Deck 3: Health and Illness Care of Adults

Question 1

During an assessment, a patient tells the nurse that she is lactose intolerant. The nurse realizes that this food intolerance is common within which cultural groups?

A) Mexican Americans
B) Scandinavian Americans
C) Indian Americans
D) Mediterranean Americans

Answer 1

Mexican Americans

Question 2

While being treated for one disease process, a patient begins demonstrating manifestations of another disease process. The nurse realizes that the patient is experiencing which type of disease?

A) iatrogenic
B) communicable
C) congenital
D) degenerative

Answer 2

iatrogenic

Question 3

A patient has not been feeling well for a few days and has been using an over-the-counter medication without improvement. The nurse understands that the patient is demonstrating which illness behavior?

A) seeking medical care
B) experiencing symptoms
C) assuming the sick role
D) assuming a dependent role

Answer 3

seeking medical care

Question 4

A patient tells the nurse that he has been fortunate since he has never experienced any major illnesses and has enjoyed good health without much effort. How should the nurse realize this patient is defining "good health?"

A) the absence of disease
B) effortless
C) fortunate
D) an integrated method of functioning

Question 5

A patient wants to be discharged to home and resume normal activities of daily living. The nurse realizes the patient is entering which stage of illness behaviors?

A) achieving recovery and rehabilitation
B) seeking medical care
C) assuming a dependent role
D) experiencing symptoms

Question 6

When planning holistic care for a patient admitted with heart failure, what should the nurse include?

A) spiritual needs
B) measuring intake and output
C) daily weights
D) ambulating with assistance

Question 7

The nurse is collecting data at the immunization clinic. Which disclosure by the patient would cause the nurse to withhold the administration of the varicella vaccine?

A) a blood transfusion after undergoing surgery 3 months ago
B) history of an allergic reaction to yeast bread
C) itching and swelling on the face and hands after ingesting eggs
D) a low-grade temperature within the past 2 days

Question 8

A female patient asks the nurse for suggestions to help her improve her health. What should the nurse instruct this patient?

A) Participate in a continuous physical activity for 30 minutes 5 or more days each week.
B) Obtain sun exposure every day.
C) Reduce tobacco use.
D) Sleep at least 6 hours each night.

Question 9

A patient tells the nurse that she has been relatively healthy until recently, which is why she made an appointment to see the physician. The nurse realizes that the primary reason individuals seek health care is for which problem?

A) pain
B) bleeding
C) vomiting
D) fatigue

Question 10

The nurse is assessing a patient who is a Native American. For which health problem should the nurse be alert?

A) diabetes mellitus
B) eye disorders
C) hypertension
D) osteoporosis

Question 11

The nurse is planning care for a patient with a chronic illness. What intervention should the nurse include in the plan of care?

A) Instruct the patient in ways to minimize the impact of the chronic illness on activities of daily living.
B) Encourage the patient to seek medical care with any changes in symptoms.
C) Limit activities until symptoms subside.
D) Suggest lifestyle alterations to prepare for more challenging symptom management in the future.

Question 12

A patient tells the nurse that he often is concerned with his declining mobility status even though he continues to experience no major health issues. When planning care according to the wellness framework, what should the nurse include for this patient?

A) interventions to restore the patient's mobility status
B) activities to promote the current level of functioning
C) suggestions to maintain the patient's current mobility status
D) activities to help the patient cope with the decline in mobility status

Question 13

A patient is admitted with a respiratory illness. During the assessment, the nurse learns the patient is a factory worker and uses public transportation to get to work. Which will be impacted by the patient's socioeconomic status?

A) lifestyle
B) cognitive abilities
C) education level
D) developmental level

Question 14

The nurse is instructing a patient on nutritional needs by using MyPlate. What should the nurse emphasize when using this food guide?

A) consuming nutrient-dense foods and beverages
B) ways to limit exposure to carcinogens
C) activities to reduce the onset of diabetes mellitus
D) avoiding overuse of aerobic exercise

Question 15

The nurse has provided care to a patient according to the concept of wellness. Which outcome indicates that care has been successful for this patient?

