatmentthat would be given to him, the client is unable to be autonomous in making a decision regardingneurosurgery.13. A client is scheduled to have open-heart surgery. His physical condition is such that heis athigh risk to experience complications during the procedure, but he has not been advised of thispossibility. Which of the following ethical concepts has been ignored in rendering care for thisclient?a. Beneficenceb. Autonomyc. Justiced. Informed consentANS: DThe client is able to substantially understand his care. Ethical care ensures that a person has all ofthe appropriate information necessary to make an autonomous decision about his or her care.This client has not been informed of his chances of dying during the surgery.14. An 18-year-old woman in whom a sexually transmitted disease (STD) was recentlydiagnosed asks the nurse not to tell her mother that she has an STD. Her mother asks the nursewhat is causing her daughters vaginal discharge. Which of the following actions should the nursetake?a. Follow the principle of veracity and tell the mother the diagnosis.b. Respect the principle of confidentiality and support the clients request not to tell her motherthe diagnosis.c. Tell theclients mother that she has a urinary tract infection, to protect the clients privacy andhonor the mothers request.d. Ignore the mothers request for information.ANS: BThe Health Insurance Portability and Accountability Act (HIPAA) guarantees clientconfidentiality. The client is the only person who can inform her mother of the diagnosis and theonly person who can give the nurse permission to inform her mother of the diagnosis. The nursecould appropriately respond to the mother by saying, I cannot share that information with you

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because of client confidentiality legislation. You might ask your daughter to share thatinformation with you.15. A nurse is providing care to a 15-year old female who has recently been diagnosed with asexually transmitted infection (STI). Which of the following actions should the nurse take next?a. Seek advice from an ethics expert.b. Facilitate interaction between the adolescent and her parents/guardians.c. Report the STI to the appropriate authorities.d. Contact the adolescents parents/guardians.ANS: BFederal and state laws generally serve to protect the privacy and autonomy of adolescents.Responsibilities of the nurse include helping an adolescent to grasp his or her authentic optionsand rights, facilitating interaction between the adolescent and parents or guardians, maintainingtrust, and preserving confidentiality.16. An elderly client has recently been diagnosed with cancer. The clients family has asked thenurse to withhold this information from the client because they feel that this information wouldcause the client to give up on life and become very depressed. The nurse believes the clientshould be told this information. Which ethical principle is being upheld by the nurse?a. Justiceb. Beneficencec. Veracityd. NonmaleficenceANS: CVeracity is also known as devotion to the truth. Veracity in giving people information about theirhealth care needs facilitates autonomous choice and enhances personal decision-making.Withholding information, or providing information that is misleading or incomprehensible, in anattempt to influence someone to agree to a treatment or intervention, conflicts with veracity.17. Which of the following concepts of ethics is described as the duty to maximize the benefitsof actionswhile minimizing harm?a. Advocacyb. Justicec. Beneficenced. AutonomyANS: CBeneficence governs actions taken to further the overall health or well-being of an individual orsociety. Beneficence means doing good.18. A nurse reflects on previous experiences with minority populations and considers how theseinteractions have influenced her present care to these populations. Which part of valuesclarification and reflection has the nurse used?a. Formulate a possible course of action.b. Examine the influence of beliefs.c. Reflect on practice.d. Determine the prevalent values.

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ANS: BIt is important for the nurse to think about the influence that beliefs and values have on his or herpractice. An understanding of how personal beliefs and values are either congruent, or are liableto interfere, with the task at hand is crucial to ethical problem solving.MULTIPLE RESPONSE1. A nurse is working with a community to increase its awareness about the dangers of leadpoisoning. Which of the following provides the best explanation as to why the nurse isperforming this action? (select all that apply)a. It is the right thing to do.b. It is a moral responsibility.c. It is an ethical responsibility.d. It is the role of the nurse.ANS: B, CWhen nurses provide service to society through health promotion interventions, their care forclients can be seen as a moral endeavor. Moral issues are confronted in the process of attemptingto enhance the well-being of a society overall, as well as promoting and protecting health forindividual members of a society. The ANA Code of Ethics for Nurses Interpretive Statementspromises that nursing encompasses the prevention of illness, the alleviation of suffering, and theprotection, promotion, and restoration of health in the care of individuals, families, groups andcommunities. The terms ethical and moral are used interchangeably throughout the chapter.2. A nurse is using feminist ethics when planning a program for women to promote screeningand early detection of breast cancer. Which of the following considerations would be made bythe nurse? (select all that apply)a. Importance of relationshipsb. Understanding of the oppression of womenc. Importance of responsibility when caring for othersd. Understanding of the imbalance of powerANS: B, CCharacteristics of feminist ethics include: understanding that human beings are inseparable fromtheir relationships with others; a focus on care and responsibility aspects of relationships, ratherthan application of abstract principles; a concern with the development of character and attitudesthat result in caring actions reflective of a person who is related to rather than detached fromcontext; and a concern for the rights and equality of all individuals that is not limited to theoppression of women.Chapter 06: Health Promotion and the IndividualEdelman: Health Promotion Throughout the Life SpanMULTIPLE CHOICE1. Healthy People 2020 objectives provide a framework for:a. assessment.

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