A) The patient is returning home with adjustments in the home environment to support a temporary alteration in mobility status.
B) The patient needs additional teaching to understand the reason for taking Coumadin at the same time every day.
C) The patient is not independent with personal care and will need assistance when at home.
D) The patient is easily fatigued and will need assistance with meal preparation and medication administration.

Question 16

The nurse is reviewing the goals for Healthy People 2020 with a group of patients in an outpatient clinic. What should the nurse include in this presentation?

A) Eliminating preventable disease, disability, injury, and premature death
B) Achieving health equity, eliminating disparities, and improving the health of all groups
C) Creating social and physical environments that promote good health for all
D) Promoting healthy development and healthy behaviors across every stage of life
E) Achieving a body weight 20% less than recommended in current standardized height/weight charts

Question 17

During an assessment, a patient tells the nurse that he drinks four alcoholic beverages every day and smokes one pack of cigarettes. The nurse realizes that these chemical agents can predispose the patient to develop:

A) a disease.
B) an illness.
C) an injury.
D) an infection.

Question 18

A patient with a chronic illness is not currently experiencing any symptoms and plans to stop following the identified course of care because the disease is cured. How should the nurse respond to this patient?

A) "The treatment plan is the reason you are not experiencing symptoms, so it would be best if you did not stop the plan."
B) "That does sound like a good idea."
C) "You can always resume the plan if the symptoms return."
D) "Plan to wean yourself off the treatment plan and not discontinue it all at once."

Question 19

A patient tells the nurse that he feels fine even though he has been told he has chronic kidney failure. What is the patient likely to manifest?

A) signs of an illness
B) an iatrogenic disease
C) a psychosomatic illness
D) an idiopathic disorder

Question 20

During an assessment, the nurse learns that a patient has a genetic predisposition to the development of several disease processes. Which illness should the nurse realize is associated with genetic makeup?

A) cancer
B) hypertension
C) osteoporosis
D) myocardial infarction

Question 21

A 50-year-old African American male is being seen by his primary healthcare provider for an annual physical. His last complete physical was 2 years ago and he has no complaints at this time. He asks what health screening tests he should expect now that he is 50 years old, in addition to his annual health examination. Based on the patient's age and ethnicity, which screening tests should the nurse review with the patient?

A) cholesterol level
B) colonoscopy and occult blood screening
C) prostate cancer screening
D) vision screening
E) osteoporosis screening

Question 22

The nurse is preparing discharge instructions for a 63-year-old African American male patient recovering from a same-day surgical procedure. What genetic, racial, ethnic, and cultural factors affecting health and well-being should the nurse consider prior to giving discharge instructions?

A) hypertension
B) sickle cell anemia
C) lactose intolerance
D) diabetes
E) osteoporosis

Question 23

The nurse is caring for an older patient experiencing confusion and lethargy after taking routine doses of medication. Which age-related changes should the nurse identify that could predispose this patient to toxic drug effects?

A) changes in tissue and organ structure
B) decrease in liver function
C) taking several drugs at once
D) decrease in renal function
E) decrease in taste sensation

Question 24

Which statement by a 52-year-old female patient admitted for evaluation of migraines reflects the changes that occur in middle adulthood?

A) "I am embarrassed by the amount of weight I have gained each year."
B) "I have recently been put on a lipid-lowering agent for an increase in my cholesterol levels."
C) "I worry about getting breast cancer like my friend who is the same age."
D) "I have been lonely since my children all married and moved far away."
E) "I am concerned about coping with an unplanned pregnancy."

Question 25

A patient with seizures is being monitored to determine if the seizure activity was present at birth or has been slowly developing. For which classifications of diseases is this patient's seizure activity being evaluated?

A) congenital versus chronic
B) acute versus chronic
C) communicable versus functional
D) idiopathic versus iatrogenic

Question 26

During a routine physical examination, a 52-year-old Caucasian male declines to have his prostate gland examined and states he does not have a family history and does not feel he is at risk. What initial response by the nurse is most appropriate?

A) "Your risk factors increase with aging."
B) "You may refuse any screening test you wish."
C) "I will need to tell the physician about your refusal."
D) "You are right. Caucasian men have a lower incidence of prostate cancer."

Question 27

A 45-year-old woman is having a routine examination and has no significant personal or family medical history. What information concerning health-promotion behaviors should the nurse provide to this patient?

A) Ensure an adequate intake of calcium.
B) Plan to have a mammogram every other year.
C) Measure blood pressure every 3 years.
D) Exercise for at least 15 minutes a day 3 days each week.

Question 28

A patient is diagnosed with an ear infection and has been prescribed antibiotics. Which level of intervention has the patient received?

A) secondary
B) primary
C) tertiary
D) acute

Question 29

The nurse is assisting an 18-year-old female patient to strategize ways to avoid the onset of disease with aging. What should the nurse include in this plan?

A) Maintain a healthy weight.
B) Avoid smoking.
C) Avoid substance abuse.
D) Schedule an annual mammogram.
E) Plan for a colonoscopy every 2 years.

Question 30

The nurse is preparing to provide disease management care to a patient with heart failure. On what should the nurse focus when caring for this patient?

A) Disease process
B) Daily monitoring
C) Medication management
D) Transfer to long-term care
E) Frequency of hospitalization

Question 31

The overall mission of Healthy People 2020 is to improve the nation's health. What topics are addressed to achieve this goal?

A) access to health services
B) nutrition and weight status
C) reproductive health
D) injury and violence
E) outpatient surgery

Question 32

A 20-year-old female nursing student has never been exposed to measles, mumps, or rubella, or received a vaccine; her last tetanus immunization was 4 years ago; and she received the tetanus, diphtheria, and pertussis vaccines as a child. She has never been vaccinated or exposed to varicella, human papillomavirus (HPV), or hepatitis. According to the recommended immunizations for adults, which immunizations should the nurse recommend the student receive at this time?

A) measles, mumps, rubella (MMR)
B) hepatitis B
C) HPV
D) influenza
E) tetanus, diphtheria, pertussis

Question 33

The nurse is planning interventions to meet a patient's tertiary care needs. Which would be applicable for the patient?

A) providing preoperative instructions
B) instruction in self-examination of breasts
C) screening for glaucoma
D) counseling on healthy nutrition

Question 34

A 75-year-old patient tells the nurse about experiencing extreme drowsiness after taking an over-the-counter cold medication. The nurse notes the patient ingested the prescribed amount of the medication. What should this information suggest to the nurse?

A) Older age is influencing the patient's response to the medication.
B) More medication was taken than was reported.
C) A reaction between the cold medication and other routine medications has occurred.
D) An allergic reaction to the cold medication occurred.

Question 35

A 45-year-old patient voices concerns about gaining 12 pounds over the past 2 years. The patient reports no change in dietary habits. Which response by the nurse is most appropriate?

A) "Age-related weight gain can occur because of consistent dietary intake and less physical activity."
B) "Are you exercising?"
C) "You might be eating more than you think."
D) "You are getting older."

Question 36

The nurse is planning an education session to discuss primary levels of disease prevention. Which topics should the nurse include in this presentation?

A) the elimination of smoking and alcohol use
B) available locations for diabetes screening
C) the need for annual colonoscopy examinations
D) the use of available community rehabilitation facilities

Question 37

A nurse is conducting an educational session on self-care initiatives for chronic heart failure patients and their support persons prior to discharge from the hospital. Which topics should be included in the discussion?

A) Adapting activities of daily living
B) Maintaining a sense of hope
C) Maintaining a feeling of being in control
D) Living as normally as possible
E) Seeking third and often fourth opinions

Question 38

A patient with a family history of breast cancer is participating in activities to prevent illness. Which primary prevention action is the patient performing?

A) Genetic testing to determine genetic predisposition
B) Obtaining a mammogram and performing monthly breast self-examinations
C) Taking lipid-reducing agent to reduce cholesterol levels
D) Supporting breast cancer research by running in a half marathon

Question 39

A patient is diagnosed with an acute onset of pulmonary embolism. Rank the illness behaviors that this patient may demonstrate in the commonly recognized sequence.

A) experiencing symptoms
B) assuming a dependent role
C) seeking medical care
D) assuming the sick role
E) recovery and rehabilitation
F) non of the above.

Question 40

In a healthcare provider's office the nurse case manager approaches a patient with type 2 diabetes mellitus to review the patient-centered medical home (PCMH) approach to care. What benefits of this approach should the case manager include in this discussion?

A) Prevents acute disease crises
B) Encourages preventive services
C) Eliminates health insurance billing
D) Comprehensive and coordinated care
E) Focus on all levels of illness prevention

Question 41

The nurse working in an acute care hospital is considering a position working with patients in the community. What care settings should the nurse consider before making a final decision?

A) Parish nursing
B) Homeless shelters
C) Adoption agencies
D) County health department
E) Ambulatory surgical center

Question 42

The nurse is determining if a patient recovering from abdominal surgery is a candidate for home care. Which information should the nurse use to help make this decision?

A) The patient needs intermittent skilled nursing care.
B) The patient prefers to use an agency that is Medicare certified.
C) The patient plans to attend the upcoming senior citizen bingo night.
D) The patient can walk to a shopping mall to do banking and purchase groceries.
E) The patient is unable to change the abdominal wound dressing because of limited upper-extremity mobility.

Question 43

A patient recovering from total hip replacement surgery is being transferred to a rehabilitation facility. When discussing this facility with the patient, what should the nurse include?

A) An assessment of functional abilities will be completed.
B) The patient should expect to provide all self-care.
C) A team of therapists and nurses will be working with the patient.
D) The focus will include interpersonal relationships and family support.
E) Plans will be made to transition the patient to a long-term care facility.

Question 44

The nurse notes that a patient with osteoarthritis receiving transition care has achieved the goals for this care delivery approach. What did the nurse observe to come to this conclusion?

A) Safety bars installed in the bathroom
B) Oldest daughter moved out of the patient's home
C) Monthly pension from previous employer reduced
D) Adhering to exercise, pain medication, and dietary plans
E) Last hospitalization for treatment from a fall 9 months ago

Question 45

The nurse is visiting the home of a patient recovering from an acute gastrointestinal bleed. Which actions should the nurse take to limit distractions during this home visit?

A) Establishing short- and long-term goals
B) Explaining the primary goal of home care
C) Exploring the patient's and family's expectations of home care
D) Asking the patient if the television could be turned off during the visit
E) Asking the patient if the visit could be conducted in the bedroom away from small children and pets

Question 46

While making a home visit the nurse learns that a patient self-administering insulin injections is placing the used needles and syringes in the family's trash can. What action should the nurse take?

A) Instruct the patient to place the needles and syringes in a separate plastic bag.
B) Nothing, because these needles and syringes are harmless to the general population.
C) Ask the patient to save all used syringes and needles after use for the nurse to dispose of.
D) Teach the patient to place all used syringes and needles into the red biohazard sharps box.

Question 47

The primary caregiver for a patient with stage 3 Alzheimer disease receiving care in the home wants to attend a granddaughter's high school graduation in a city 50 miles from the patient's home. What should the home care nurse suggest so that the caregiver can attend this event?

A) Admit the patient to hospice.
B) Schedule respite care for the caregiver.
C) Admit the patient to an inpatient facility.
D) Transport the patient with the caregiver to the graduation.

Question 48

During a home visit the nurse notes that the caregiver does not apply clean gloves before removing the patient's leg wound dressings. What should the nurse do to encourage infection control practices in this home?

A) Place the box of gloves next to the sink in the bathroom.
B) Remind the caregiver to wash hands after completing wound care.
C) Place the box of gloves next to the bag used to discard soiled dressings.
D) Encourage the caregiver to touch only the edges of the soiled dressings.

Question 49

After completing a home assessment the nurse determines that safety hazards exist in a patient's bathroom. What did the nurse assess to come to this conclusion?

A) Water temperature of 150°F
B) Grab bars around the toilet only
C) Scatter rug outside the shower stall
D) Smoke detector battery with a low reading
E) Electrical outlet on the wall near the shower door

Question 50

The nurse is preparing to transition a patient with chronic obstructive pulmonary disease from a rehabilitation facility back to home. What preparations has the nurse made to support this patient's transition?

A) Instructing on symptoms to report
B) Scheduling healthcare provider visits
C) Submitting facility charges to Medicare
D) Creating an evidence-based plan of care
E) Reviewing health insurance coverage plans